Campylobacter jejuni infection is a gram-negative rod that appears "S" shaped or comma shaped. Cattle, chickens, and dogs serve as the reservoir of this organism. Transmission is usually via raw or under-cooked food, especially poultry. However, other modes of transmission include ingestion of unpasteurized milk, untreated water, or contact with infected household pets. Campylobacter jejuni diarrhea is more common than Salmonella and Shigella. It can happen by eating under-cooked poultry or swallowing ocean water while swimming.

Treatment of Campylobacter jejuni enteritis: As with all diarrheal illnesses, it is important to drink fluids and replace electrolytes. A 5-7 day course of erythromycin should be sufficient. Other antibiotics such as azithromycin or clarithromycin could be used in place of erythromycin. Ciprofloxacin or amoxicillin can also be employed. Campylobacter jejuni is an organism that is largely responsible for the majority of food-borne infections.

Campylobacters are found in natural water sources year round. Cold water survival is important and these microorganisms enter a "viable but nonculturable state" when in a stressful environment. Organisms in this state can still be transmitted to animals. C-jejuni is found in many foods of animal origin including poultry, beef, swine, goats and raw milk. C-jejuni is a common organism found in the intestinal tract of cattle. Young animals are more colonized than old and colonization is associated with drinking unchlorinated water. Poultry intestines are also easily colonized and reservoirs include beetles, unchlorinated drinking water, C-jejuni also colonizes in wildlife including cranes, ducks, geese, seagulls, rodents and insects.

Campylobacter jejuni is the most common cause of acute gastroenteritis and although present year round usually peaks during the summer season. It most commonly occurs in the very young and the elderly. Campylobacter jejuni has an incubation period from 1-7 days, dependent on the number of organisms ingested. These germs multiply within the small and large intestines and the resultant lesions exhibit an acute exudative and hemorrhagic inflammation. Symptoms of fever, headache, and malaise are present 12-24 hours prior to the onset of diarrhea. Diarrhea typically begins 2-4 days following ingestion but may be as many as 10. Diarrhea may last 5-7 days and will be blood stained with leukocytes present.

The mechanism of infection of Campylobacter jejuni is uncertain, however it is believed that the organism is invasive. Some isolates of Campylobacter jejuni exhibit low levels of cytotoxins and this is seen where the disease manifests itself primarily as watery diarrhea and typically more severely. C-jejuni is capable of infecting immunocompromised as well as healthy persons. The organism can be killed by hydrochloric acid which is a component of normal gastric acidity.

Diagnosis is primarily accomplished by microscopic examination of stained stool samples. The presence of neutrophils (as well as blood and leukocytes) is an important component of Campylobacter infection. Special lab techniques are needed because of the microaerobic environment needed for growth. Campylobacter jejuni organisms are isolated using antibiotic media and or by using filtration methods.

If you have experienced these symptoms, make sure to ask your doctor to check for Campylobacter jejuni, specifically. Properly cook and store meat and dairy products, avoid unchlorinated drinking water and unpasteurized milk. Always wash your hands after contact with animals and animal products.

References: CDC, IntMed, Microbios1