Campylobacteriosis

1. Campylobacteriosis Increasing awareness in Delawareans about this common food borne illness Presented by: Ashley Jackson Masters in Public Health Walden University PH 6165-2 Instructor: Dr. Rebecca Heick Fall Quarter 2009

2. Purpose • To educate Delaware residents about Campylobacterosis • Show how we can reduce the incidence of this food borne disease.

3. Learning Objectives • Learning Objectives: • To fully understand Campylobacterosis including what causes it, how frequent it is disease, where it’s found, how it’s spread, its symptoms, complications, duration, and treatment, and who is at risk. • To fully understand how Campylobacterosis is being controlled on a national level • To fully understand how Campylobacterosis is being controlled on a state level • Implement ways that you can prevent the spread of Campylobacterosis

4. What is Campylobacterosis? • Campylobacteriosis is a food borne illness caused by the bacteria named Campylobacter (USDA Food Safety and Inspection Service, 2006). • Campylobacter is the second most frequent cause of reported food borne illnesses (USDA Food Safety and Inspection Service, 2006). • Is the leading cause of bacterial diarrhea in the United States (FDA, 2009). • There were 99 reported cases of Campylobacterosis in Delaware last year (State of Delaware Division of Public Health, 2008). Image provided by http://www.microbelibrary.org/microbelibrary/files/ccImages/Articleimages/gini/Campylobacter%20jejuni.jpg

5. Where is Campylobacter found and how is it spread to humans? • Campylobacter is found in: • Intestinal tracts of animals, particularly poultry (USDA Food and Safety Inspection Service, 2007). • Untreated water (USDA Food and Safety Inspection Service, 2007) • Raw milk (USDA Food and Safety Inspection Service, 2007) • This illness is spread to humans through consumption of unpasteurized milk, raw or undercooked meat and poultry, or contaminated water, also contact with animal feces can be another source (USDA Food and Safety Inspection Service, 2007). Image provided by http://www.faqs.org/photo-dict/photofiles/list/2640/7330raw_chicken.jpg

6. The illness, symptoms, and possible complications • The illness occurs 2-5 days after consuming contaminated food or water (FDA, 2009) • Symptoms can include diarrhea, fever, abdominal pain, nausea, headache, and muscle pain (FDA, 2009). • Rare but possible complications: • Arthritis (FDA, 2009) • Hemolytic uremic syndrome (FDA, 2009) • Sepsis and infection of other organs (FDA, 2009)

7. Duration and Treatment • Campylobacter infections last about 7-10 days (FDA, 2009). • Relapses occur in about 25% of cases (FDA, 2009). • Most infections are self limiting and not treated with antibiotics although erythromycin can reduce the length of infection (FDA, 2009). Image provided by: http://nexus404.com/Blog/2007/09/13/huge-alarm-clock-for-deep-sleepers-promises-morning-headaches/

8. Who is at risk of Campylobacterosis? • Everyone is at risk of this illness (FDA, 2009) • More prominent in children under 5 years old and young adults, ages 15-29 (FDA, 2009) • Pregnant women and people who have weak immune systems (USDA Food Safety and Inspection Service, 2007) Image provided by: http://thumbs.dreamstime.com/thumb_314/1222458628EV3l6Y.jpg

9. What is being done to prevent this food borne illness on the national level? • FSIS: Food Safety and Inspection Service • Inspects all meat and poultry to make sure they meet U.S. standards (FSIS, 2001) • Sets requirements for meat and poultry labels and processing activities (FSIS, 2001) • Tests for microbiological and chemical contamination (FSIS, 2001) • Conducts investigations on food borne health hazards and disease outbreaks (FSIS, 2001) • Assess state inspection programs to make sure they are in line with federal standards (FSIS, 2001)

10. What is being done to prevent this food borne illness in Delaware? • State of Delaware Food Code • Inspects over 3,300 food establishments (Delaware Division of Public Health, n.d.) • Identifies risk factors and key interventions most likely to impact the establishment’s ability to deliver safe food for the consumers and then reduces the risk of food borne illness through timely corrective action (Delaware Division of Public Health, n.d.) • Controls risks associated with: • Unsafe food sources • Inadequate cooking • Improper holding • Contaminated equipment • Poor personal hygiene (Delaware Division of Public Health, n.d.) Image provided by: http://www.iloveinns.com/images/regionmap/delaware.gif

11. Steps we can take to reduce the prevalence of Campylobacterosis • First Step: Wash hands and clean surfaces regularly (USDA Food Safety and Inspection Service, 2007) • Wash hands for a minimum of 20 seconds before and after handling food and after using the bathroom, changing diapers, or handling pets. • Wash all cooking utensils and dishes with hot soapy water before you move on to the next item • It is recommended that paper towels are used to clean kitchen surfaces but if a dish towel is desirable, wash often with the hot water cycle in the washing machine. Image provided by: http://www.edina.k12.mn.us/district/h1n1/hand_washing.jpg

12. Steps we can take to reduce the prevalence of Campylobacterosis • Second step: Separate food items. Don’t Cross-Contaminate (USDA Food Safety and Inspection Service, 2007) • Separate raw meat, poultry, and seafood from other food in grocery bags and in the refrigerator. • If at all possible, use one cutting board for vegetables and fruits and another for raw meats • Never place cooked food on a plate that previously had raw meat on it

13. Steps we can take to reduce the prevalence of Campylobacterosis • Third step: Cook at safe temperatures (USDA Food Safety and Inspection Service, 2007) • Use a clean cooking thermometer to determine safe internal temperatures. • Safe temperatures for food are: • Beef, lamb, veal, roasts, and chops: 145 °F • Pork: 160 °F • Egg dishes and casseroles: 160 °F • Poultry: 165 °F • Leftovers: 165°F • Fish: 145 °F Image provided by: http://barfblog.foodsafety.ksu.edu/uploads/image/pot_pie_thermometer(1).jpg

14. Steps we can take to reduce the prevalence of Campylobacterosis • Step four: Refrigerate promptly (USDA Food Safety and Inspection Service, 2007) • Refrigerate promptly and properly. Refrigerate or freeze perishables, prepared foods, and leftovers within 2 hours. • Freezers should be 0 °F and refrigerators should be 40 °F or below. • Foods should not be thawed at room temperature. Thaw food in cold water, the refrigerator, or microwave. • Marinate foods in the refrigerator • Don’t pack the refrigerator. Image provided by: http://homeappliances.files.wordpress.com/2008/02/ge-cafe-e-side-by-side-refrigerator-2.jpg

15. Further reading sources • Campylobacter Questions and Answers http://www.fsis.usda.gov/Fact_Sheets/Campylobacter_Questions_and_Answers/index.asp • Frequently asked questions about Campylobacter http://www.dhss.delaware.gov/dhss/dph/files/campylfaq.txt • Delaware Inspection Services http://www.dhss.delaware.gov/dhss/dph/hsp/indinspect.html • New technologies being developed to reduce food pathogens: http://www.csrees.usda.gov/newsroom/lgunews/technology/destroy_food_pathogens.html

16. References Food and Drug Administration (FDA). (2009). Bad Bug Book: Campylobacter jejuni. Retrieved Oct. 23, 2009 from http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm070024.htm. Food Safety and Inspection Service (FSIS). (2001). Protecting the Public from Food Borne Illness: Food Safety and Inspection Service. Retrieved Oct. 23, 2009 from http://www.fsis.usda.gov/OA/background/fsisgeneral.htm State of Delaware Division of Public Health. (2008). 2008 Communicable Disease Statistics. Retrieved Oct. 23, 2009 from http://www.dhss.delaware.gov/dhss/dph/epi/disrannual.html. USDA Food Safety and Inspection Service. (2007). Food Borne Illness and Disease: Campylobacter. Retrieved Oct. 23, 2009 from http://www.fsis.usda.gov/Fact_Sheets/Campylobacter_Questions_and_Answers/index.asp.