Campylobacteriosis

Campylobacteriosis is a diarrheal disease caused by Campylobacter bacteria. The disease is the most frequently reported gastrointestinal disease and zoonosis (i.e., a human disease with an origin in animals) in the European Union. Campylobacter infections have steadily increased until 2015, after which the disease incidence remained relatively stable until marked reduction in 2020-2021, largely due to the COVID-19 pandemic and its regulations (ECDC, 2017-2022; 2023; EFSA and ECDC, 2022). The high incidence of campylobacteriosis (e.g., 44.5 cases per 100 000 inhabitants in 2021), and its potential to cause long term complications make this disease highly important from a socio-economic perspective (Devleesschauwer et al., 2017; Kuhn et al. 2020). Future expected changes in climatic conditions and extreme weather events are projected to favour Campylobacter transmission.

Source & transmission

People mostly get infected by Campylobacter bacteria via consumption of contaminated food, often undercooked meat or unpasteurized milk, or via use of contaminated utensils when processing contaminated food. Campylobacter bacteria are common in animals, both in those raised for food consumption as well as in pets (Heimesaat et al., 2021). Humans can also get sick after contact with contaminated water during recreational activities or when drinking unchlorinated water (Tang et al., 2011), resulting from direct contact with infected animals or their faeces, or via direct person-to-person transmission (Romdhane and Merle, 2021).

Health effects

Campylobacteriosis causes an inflammation of the stomach (gastroenteritis), leading to (often bloody) diarrhoea and vomiting, as well as abdominal pains, fever, headache or nausea. Symptoms may last one to ten days. In severe cases, delayed associated symptoms, neurological disorders or other complications may arise. In seldom cases, infections can cause a form of paralysis (i.e., the Guillain-Barré syndrome), which may result in a permanent disability (Saito, 2002).

Morbidity

In the EEA member countries (excluding Switzerland and Türkiye due to absence of data), in the period 2007-2021:

2,348,633 infections (ECDC, 2023)
Low probability of hospitalisation (< 25% in 2020-2021)
313 deaths and a case fatality ranging between 0.03 and 0.05%
Stable incidence since 2015, followed by a drop in number of infections in 2020, possibly due to the Covid-19 pandemic restrictions and potential underreporting. In 2021, the overall notification rate was 44.5 cases per 100 000 population, still lower than the notification rate before the 2020.
Until 2019, around 11-15% of the cases was travel related.

(ECDC, 2017-2022; ECDC, 2023)

Distribution across population

Age group with the highest disease incidence in Europe: 0 – 4 years old (ECDC, 2017-2022)
Groups at risk of severe disease course: young children, the elderly, people with low immunity

Climate sensitivity

Climatic Suitability

The Camplyobacter strains with the highest relevance to human health prefer temperatures between 37 and 42°C, which fit the inside body temperature of several animals (Duffy and Dykes, 2006). Nevertheless, the bacteria can also survive outside of an animal’s body. In aquatic environments for example, Campylobacter activity and formation of biofilms (i.e., thin, robust slime layers of bacteria communities) are highest at temperatures between 10 and 15°C. (Thomas et al., 1999; Bronowski et al., 2014).

Seasonality

In Europe, infections occur throughout the year, but peak sharply in summer, between June and August/September. Some years show an additional smaller peak in the beginning of the year, often in January (ECDC, 2017-2022). The timing and intensity of the summer peak varies across European countries. The occurrence of Campylobacter infections increases with higher temperatures and – although less strongly – with increasing precipitation (Lake et al., 2019).

Climate Change Impact

A warmer and wetter climate with more extreme events will facilitate bacteria multiplication and people’s exposure to pathogens (Fitzgerald, 2015) hence more Campylobacter infections are expected in Europe. Flooding increases the human contact with muddy environments and the spreading of bacteria, which can favour Campylobacter transmission. Estimates available for the Scandinavian region expect the incidence of campylobacteriosis to double by 2080 due to the expected increase in mean temperatures and more heavy rainfall (Kuhn et al., 2020; Zeigler et al., 2014).

Prevention & Treatment

Prevention

Vaccination of laying and broiler chickens and good sanitary conditions when handling birds to reduce Campylobacter prevalence in living animals
Good sanitary hygiene on (poultry) farms and in slaughterhouses to minimize faecal contamination
Efficient sanitary practices in meat processing industries and domestic kitchens
Cooking and pasteurizing raw food
Awareness raising about disease transmission

Treatment

Rehydration
Antibiotics in severe cases

Links to further information

References

Bronowski, C., et al., 2014, Role of environmental survival in transmission of Campylobacter jejuni, FEMS microbiology letters 356(1), 8-19. http://doi.org/10.1111/1574-6968.12488

Devleesschauwer, B., et al., 2017, Chapter 2—Health and economic burden of Campylobacter, in: Klein, G. (ed.), Campylobacter, pp. 27–41. http://doi.org/10.1016/B978-0-12-803623-5.00002-2

Duffy, L., and Dykes, G. A., 2006, Growth temperature of four Campylobacter jejuni strains influences their subsequent survival in food and water, Letters in Applied Microbiology 43(6), 596–601. https://doi.org/10.1111/j.1472-765X.2006.02019.x

ECDC, 2017-2022, Annual epidemiological reports for 2014-2021 – Campylobacteriosis. Available at https://www.ecdc.europa.eu/en/campylobacteriosis/surveillance. Last accessed June 2023.

ECDC, 2023, Surveillance Atlas of Infectious Diseases. Available at https://atlas.ecdc.europa.eu/public/index.aspx. Last accessed April 2023.

EFSA and ECDC, 2022, The European Union One Health 2021 Zoonoses Report, EFSA Journal 20(12), e07666. https://doi.org/10.2903/j.efsa.2022.7666

Fitzgerald, C., 2015, Campylobacter. Clinics in Laboratory Medicine 35(2), 289–298.https://doi.org/10.1016/j.cll.2015.03.001

Heimesaat, M. M., et al., 2021, Human Campylobacteriosis—A Serious Infectious Threat in a One Health Perspective, in: Backert, S. (ed.), Fighting Campylobacter Infections: Towards a One Health Approach, Current Topics in Microbiology and Immunology, Springer International Publishing, pp. 1–23. https://doi.org/10.1007/978-3-030-65481-8_1

Kuhn, K. G., et al., 2020, Campylobacter infections expected to increase due to climate change in Northern Europe, Scientific Reports 10(1), 13874–13885. https://doi.org/10.1038/s41598-020-70593-y

Lake, I., et al., 2019, Exploring Campylobacter seasonality across Europe using The European Surveillance System (TESSy), 2008 to 2016, Eurosurveillance 24(13), 1800028. https://doi.org/10.2807/1560-7917.ES.2019.24.13.180028

Romdhane, R. B., and Merle, R., 2021, The Data Behind Risk Analysis of Campylobacter Jejuni and Campylobacter Coli Infections, Current Topics in Microbiology and Immunology 431, 25–58. https://doi.org/10.1007/978-3-030-65481-8_2

Saito, T., 2002, Fulminant Guillain-Barrè syndrome after campylobacter jejuni enteritis and anti-ganglioside antibody, Internal medicine 41(10), 760-761. https://doi.org/10.2169/internalmedicine.41.889

Tang, J. Y. H., et al., 2011, Transfer of Campylobacter jejuni from raw to cooked chicken via wood and plastic cutting boards: Campylobacter jejuni cross-contamination via contaminated cutting boards, Letters in Applied Microbiology 52(6), 581–588. https://doi.org/10.1111/j.1472-765X.2011.03039.x

Thomas, C., et al., 1999, Evaluation of the effect of temperature and nutrients on the survival of Campylobacter spp. In water microcosms, Journal of Applied Microbiology 86(6), 1024–1032. https://doi.org/10.1046/j.1365-2672.1999.00789.x

Zeigler, M., et al., 2014, Outbreak of Campylobacteriosis Associated with a Long-Distance Obstacle Adventure Race—Nevada, October 2012, Morbidity and Mortality Weekly Report 63(17), 4. Available at https://www.cdc.gov/mmwr/preview/mmwrhtml/mm6317a2.htm