Campylobacter

Campylobacter bacteria are found in the poo of many animals, including farm animals and household pets. People and animals can carry and spread the infection even if they don’t have symptoms. Campylobacter bacteria is often spread to humans in the following ways:

Eating contaminated food: This includes undercooked meat, especially chicken, or contaminated raw fruit and vegetables. Contamination of food can also happen when hands are not washed properly after going to the toilet or changing the nappy of an infected infant.
Cross-contamination: Campylobacter can spread in the kitchen by cross-contamination from raw chicken meat, including juices from the meat, to other food, utensils (such as cutting boards), food contact surfaces and the hands and clothing of food handlers.  
Drinking contaminated water: Drinking contaminated water is responsible for a number of outbreaks globally, such as contamination of water from sewage outflow systems, waste run-off from grazed pasture and poo from wild birds. 
Direct handling of animals: Campylobacter bacteria are found in the poo of many animals, including farm animals and household pets. It can be spread by handling infected animals and not washing hands afterwards. 

Travellers to developing countries where sanitation and food hygiene may be less strict, farm workers, meat processing workers and those who handle raw meat may be more likely to be exposed to the bacteria. Those at higher risk of serious infection are young children, the elderly and those with other serious health conditions.   

The typical symptoms are feeling sick (nausea), runny poos (diarrhoea), and being sick (vomiting). The runny poos can sometimes be bloody. You may also have crampy stomach pains and develop a high temperature (fever).

Symptoms will usually appear 2 to 5 days after exposure. Some people will have mild symptoms only or none at all. Others get a flu-like illness first, such as headache, muscle pains, fever and feeling very tired.

Most people with campylobacter infection recover from the illness within 1 week, but symptoms can last for up to 10 days. In serious cases, complications can occur including dehydration and bloodstream infection. Long-term problems are rare, but may include irritable bowel syndrome, arthritis or acute paralysis (Guillain-Barre syndrome).

Most cases of gastro do not require special investigations. If your symptoms are severe or ongoing, or your doctor suspects you might have campylobacter, you may be asked to provide a stool (poo) sample. This can be tested in the laboratory for campylobacter and other germs. 

Campylobacter is a notifiable disease. This means that if you are found to have campylobacter, your doctor will notify the Public Health Service. Someone from your local public health team may contact you to find out how you picked up the bacteria. This helps them trace the source of infection to reduce the risk of a large outbreak. 

Most people will recover without the need for any special medication. You can help your recovery by drinking plenty of fluids to avoid getting dehydrated. Take extra care with young children and older adults who can become dehydrated very quickly. Also, eat as you feel able – be guided by your appetite. Start with bland food such as toast or rice and small, light meals.  

Antibiotics

Antibiotics are not commonly needed to treat campylobacter infections. They have little impact on how long you are sick or how severe your symptoms are. They may help prevent the spread of the disease by killing the bacteria in your poos. Antibiotics may be considered when symptoms are severe or prolonged, or for people at high risk of complications, such as pregnant women or people with weakened immune systems. 

Medicines for diarrhoea

Medicines for diarrhoea, such as loperamide and Diastop®, are not routinely recommended, but may be considered in some circumstances. They must be avoided if you have blood and mucous in your poos. This can make things worse as it can prolong the diarrhoea and there is the risk of the serious complication, toxic megacolon. Medicines for diarrhoea are also not recommended for use in children under 12 years. Before taking them, check with your doctor whether they are safe for you.  

Usually, people can go back to work and children can return to early childhood centres and school if they have been free of symptoms for 24 hours. However, as campylobacter infection is a notifiable disease (see diagnosis above) you will need to check with your doctor first.

If you work in a hospital, rest home, school, early childhood centre, or your job involves handling food, you may be required to stay away from work until you have been free of symptoms for 48 hours.

Practice good hygiene

Campylobacter can be carried on your hands so it is important to wash your hands thoroughly with soap and warm water after going to the toilet, after changing infants in nappies, before handling and eating food, after handling raw food (especially raw poultry), after gardening and after contact with pets and other animals. Read more about hygiene and hand washing.

Food preparation

Take care when preparing food, cook food well, watch what you eat and wash your hands frequently and properly. Use different chopping boards, trays, utensils and plates when preparing raw foods and ready-to-eat food. If you have only one chopping board wash it well in hot soapy water before reuse.

• Clean: keep all food preparation areas, utensils and equipment clean. Wash raw vegetables properly.
• Cook: raw foods well and leftovers until steaming hot. Ensure minced meat, chicken and sausages are cooked thoroughly until juices are clear. Thorough cooking of food kills Campylobacter. 
• Cover: all foods in the fridge, cupboard and outdoors. Separate and store raw and cooked foods so there is no chance of cross-contamination.
• Chill: store ready-to-eat food between 0-4°C. Any leftover cooked food should be covered and chilled (within 2 hours). 

See also: Food safety tips(external link)(external link) NZ Food Safety Authority 

If your water source is believed to be contaminated, you must boil all water(external link)(external link) for 1 minute before drinking, making up infant formula, food preparation and cleaning teeth. See also Campylobacter, E.Coli and Salmonella(external link) (HealthEd, NZ) and food safety tips at home.

Learn more

The following links provide further information about campylobactor. Be aware that websites from other countries may have information that differs from New Zealand recommendations.    

Campylobacter, E.Coli and Salmonella(external link) HealthEd, NZ
Campylobacter infections(external link)(external link) Centers for Disease Control and Prevention

Resources

Campylobacter, E coli & samonella(external link)(external link) Health Promotion Agency and Ministry of Heath, NZ, 2016
Food safety in the home(external link)(external link) Ministry for Primary Industries, NZ, 2021
Household water supplies(external link) Taumata Arowai NZ, 2021
Meet the bugs(external link)(external link) Ministry of Primary Industries, NZ, 2017

Related topics

Food safety

References

1. Campylobacter(external link)(external link) NZ Food Safety, August 2018
2. Food and water borne diseases(external link)(external link) NZ Ministry of Health February 2017
3. Investigating and managing people with diarrhoea(external link)(external link) BPAC, NZ, Feb 2014

Antibiotic guidelines

If antibiotics are needed for campylobacter, the first choice is erythromycin:

• Child: 10 mg/kg/dose, four times daily, for five days.
• Adult: 400 mg, four times daily, for five days.

More information: Antibiotics guide, gastrointestinal section(external link)(external link) BPAC, NZ, 2017

Laboratory investigation of infectious diarrhoea(external link)(external link) BPAC, NZ, 2012
Assessment and management of infectious diarrhoea(external link)(external link) BPAC, NZ, 2009
Schedule of notifiable diseases(external link)(external link) Ministry of Health, NZ, 2013