“The text is well written and amply interspaced with tables so that it is very informative and not too heavy to read, which is an almost unique combination in scientific books!” –International Poultry Production, Volume 18, Number 1, and International Food Hygiene, Volume 20, Number 7
The records of human gastrointestinal illness gathered by national and international bodies concerned with matters relating to public health clearly demonstrate that Campylobacter spp. are the most frequently identified bacteria causing infectious intestinal disease. This new book provides up to date information about the species of Campylobacter most often associated with food poisoning, namely C. jejuni and C. coli.
Like Salmonella spp., Campylobacter spp. are zoonotic agents. Many different domestic and wild animal, avian, and also insect reservoirs of these organisms have been identified. They are also widespread in the environment and have been found to survive in both soil and natural waters.
Part of the authors’ Practical Food Microbiology Series, which includes books covering Listeria monocytogenes, E. coli, Clostridium botulinum and Salmonella spp., this book again offers a practical treatment of Campylobacter spp., drawing on real-life cases to highlight effective means of controlling these pathogenic microorganisms in foods.
Each volume in the series has been devised to provide practical and accurate information about specific microorganisms of concern to public health. This new book includes information concerning the taxonomy of Campylobacter spp. and methods used for their isolation and characterisation, the illnesses caused by them, the occurrences of outbreaks of illness and their investigation, and the lessons that can be learnt from these. Also discussed are the sources of these organisms, routes by which they may contaminate foods, factors affecting their survival and growth and, importantly, means for the control of Campylobacter spp. and their subsequent impact on public health.
The information in this book is designed for use by those in the food industry working in manufacturing, retailing and quality assurance and those in associated professional sectors, e.g. health, and students in each of these areas. This book is an invaluable tool and essential reference for all food microbiologists.
"synopsis" may belong to another edition of this title.
Chris Bell is a Consultant Microbiologist based in the UK
Alec Kyriakides is Head of Product Safety at Sainsbury's Supermarkets Ltd, London, UK
The records of human gastrointestinal illness gathered by national and international bodies concerned with matters relating to public health clearly demonstrate that Campylobacter spp. are the most frequently identified bacteria causing infectious intestinal disease. This new book provides up to date information about the species of Campylobacter most often associated with food poisoning, namely C. jejuni and C. coli. <p>Like Salmonella spp., Campylobacter spp. are zoonotic agents. Many different domestic and wild animal, avian, and also insect reservoirs of these organisms have been identified. They are also widespread in the environment and have been found to survive in both soil and natural waters.</p> <p>Part of the authors’ Practical Food Microbiology Series, which includes books covering Listeria monocytogenes, E. coli, Clostridium botulinum and Salmonella spp., this book again offers a practical treatment of Campylobacter spp., drawing on real-life cases to highlight effective means of controlling these pathogenic microorganisms in foods.<br />  <br /> Each volume in the series has been devised to provide practical and accurate information about specific microorganisms of concern to public health. This new book includes information concerning the taxonomy of Campylobacter spp. and methods used for their isolation and characterisation, the illnesses caused by them, the occurrences of outbreaks of illness and their investigation, and the lessons that can be learnt from these.  Also discussed are the sources of these organisms, routes by which they may contaminate foods, factors affecting their survival and growth and, importantly, means for the control of Campylobacter spp. and their subsequent impact on public health.</p> <p>The information in this book is designed for use by those in the food industry working in manufacturing, retailing and quality assurance and those in associated professional sectors, e.g. health, and students in each of these areas. This book is an invaluable tool and essential reference for all food microbiologists.</p> <p><b>About the authors<br /> </b>Chris Bell is a Consultant Food Microbiologist.<br /> Alec Kyriakides is Head of Product Quality, Safety & Supplier Performance, Sainsbury's Supermarkets Ltd.<br />  <br />  Also available from the same authors<br />  <br /> Listeria second edition<br /> ISBN 978-1-4051-0618-4<br /> <br /> Clostridium Botulinum<br /> ISBN 978-0-632-05521-0<br />  <br /> Salmonella<br /> ISBN 978-0-632-05519-7<br /> <br /> E. Coli<br /> ISBN 978-0-7514-0462-3<br />  </p>
The records of human gastrointestinal illness gathered by national and international bodies concerned with matters relating to public health clearly demonstrate that Campylobacter spp. are the most frequently identified bacteria causing infectious intestinal disease. This new book provides up to date information about the species of Campylobacter most often associated with food poisoning, namely C. jejuni and C. coli.
Like Salmonella spp., Campylobacter spp. are zoonotic agents. Many different domestic and wild animal, avian, and also insect reservoirs of these organisms have been identified. They are also widespread in the environment and have been found to survive in both soil and natural waters.
Part of the authors’ Practical Food Microbiology Series, which includes books covering Listeria monocytogenes, E. coli, Clostridium botulinum and Salmonella spp., this book again offers a practical treatment of Campylobacter spp., drawing on real-life cases to highlight effective means of controlling these pathogenic microorganisms in foods.
Each volume in the series has been devised to provide practical and accurate information about specific microorganisms of concern to public health. This new book includes information concerning the taxonomy of Campylobacter spp. and methods used for their isolation and characterisation, the illnesses caused by them, the occurrences of outbreaks of illness and their investigation, and the lessons that can be learnt from these. Also discussed are the sources of these organisms, routes by which they may contaminate foods, factors affecting their survival and growth and, importantly, means for the control of Campylobacter spp. and their subsequent impact on public health.
The information in this book is designed for use by those in the food industry working in manufacturing, retailing and quality assurance and those in associated professional sectors, e.g. health, and students in each of these areas. This book is an invaluable tool and essential reference for all food microbiologists.
About the authors
Chris Bell is a Consultant Food Microbiologist.
Alec Kyriakides is Head of Product Quality, Safety & Supplier Performance, Sainsbury's Supermarkets Ltd.
Also available from the same authors
Listeria second edition
ISBN 978-1-4051-0618-4
Clostridium Botulinum
ISBN 978-0-632-05521-0
Salmonella
ISBN 978-0-632-05519-7
E. Coli
ISBN 978-0-7514-0462-3
INTRODUCTION
It is possible that Dr Theodor Escherich (after whom the genus Escherichia was named) was the first to see campylobacters although he could not grow them in culture. In 1886, he made drawings of, and described, small vibrios in smears made of the intestinal mucus of infants who had died from 'cholera infantum'; these very closely resemble what we now know as Campylobacter jejuni or C. coli. The first isolation of the organisms made from the uterine mucus/exudate of aborting sheep was made in 1906 and reported in 1913 by veterinary investigators, John McFadyean and Stewart Stockman (Nachamkin and Skirrow, 1998; Skirrow, 2006).
Subsequently, through the early decades of the 1900s, spiral-shaped bacteria isolated from a variety of farm animals suffering abortion, fertility problems or diarrhoea were named Vibrio spp. Those species associated with abortion and infertility were named V. fetus, those associated with diarrhoea in pigs were named V. coli, and those linked to diarrhoea in cattle, V. jejuni (Vandamme and Goossens, 1992).
In 1963, M. Sebald and M. Vron transferred V. fetus into a new genus, Campylobacter (campylo - Greek adjective meaning curved; bacter - Greek noun meaning rod), along with Vibrio bubulus isolated from bovine material, as a group of veterinary intestinal pathogens. In 1973, following a detailed study of the taxonomy of microaerophilic (sic) Vibrio-like organisms, M. Vron and R. Chatelain proposed the species names Campylobacter jejuni, C. coli, C. sputorum subsp. sputorum and C. sputorum subsp. bubulus, and C. fetus with subspecies of fetus (causing sporadic abortions) and venerealis (causing infectious infertility), C. fetus being described as the type species (Vandamme and Goossens, 1992). These names are still used and, currently, 26 species and 11 subspecies of Campylobacter are recognised and named (On, 2001; Euzby, 2008).
Since the 1970s when Campylobacter jejuni and Campylobacter coli were recognised as important causes of diarrhoeal illness in humans (Skirrow, 1977), records of human gastrointestinal illness gathered by national bodies concerned with matters relating to public health clearly demonstrate that, together, these organisms are the most frequently identified bacteria causing infectious intestinal disease in most industrialized countries.
In consequence, an extraordinary amount of work has been carried out internationally to provide information that may assist a better understanding of the molecular biology, virulence factors and mechanisms of pathogenicity of species within the genus, particularly Campylobacter jejuni, the illnesses caused by Campylobacter species and the sources and prevalence of these organisms in food producing and processing environments.
This book aims to provide the reader with information about the nature of the hazard presented by Campylobacter to the consumer from a range of food products, and the means for controlling these organisms so as to prevent illness.
TAXONOMY OF CAMPYLOBACTER
It was only in the last three decades or so of the twentieth century that the concerted effort of research workers and public health and related professional microbiologists around the world was concentrated to provide the information necessary to support others in implementing means whereby illnesses caused by species of Campylobacter might be prevented. This information included the basic morphological and biochemical characteristics of the genus and distinguishing characteristics between the species within the genus.
Campylobacter spp. are Gram-negative, S- or spiral-shaped, non-spore-forming, small (0.2-0.5 0.5-5.0 m) rods with a single polar flagellum at one or both ends of the cell. They exhibit a characteristic corkscrew-like, rapid motility and require micro-aerobic conditions (see Glossary of Terms) for optimal growth. Table 1.1 shows some key characteristics of Campylobacter spp.; it should be noted however, that they exhibit only a limited range of biochemical reactivity.
The relative lack of reaction of Campylobacter spp. in routinely used biotyping tests makes practical species separation and identification quite difficult. The application, since the early 1990s, of the variety of techniques available for use in DNA homology studies has helped to clarify the relationships between different species of Campylobacter and closely related genera and has facilitated the development of a better understanding of the group's taxonomic structure (Figure 1.1) now summarized in Bergey's 2005 Manual of Systematic Bacteriology referring to 'The Proteobacteria', 1356 species in 332 genera (www.oriented. cz/3/41450.Bergeys.manual.of.systematic.bacteriology.vol.2C.htm), and which is still under study (On, 2001).
The most important species of Campylobacter in relation to human health are C. jejuni and C. coli although, occasionally, other species may also cause human illness, e.g. C. lari (first known as C. laridis) (Tauxe et al., 1985) and C. upsaliensis (Vandamme et al., 1991). These species are often referred to as thermotolerant or, sometimes, thermophilic campylobacters as they tolerate higher incubation temperatures than most foodborne bacterial pathogens and grow optimally at 42C (thermophiles are widely accepted as those organisms with an optimum growth temperature above 45C) and it is generally accepted that C. jejuni do not grow at 25C (minimum growth temperature 32C stated by the International Commission on Microbiological Specifications for Foods, 1996). This latter characteristic has been somewhat confused by a report that a clinically derived strain of C. jejuni used in survival and growth experiments following inoculation onto chicken skin and stored under different packaging and temperature conditions apparently replicated, showing an increase in numbers at both 4C and ambient room temperature (25C) when stored for seven days and three days respectively and packaged under vacuum or a nitrogen atmosphere (Lee et al., 1998). Results published by other workers indicate that populations of C. jejuni decline but can survive for different periods of time at these temperatures in different environments (see Chapter 3). If, however, such a report were confirmed, this would have significant consequences in relation to the safety of many chilled foods.
Methods used to isolate thermotolerant/thermophilic Campylobacter spp. from food samples involve selective enrichment in a broth medium followed by the inoculation of selective agar media, incubation under micro-aerobic conditions at elevated temperature, then subjecting typical Campylobacter spp. colonies to further tests (Table 1.2) for identification and differentiation (see Chapter 6).
To assist the further differentiation of strains of clinical isolates of Campylobacter jejuni and, thus, support the increasingly necessary study of the epidemiology of Campylobacter infections, serotyping schemes have been developed and were described in the early 1980s (Penner and Hennessy, 1980; Lior et al., 1982).
The 'Penner' scheme targets soluble heat-stable (HS) lipopolysaccharide antigens and employs a passive haemagglutination detection technique (Moran and Penner, 1999). To date, for C. jejuni, C. coli and C. lari, 65 serogroups have been recognised by this scheme. The 'Lior' scheme targets heat-labile (HL) protein antigens expressed on the cell surface and flagella and employs the classical (traditional) method of bacterial cell agglutination. To date, 160 serogroups of C. jejuni, C. coli and C. lari have been recognised by this scheme. The two schemes are regarded as complementary and it is reported that good discrimination between strains can be obtained when they are used together (Nachamkin and Skirrow, 1998). Modern molecular typing methods may be used more extensively now to assist further strain discrimination (Dingle and Maiden, 2005; see also Chapter 6).
ILLNESS CAUSED BY CAMPYLOBACTER
Campylobacter enteritis is most often caused in the UK by C. jejuni subsp. jejuni (>90% of infections) or C. coli (less than 10% of infections). Much higher proportions, >50%, of such infections caused by C. coli have been recorded in some other countries (Skirrow, 1998). Co-infection with two different strains of C. jejuni has also been reported. Richardson et al. (2001) examined, in detail, cultures from 53 infected individuals. They found four (7.5%) of these patients to be co-infected with two strains of C. jejuni although, in each case, one of the strains appeared to be more predominant.
The illness, campylobacteriosis, is caused as a result of infection, by the organism, of the intestine. Records of campylobacteriosis gathered since Campylobacter spp. were recognised as a significant cause of infectious intestinal disease indicate that, in many countries, annual case numbers of campylobacteriosis far exceed those of salmonellosis which was previously considered to be the most important foodborne illness throughout the world. Salmonella spp. are still linked to numerous outbreaks of foodborne illness each year, some of these involving large numbers of people (Bell and Kyriakides, 2002); however, unlike Salmonella spp., so far Campylobacter spp. have not been identified as a causal agent in many general outbreaks of foodborne illness. Instead, cases recorded have been, apparently, largely sporadic in nature involving only one person or very few people.
Pebody et al. (1997), following a review of Campylobacter infections in England and Wales from 1992 to 1994, reported that there were just 21 general outbreaks of Campylobacter infection identified affecting 706 people and accounting for less than 1% of the total of more than 120,000 cases of Campylobacter infection reported for the same period. Similarly, Frost et al. (2002) reported that only 50 (2%) of the 2374 outbreaks of infectious intestinal disease recorded between 1995 and 1999 in England and Wales, for which a causal agent was identified, were due to Campylobacter spp. These outbreaks affected 966 people, less than 0.5% of the total of more than 250,000 (Table 1.3) cases of Campylobacter infection reported for the same period. It was suggested that some general outbreaks may not have been identified and that enhanced surveillance and more detailed investigation using newly available reference facility techniques may help identify clusters of Campylobacter infection which can then be investigated for epidemiological links.
A Sentinel Surveillance Scheme for campylobacteriosis was set up for England and Wales in 2000 (Anon., 2000a, 2001a) covering approximately 23% of the population. In assessing some of the data from this scheme, Gillespie et al. (2003a) found that the data suggested that outbreaks of Campylobacter infection may be more common than previously believed. A study carried out in New Zealand (Hudson et al., 1999) of campylobacters isolated from human cases of campylobacteriosis, animal, environmental and food sources and characterised by Penner serotyping and pulsed-field gel electrophoretic methods, indicated that some of the isolates from human cases were indistinguishable by these methods from isolates obtained from raw chicken and environmental waters. Such findings that suggest widespread sources of organisms of the type found in human cases also support the possibility that outbreaks may be occurring but are unrecognised.
The application of modern molecular-based methods is likely to assist in more clearly identifying linked cases of infection in the community and, consequently, will allow the identification of possible risk factors associated with such infections. The first report from Poland, of a small family outbreak of C. coli infection involving four people that occurred in 2006, was published in 2008 (Wardak et al., 2008). The investigation of this outbreak was assisted by the use of molecular-based methods including the polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP) and pulsed-field gel electrophoresis (PFGE) to compare the genotypes of the isolates obtained.
Laboratory report data published annually by the Health Protection Agency of England and Wales show that the number of faecal isolates of Campylobacter from 1986 to 1993 rose steadily from approximately 25,000 to a figure approaching 40,000 compared to Salmonella which rose from approximately 16,000 to 29,276, having reached approximately 31,300 in 1992. Table 1.3 shows the reported figures from 1994 to 2006 for both of these organisms. Apart from a rise in reported cases of Salmonella from 1996 to 1997 attributable to a significant increase in egg- and poultry meat-related cases of S. Enteritidis, there has been a general decline in the reported numbers of human cases of salmonellosis in England and Wales. Comparative figures reported for isolations of Campylobacter indicate they have been significantly higher than those reported for Salmonella throughout the period 1994-2006 and, since 2000, reported numbers have been from three to more than four times higher than for Salmonella.
In the first two years of the Sentinel Surveillance Scheme set up in England and Wales in 2000, 15,738 laboratory-confirmed cases were reported, with C. jejuni accounting for over 90% of the isolates characterized during the period. It has been reported that 13,899 cases accumulated a total 156,341 days of illness; 1194 cases were admitted to hospital and hospital admissions totalled 5474 days (Anon., 2003a). In the first year alone of the Surveillance Scheme, work or normal activity days lost to illness amounted to 38,769 days for 5107 people (Anon., 2001a).
Even though microbiological methods and monitoring systems vary among the different countries in the European Union, data relating to foodborne illness, including campylobacteriosis, has been reported centrally since 2001 from a growing number of Member States. Data reported by the European Food Safety Authority (EFSA) for 2005 from 19 Member States indicated the incidence of human campylobacteriosis was 51.6 confirmed cases per 100,000 population (total confirmed cases 195,426) which represented an increase of over 7.5% over 2004. These figures were well in excess of the incidence of Salmonella infections in humans, reported to be 38.2 cases per 100,000 population with 173,879 total confirmed cases from 25 Member States. Similar data for human campylobacteriosis reported for 2006 from 21 Member States compared to that reported for 2005 indicated a decrease in number of confirmed cases to 175,561 with an associated incidence of 46.1 cases per 100,000 population. Yet again, these figures were higher than those reported for human salmonellosis for the same year with 160,649 confirmed cases from 25 Member States (incidence 34.6 cases per 100,000 population) (European Food Safety Authority, 2007). Figures for 2007 from 23 Member States reporting cases of campylobacteriosis showed an increase in confirmed cases to 200,507; some 14% more than 2006 (21 Member States reporting). Of these, confirmed case numbers reported from the Czech Republic, Germany and the UK were 24,137, 66,107 and 57,815 respectively. For all other reporting countries, confirmed case numbers reported ranged from 17 (Cyprus) to 7,106 (Sweden).
(Continues...)
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