What is Campylobacter

Campylobacter infection also called campylobacteriosis is a common foodborne illness with Campylobacter infection affecting more than 1.3 million people each year in the United States ¹. Most human illness is caused by one species, called Campylobacter jejuni, but other species also can cause human illness. The Foodborne Diseases Active Surveillance Network (FoodNet) indicates that about 14 cases are diagnosed each year for every 100,000 people ². Most campylobacter illnesses likely occur due to eating contaminated food, especially raw or undercooked poultry, or to eating something that touched it. Some campylobacter infections are due to contaminated water, contact with animals, handling infected animal feces (poop) or drinking raw (unpasteurized) milk. Most cases are not part of recognized outbreaks, and more cases occur in summer than in winter.

Campylobacter infection causes gastroenteritis that can last for 1 to 2 weeks. Most people with Campylobacter infection recover if they rest and drink fluids, but they can also be given antibiotics if needed. In rare cases, campylobacter may cause other illnesses.

Unlike some other microorganisms that cause food poisoning, Campylobacter doesn’t often cause outbreaks of gastroenteritis that affect many people. It usually causes only isolated cases of illness.

Some infected people don’t have any symptoms. If you do have symptoms, they start two to five days after you are infected. They usually last about one week, and can include:

• Diarrhea (which could be bloody)
• Cramping
• Abdominal pain
• Fever
• Fatigue
• Nausea and vomiting

Health care providers use stool tests to make Campylobacter infection diagnosis. Most people get better without treatment. You should drink extra fluids for as long as the diarrhea lasts. People who have a severe Campylobacter infection or a weakened immune system may need to take antibiotics. In rare cases, the infection can cause reactive arthritis or Guillain-Barre syndrome.

To prevent Campylobacter infection, cook poultry thoroughly. Use a separate cutting board and utensils for meats. Make sure to clean them carefully with soap and hot water after you use them.

Campylobacter food sources

Many chickens, cows, and other birds and animals that show no signs of illness carry Campylobacter. Campylobacter can be carried in the intestines, liver, and giblets of animals and can be transferred to other edible parts of an animal when it’s slaughtered. In 2014, National Antimicrobial Resistance Monitoring System testing found Campylobacter on 33% of raw chicken bought from retailers ³.

Milk can become contaminated when a cow has a Campylobacter infection in her udder or when milk is contaminated with manure. Other foods, such as fruits and vegetables, can be can become contaminated through contact with soil containing feces from cows, birds, or other animals. Animal feces can also contaminate lakes and streams. Pasteurization of milk, washing or scrubbing of fruits and vegetables, and disinfection of drinking water helps prevent illness.

You can be infected with Campylobacter if you:

• eat raw or undercooked poultry or other meat
• eat food that has been contaminated by raw meat
• eat raw seafood, especially oysters
• drink unpasteurized (raw) milk
• drink or have contact with contaminated water
• have contact with contaminated pets or farm animals

You are more likely to pick up a Campylobacter infection if you have an impaired immune system or if you are malnourished.

Who gets Campylobacter infections?

More than 2 million people get a Campylobacter infection each year, with babies younger than 1 year old, teens, and young adults most commonly affected.

How do people get infected with Campylobacter bacteria?

Most Campylobacter infections are associated with eating raw or undercooked poultry or from contamination of other foods by these items. People can get infected when a cutting board that has been used to cut and prepare raw chicken isn’t washed before it is used to prepare foods that are served raw or lightly cooked, such as salad or fruit. People also can get infected through contact with the feces of a dog or cat. Campylobacter does not usually spread from one person to another.

Outbreaks of Campylobacter infections have been associated most often with poultry, raw (unpasteurized) dairy products, untreated water, and produce.

Campylobacter infection is common in the developing world, and people who travel abroad have a greater chance of becoming infected. About 1 in 5 Campylobacter infections reported to the Foodborne Diseases Active Surveillance Network are associated with international travel ².

Even more rarely, people may become infected through contaminated blood during a transfusion.

Is campylobacter contagious?

Yes. Campylobacteriosis can spread from person to person when someone comes into contact with fecal matter (poop) from an infected person (especially a child in diapers). Household pets can carry and spread the bacteria to people.

Is Campylobacter infection serious?

Most people with a Campylobacter infection recover completely within a week, although they may shed (get rid of) Campylobacter bacteria in their stool for several weeks after recovery, which might result in person-to-person transmission. Campylobacter infection rarely results in long-term consequences. Some studies have estimated that 5–20% of people with Campylobacter infection develop irritable bowel syndrome for a limited time and 1–5% develop arthritis.

About 1 in every 1,000 reported Campylobacter illnesses leads to Guillain-Barre syndrome. Guillain-Barré syndrome happens when a person’s immune system is triggered by an earlier infection, such as Campylobacter infection. Guillain-Barre syndrome can lead to muscle weakness and sometimes paralysis that can last for a few weeks to several years, and often requires intensive medical care. Most people recover fully, but some have permanent nerve damage, and some have died of Guillain-Barre syndrome. As many as 40% of Guillain-Barre syndrome cases in the United States may be triggered by Campylobacter infection.

What is Guillain-Barre syndrome?

Guillain-Barre syndrome is a rare disorder in which your body’s immune system attacks your nerves. Weakness and tingling in your extremities are usually the first symptoms.

These sensations can quickly spread, eventually paralyzing your whole body. In its most severe form Guillain-Barre syndrome is a medical emergency. Most people with the condition must be hospitalized to receive treatment.

The exact cause of Guillain-Barre syndrome is unknown. But it is often preceded by an infectious illness such as a respiratory infection or the stomach flu.

There’s no known cure for Guillain-Barre syndrome, but several treatments can ease symptoms and reduce the duration of the illness. Most people recover from Guillain-Barre syndrome, though some may experience lingering effects from it, such as weakness, numbness or fatigue.

Guillain-Barre syndrome symptoms

Guillain-Barre syndrome often begins with tingling and weakness starting in your feet and legs and spreading to your upper body and arms. In about half of people with the disorder, symptoms begin in the arms or face. As Guillain-Barre syndrome progresses, muscle weakness can evolve into paralysis.

Signs and symptoms of Guillain-Barre syndrome may include:

• Prickling, pins and needles sensations in your fingers, toes, ankles or wrists
• Weakness in your legs that spreads to your upper body
• Unsteady walking or inability to walk or climb stairs
• Difficulty with eye or facial movements, including speaking, chewing or swallowing
• Severe pain that may feel achy or cramplike and may be worse at night
• Difficulty with bladder control or bowel function
• Rapid heart rate
• Low or high blood pressure
• Difficulty breathing

People with Guillain-Barre syndrome usually experience their most significant weakness within two to four weeks after symptoms begin.

Guillain-Barre syndrome affects your nerves. Because nerves control your movements and body functions, people with Guillain-Barre may experience:

• Breathing difficulties. The weakness or paralysis can spread to the muscles that control your breathing, a potentially fatal complication. Up to 30 percent of people with Guillain-Barre syndrome need temporary help from a machine to breathe when they’re hospitalized for treatment.
• Residual numbness or other sensations. Most people with Guillain-Barre syndrome recover completely or have only minor, residual weakness, numbness or tingling.
• Heart and blood pressure problems. Blood pressure fluctuations and irregular heart rhythms (cardiac arrhythmias) are common side effects of Guillain-Barre syndrome.
• Pain. Up to half of people with Guillain-Barre syndrome experience severe nerve pain, which may be eased with medication.
• Bowel and bladder function problems. Sluggish bowel function and urine retention may result from Guillain-Barre syndrome.
• Blood clots. People who are immobile due to Guillain-Barre syndrome are at risk of developing blood clots. Until you’re able to walk independently, taking blood thinners and wearing support stockings may be recommended.
• Pressure sores. Being immobile also puts you at risk of developing bedsores (pressure sores). Frequent repositioning may help avoid this problem.
• Relapse. Around 3 percent of people with Guillain-Barre syndrome experience a relapse.

Severe, early symptoms of Guillain-Barre syndrome significantly increase the risk of serious long-term complications. Rarely, death may occur from complications such as respiratory distress syndrome and heart attack.

Guillain-Barre syndrome treatment

There’s no cure for Guillain-Barre syndrome. But two types of treatments can speed recovery and reduce the severity of the illness:

• Plasma exchange (plasmapheresis). The liquid portion of part of your blood (plasma) is removed and separated from your blood cells. The blood cells are then put back into your body, which manufactures more plasma to make up for what was removed. Plasmapheresis may work by ridding plasma of certain antibodies that contribute to the immune system’s attack on the peripheral nerves.
• Immunoglobulin therapy. Immunoglobulin containing healthy antibodies from blood donors is given through a vein (intravenously). High doses of immunoglobulin can block the damaging antibodies that may contribute to Guillain-Barre syndrome.

These treatments are equally effective. Mixing them or administering one after the other is no more effective than using either method alone.

You also are likely to be given medication to:

• Relieve pain, which can be severe
• Prevent blood clots, which can develop while you’re immobile

People with Guillain-Barre syndrome need physical help and therapy before and during recovery. Your care may include:

• Movement of your arms and legs by caregivers before recovery, to help keep your muscles flexible and strong
• Physical therapy during recovery to help you cope with fatigue and regain strength and proper movement
• Training with adaptive devices, such as a wheelchair or braces, to give you mobility and self-care skills

Recovery

Although some people can take months and even years to recover, most people with Guillain-Barre syndrome experience this general timeline:

• After the first signs and symptoms, the condition tends to progressively worsen for about two weeks
• Symptoms reach a plateau within four weeks
• Recovery begins, usually lasting six to 12 months, though for some people it could take as long as three years

Among adults recovering from Guillain-Barre syndrome:

• About 80 percent can walk independently six months after diagnosis
• About 60 percent fully recover motor strength one year after diagnosis
• About 5 to 10 percent have very delayed and incomplete recovery

Children, who rarely develop Guillain-Barre syndrome, generally recover more completely than adults.

Campylobacter infection complications

Very occasionally, people with campylobacter infection develop complications including:

• Guillain–Barré syndrome — a nervous disorder that causes weakness or paralysis, often for several weeks or months
• Reactive arthritis — joint swelling and pain that usually lasts for 3 to 12 months
• Sepsis (septicaemia or blood poisoning)
• Meningitis
• Urinary tract infection

What causes Campylobacter infections?

Campylobacter bacteria live in the intestines of many wild and domestic animals. They can pass to humans when animal feces (poop) contaminate food, meats (especially chicken), water (streams or rivers near where animals graze), and unpasteurized (raw) milk.

Once inside the human digestive system, Campylobacter infect and attack the lining of the small and large intestines. The bacteria also can affect other parts of the body. In some cases — particularly in very young kids and those with chronic illnesses or a weak immune system — they can get into the bloodstream (this is called bacteremia).

Campylobacter prevention

Wash your hands

When and How to Wash Your Hands

Keeping hands clean through improved hand hygiene is one of the most important steps we can take to avoid getting sick and spreading germs to others. Many diseases and conditions are spread by not washing hands with soap and clean, running water. If clean, running water is not accessible, as is common in many parts of the world, use soap and available water. If soap and water are unavailable, use an alcohol-based hand sanitizer that contains at least 60% alcohol to clean hands.

When should you wash your hands?

Campylobacter bacteria can survive on your hands. Wash your hands thoroughly with soap and water during these times:

• Before, during, and after preparing food
• Before eating food
• After using the toilet
• After changing diapers or cleaning up a child who has used the toilet
• After blowing your nose, coughing, or sneezing
• Before and after caring for someone who is sick
• Before and after treating a cut or wound
• After touching an animal, animal feed, or animal waste
• After handling pet food or pet treats
• After touching garbage

How should you wash your hands?

• Wet your hands with clean, running water (warm or cold), turn off the tap, and apply soap.
• Lather your hands by rubbing them together with the soap. Be sure to lather the backs of your hands, between your fingers, and under your nails.
• Scrub your hands for at least 20 seconds. Need a timer? Hum the “Happy Birthday” song from beginning to end twice.
• Rinse your hands well under clean, running water.
• Dry your hands using a clean towel or air dry them.

What should you do if you don’t have soap and clean, running water?

Washing hands with soap and water is the best way to reduce the number of germs on them in most situations. If soap and water are not available, use an alcohol-based hand sanitizer that contains at least 60% alcohol. Many studies have found that sanitizers with an alcohol concentration between 60–95% are more effective at killing germs than those with a lower alcohol concentration or non-alcohol-based hand sanitizers ⁴. Non-alcohol-based hand sanitizers may 1) not work equally well for all classes of germs (for example, Gram-positive vs. Gram-negative bacteria, Cryptosporidium, norovirus); 2) cause germs to develop resistance to the sanitizing; 3) merely reduce the growth of germs rather than kill them outright, or 4) be more likely to irritate skin than alcohol-based hand sanitizers ⁵.

Alcohol-based hand sanitizers can quickly reduce the number of germs on hands in some situations, but sanitizers do not eliminate all types of germs and might not remove harmful chemicals. Although alcohol-based hand sanitizers can inactivate many types of microbes very effectively when used correctly ⁶, people may not use a large enough volume of the sanitizers or may wipe it off before it has dried ⁷. Furthermore, soap and water are more effective than hand sanitizers at removing or inactivating certain kinds of germs, like Cryptosporidium, norovirus, and Clostridium difficile ⁸.

Hand sanitizers are not as effective when hands are visibly dirty or greasy. Many studies show that hand sanitizers work well in clinical settings like hospitals, where hands come into contact with germs but generally are not heavily soiled or greasy ⁹. Some data also show that hand sanitizers may work well against certain types of germs on slightly soiled hands ¹⁰. However, hands may become very greasy or soiled in community settings, such as after people handle food, play sports, work in the garden, or go camping or fishing. When hands are heavily soiled or greasy, hand sanitizers may not work well ¹¹. Handwashing with soap and water is recommended in such circumstances.

How do you use hand sanitizers?

• Apply the product to the palm of one hand (read the label to learn the correct amount).
• Rub your hands together.
• Rub the product over all surfaces of your hands and fingers until your hands are dry.

Caution: Swallowing alcohol-based hand sanitizers can cause alcohol poisoning if a person swallows more than a couple of mouthfuls ¹². From 2011 – 2015, U.S. poison control centers received nearly 85,000 calls about hand sanitizer exposures among children ¹³. Children may be particularly likely to swallow hand sanitizers that are scented, brightly colored, or attractively packaged. Hand sanitizers should be stored out of the reach of young children and should be used with adult supervision. Child-resistant caps could also help reduce hand sanitizer-related poisonings among young children ¹². Older children and adults might purposefully swallow hand sanitizers to become drunk ¹³. Keep it out of reach of young children.

Keep Certain Foods Separated

Keep raw poultry away from other foods. Use separate cutting boards and clean them properly.

• Use one cutting board for raw meat (including poultry, seafood, and beef)
• Use another cutting board for fresh fruits and vegetables, and other foods.
• Clean all cutting boards, countertops, and utensils with soap and hot water after preparing any type of raw meat.

Even after you’ve cleaned your hands and surfaces thoroughly, raw meat, poultry, seafood, and eggs can still spread illness-causing bacteria to ready-to-eat foods—unless you keep them separate.

Keep meat, poultry, seafood, and eggs separate from all other foods at the grocery:

Make sure you aren’t contaminating foods in your grocery bag by:

• Separating raw meat, poultry, seafood, and eggs from other foods in your shopping cart.
• At the checkout, place raw meat, poultry, and seafood in plastic bags to keep their juices from dripping on other foods.

Keep meat, poultry, seafood, and eggs separate from all other foods in the fridge:

Bacteria can spread inside your fridge if the juices of raw meat, poultry, seafood, and eggs drip onto ready-to-eat foods. But stopping this contamination is simple.

• Place raw meat, poultry, and seafood in containers or sealed plastic bags to prevent their juices from dripping or leaking onto other foods. If you’re not planning to use these foods within a few days, freeze them instead.
• Keep eggs in their original carton and store them in the main compartment of the refrigerator—not in the door.

Cook Food to the Right Temperature

Be extra careful with poultry, one of the top causes of Campylobacter illnesses in the United States. Poultry includes chicken, turkey, duck, goose, and other farmed birds.

• All poultry and foods containing poultry, such as sausages and casseroles, should be cooked to reach a minimum internal temperature of 165°F (74 °C).
• If you are served poultry that appears to be undercooked in a restaurant, send it back for further cooking.

Did you know that the bacteria that cause food poisoning multiply quickest in the “Danger Zone” between 40˚F (4.4 °C) and 140˚F (60 °C)?

And while many people think they can tell when food is “done” simply by checking its color and texture, there’s no way to be sure it’s safe without following a few important but simple steps

Follow these top tips to keep your family safe

• Use a food thermometer.

Cooked food is safe only after it’s been heated to a high enough temperature to kill harmful bacteria. Color and texture alone won’t tell you whether your food is done. Instead, use a food thermometer to be sure.

• If you don’t already have one, consider buying a food thermometer. Learn more about the different types of food thermometers available.
• When you think your food is done, place the food thermometer in the thickest part of the food, making sure not to touch bone, fat, or gristle.
• Wait the amount of time recommended for your type of thermometer.
• Compare your thermometer reading to our Minimum Cooking Temperatures Chart to be sure it’s reached a safe temperature.
• Some foods need 3 minutes of rest time after cooking to make sure that harmful germs are killed.
• Clean your food thermometer with hot, soapy water after each use.

Safe Minimum Cooking Temperatures

Use this chart and a food thermometer to ensure that meat, poultry, seafood, and other cooked foods reach a safe minimum internal temperature.

Remember, you can’t tell whether meat is safely cooked by looking at it. Any cooked, uncured red meats – including pork – can be pink, even when the meat has reached a safe internal temperature.

Why the Rest Time is Important

After you remove meat from a grill, oven, or other heat source, allow it to rest for the specified amount of time. During the rest time, its temperature remains constant or continues to rise, which destroys harmful germs.

Microwave food thoroughly (to 165 ˚F [74 °C]).

To make sure harmful bacteria have been killed in your foods, it’s important to microwave them to 165˚F (74 °C) or higher. Here’s how:

• When you microwave, stir your food in the middle of heating.
• If the food label says, “Let stand for x minutes after cooking,” don’t skimp on the standing time. Letting your microwaved food sit for a few minutes actually helps your food cook more completely by allowing colder areas of food time to absorb heat from hotter areas of food. That extra minute or two could mean the difference between a delicious meal and food poisoning.
• After waiting a few minutes, check the food with a food thermometer to make sure it is 165˚F (74 °C) or above.

Barbeques and Smokers

Cooking doesn’t necessarily have to take place on the stovetop or in a conventional oven. While the basics of food safety apply to any type of cooking, special guidelines apply to appliances such as grills and smokers.

• Wash hands.
• Keep raw food separate from cooked food. Don’t use a plate that previously held raw meat, poultry, or seafood for anything else unless the plate has first been washed in hot, soapy water. Keep utensils and surfaces clean.
• Marinate food in the refrigerator, not out on the counter. And if you want to use some of the marinade as a sauce on the cooked food, reserve a separate portion. Don’t reuse marinade that contained raw meat.

Cook food thoroughly

To kill any harmful bacteria that may be present, use a food thermometer. Hamburgers should be cooked to 160°F (71 °C). If a thermometer is not available, make sure hamburgers are brown all the way through, not pink. Chicken should be cooked to at least 165°F (74 °C). If you partially cook food in the microwave, oven or stove to reduce grilling time, do so immediately before the food goes on the hot grill.

Refrigerate and freeze food promptly

It can be hard to remember while a party is going on, but food should not be left out of the cooler or off the grill for more than two hours. Never leave food out for more than one hour when the temperature is above 90°F (32 °C).

Keep hot food hot

Hot food should be kept at or above 140°F (60 °C). Hot food should be wrapped well and placed in an insulated container. If bringing hot take-out food such as fried chicken or barbecue to an outdoor party, eat it within two hours of purchase. In addition to bringing a grill and fuel for cooking to an outdoor location, remember to pack a food thermometer to check that your meat and poultry reach a safe internal temperature. When re-heating food at the outing, be sure it reaches 165°F.

Keep cold food cold

Cold food should be held at or below 40°F (4.4 °C). Foods like chicken salad and desserts that are in individual serving dishes can be placed directly on ice or in a shallow container set in a deep pan filled with ice. Drain off water as ice melts and replace ice frequently.

Drink Pasteurized Milk

Raw milk can carry Campylobacter and other harmful germs that can make you very sick. The risk of getting sick from drinking raw milk is greater for:

• infants and young children
• adults aged 65 and older
• pregnant women
• people with weakened immune systems, such as people with the blood disorders thalassemia and hypogammaglobulinemia, AIDS, or people receiving chemotherapy.

5 Raw Milk Myths Busted!

Here are the facts:

1. Most of the nutritional benefits of drinking raw milk are available from pasteurized milk without the risk of disease that comes with drinking raw milk.
2. Raw milk made into other products, like soft cheese, ice cream, and yogurt, can still cause dangerous infections. When consuming these products, make sure they are made from pasteurized milk.
3. Only organic milk that has been pasteurized is safe to drink.
4. Healthy animals can carry illness-causing germs, such as Brucella, Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella, that can contaminate milk.
5. Even dairy farms with very good safety practices can contain illness-causing germs. And even if tests on a batch of a farm’s raw milk come back negative, it is no guarantee that the next batch of milk will be free of harmful germs.

Is it true that raw milk has more enzymes and nutrients than pasteurized milk?

The heating process of pasteurization inactivates some enzymes in milk but scientists do not believe these enzymes are important in human health. Some nutrients are somewhat reduced in pasteurized milk, but the U.S. diet generally has plenty of other sources of these nutrients. For example, vitamin C is reduced by pasteurization, but raw milk is not a major source of vitamin C for humans.

Has pasteurized milk ever been linked to illnesses or outbreaks?

Pasteurized milk products have occasionally caused illnesses and outbreaks. Usually, this has happened because of germs introduced in the dairy after the pasteurization process. Pasteurized milk that is correctly handled in the dairy, bottled, sealed, and refrigerated after pasteurization, and that is properly handled by the consumer, is very unlikely to contain illness-causing germs. Considering the large amount of pasteurized milk that people drink, illness from it is very rare.

What are the risks associated with drinking raw milk?

Raw milk is milk from any animal that has not been pasteurized to kill harmful bacteria. Raw milk can carry harmful bacteria and other germs that can make you very sick or kill you. While it is possible to get foodborne illnesses from many different foods, raw milk is one of the riskiest of all.

Some people who chose raw milk thinking they would improve their health instead found themselves (or their loved ones) sick in a hospital for several weeks due to infections caused by germs in raw milk. Getting sick from raw milk can mean many days of diarrhea, stomach cramping, and vomiting. Some people who drank raw milk have developed severe or even life-threatening diseases, including Guillain-Barré syndrome, which can cause paralysis, and hemolytic uremic syndrome, which can result in kidney failure, stroke, and even death.

Here are some things you should know:

• Illness can occur from the same brand and source of raw milk that people had been drinking for a long time without becoming ill.
• A wide variety of germs that are sometimes found in raw milk can make people sick. These germs include Brucella, Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella.
• Each ill person’s symptoms can differ depending on the type of germ, the amount of contamination, and the person’s immune defenses.

Who is at greatest risk of getting sick from drinking raw milk?

The risk of getting sick from drinking contaminated raw milk is greater for infants and young children, older adults, pregnant women, and people with weakened immune systems, such as people with cancer, an organ transplant, or HIV, than it is for healthy older children and adults. But healthy people of any age can get very sick or even die if they drink raw milk contaminated with harmful germs.

Can drinking raw milk hurt me or my family?

Yes. Raw milk can cause serious illnesses. Raw milk and raw milk products, including soft cheese, ice cream, and yogurt, can be contaminated with harmful bacteria and other germs that can cause serious illness, hospitalization, or death. These harmful germs include Brucella, Campylobacter, Cryptosporidium, E. coli, Listeria, and Salmonella.

From 1993 through 2012, 127 outbreaks reported to CDC were linked to raw milk ¹⁵. These outbreaks included 1,909 illnesses and 144 hospitalizations. Most of the outbreaks were caused by Campylobacter, Shiga toxin-producing Escherichia coli, or Salmonella. A large number of raw milk outbreaks involve children. At least one child younger than 5 was involved in 59% of the raw milk outbreaks reported to CDC from 2007 through 2012. Children aged 1 to 4 years accounted for 38% of Salmonella illnesses in these outbreaks and 28% of illnesses caused by Shiga toxin-producing E. coli, which can cause kidney failure and death.

Reported outbreaks represent the tip of the iceberg. Most illnesses are not a part of recognized outbreak, and for every outbreak and every illness reported, many others occur.

What is pasteurization, and what is pasteurized milk?

Pasteurization is the process of heating milk to a high enough temperature for a long enough time to kill illness-causing germs. Pasteurized milk is milk that has gone through this process.

Does pasteurization change milk’s nutritional benefits?

Most of the nutritional benefits of drinking milk are available from pasteurized milk without the risk of disease that comes with drinking raw milk.

How does milk get contaminated?

Milk contamination may occur in these ways:

• Animal feces coming into direct contact with the milk
• Infection of the udder (mastitis)
• Cow diseases (for example, bovine tuberculosis)
• Bacteria that live on the skin of animals
• Environment (for example, feces, dirt, and processing equipment)
• Insects, rodents, and other animal vectors
• Unsanitary conditions in milk processing plant
• Cross-contamination from dairy workers, such as contact with dirty clothing or boots

Pasteurization is the only way to kill many of the bacteria in milk that can make people very sick.

Does milk have a “built-in” safety mechanism that prevents bacterial contamination?

No. Disease-causing germs can be eliminated in milk only by pasteurization or by adding chemicals to the milk. Pasteurization is the best method of getting rid of disease-causing organisms in milk and the only method routinely used in the United States.

My farmer performs laboratory tests for bacteria in raw milk, so isn’t it safe?

No. Negative tests do not guarantee that raw milk is safe to drink. Milk that is safe one day may not be safe the next day. Also, tests do not always detect low levels of contamination. People have become very sick from drinking raw milk that came from farms that regularly tested their milk for bacteria and whose owners were sure that their milk was safe.

My farmer uses grass-fed cows and goats to produce raw milk, so isn’t it safe?

Outbreaks of illness related to raw milk have been traced back to both grass-fed and grain-fed animals.

My farmer’s raw milk is organic, so isn’t it safe?

Raw milk, regardless of whether it is organic, can contain harmful germs. Pasteurized organic milk is available in many places, including supermarkets, farmers’ markets, and dairies.

I’ve heard that many organic and raw milk producers are creating sanitary and humane conditions for raising animals and producing “safe” raw milk and raw milk products (like ice cream and cheese). Does this help reduce milk contamination?

Following good hygienic practices during milking can reduce the chance of milk contamination but not completely eliminate it.

That’s because illness-causing germs thrive in the environment of dairy farms, even if the farm or barns are kept clean and the farmers are careful when milking. Farmers cannot guarantee that their raw milk and the products made from it are free of harmful germs – even if tests indicate the raw milk does not contain harmful germs.

Can I still get a disease from raw milk and raw milk products if the animals are healthy, clean, and grass-fed or if the dairy is especially careful and clean when collecting the milk?

Yes. Even healthy animals may carry germs that can contaminate milk . Small numbers of bacteria can multiply and grow in milk from the time it is collected until the time a person drinks it. If the milk is not pasteurized to kill germs, people who drink it can get sick. Methods for collecting milk have improved over the years but cannot be relied on to be sure milk is safe to drink. Raw milk from “certified,” “organic,” or “local” dairies is not guaranteed to be safe. Only pasteurization can make milk safe to drink. You can find pasteurized organic milk and products made from it at many local, small farms.

Aren’t raw or natural foods better than processed foods?

Many people believe that foods with little to no processing are better for their health. Many people also believe that small, local farms are better sources of healthy food. However, some types of processing are needed to protect health. One type of processing happens when we cook raw meat, poultry, and fish to make them safe to eat. Similarly, when milk is pasteurized, it is made safe by heating it just long enough to kill disease-causing germs. Most nutrients remain in milk after it is pasteurized.

Is raw milk a good source of beneficial bacteria?

Raw milk contains bacteria, and some of them can be harmful. So, if you’re thinking about consuming raw milk because you believe it is a good source of beneficial bacteria, you need to know that you may instead get sick from the harmful bacteria. If you think that certain types of bacteria may be beneficial to your health, consider getting them from foods that don’t involve such a high risk. For example, pasteurized fermented foods, such as yogurt and kefir, contain bacteria that are safe to eat.

I know people who have been drinking raw milk for years, and they never got sick. Why is that?

The presence of germs in raw milk is unpredictable. People can drink it for a long time without getting sick, and then get sick if their milk is contaminated.

Do Not Drink Untreated Water

It is important to know where drinking water comes from, if it’s been treated to remove harmful germs, and if it’s safe to drink.

• Do not drink untreated water from a stream, river, pond, or lake.
• Be sure that wells are located a safe distance from possible sources of contamination, such as septic tanks, livestock, and manure.
• If you have a septic tank or well, have it inspected regularly to ensure that it is functioning properly.

Campylobacter signs and symptoms

People with Campylobacter infection usually have diarrhea (often bloody), fever, and stomach cramps. The diarrhea may be accompanied by nausea and vomiting. These symptoms usually start within two to five days after exposure and last about a week. Some infected people do not have any symptoms. In people with weakened immune systems, such as people with the blood disorders thalassemia and hypogammaglobulinemia, AIDS, or people receiving some kinds of chemotherapy, Campylobacter occasionally spreads to the bloodstream and causes a life-threatening infection.

In young infants, bloody diarrhea may be the only sign that Campylobacter infection is present. Severe diarrhea can cause dehydration, with symptoms such as excessive thirst and a decline in the frequency of urination. Campylobacter can also enter the blood stream and infect other organs, though this is not common.

Symptoms usually appear between 2 and 5 days after Campylobacter infection. The illness usually starts with a fever, followed by stomach cramps and diarrhea, which might be bloody. Most people with campylobacter infection don’t vomit.

Campylobacter infection generally lasts for 1 or 2 weeks.

In rare cases, complications caused by the body’s immune system may develop. The antibodies made against Campylobacter can react against the your body, causing an uncommon form of arthritis called reactive arthritis, a skin sore called erythema nodosum, and a serious condition of the nerves called Guillain-Barré syndrome. With Guillain-Barré syndrome, you’ll develops weakness that usually starts in the legs and moves up the body.

Campylobacter diagnosis

Campylobacter infection is diagnosed when a laboratory test detects Campylobacter bacteria in stool, body tissue, or fluids. The test could be a culture that isolates the bacteria or a rapid diagnostic test that detects genetic material of the bacteria.

Campylobacter treatment

Most people with Campylobacter infection recover in a few days without medical treatment. Patients should drink extra fluids as long as the diarrhea lasts.

The best treatment for gastroenteritis symptoms is to rest and drink fluids:

• Keep hydrated by drinking plenty of fluids, such as an oral rehydration solution available from pharmacies.
• If you don’t have a rehydration drink, you could use diluted juice or a soft drink (mix 1 part drink to 4 parts water – for example, 40 ml drink with 160 ml water).
• Alternatively, use cordial (mix 1 part cordial to 20 parts water – for example, 5 ml cordial with 100 ml water).
• Avoid taking anti-vomiting or anti-diarrhoeal medications unless they are recommended by your doctor. Over the counter antidiarrheal medicines may make you or your child sicker and should not be taken if there is blood in the stools.
• See your doctor if your symptoms are severe. You might be asked to take antibiotics if you are seriously ill.
• After seeing a doctor, most kids with Campylobacter infections can recover at home, especially if they aren’t dehydrated. They should drink plenty of fluids for as long as the diarrhea lasts and be watched for signs of dehydration. Kids with mild diarrhea and no dehydration should continue to eat normally and drink lots of fluids. Fruit juices and soft drinks can make diarrhea worse, though, and should be avoided. If your child is dehydrated, your doctor may recommend using an oral rehydration solution. Breastfed babies who get campylobacteriosis should continue to be breastfed throughout the illness.

Diarrhea usually stops within 2 to 5 days. Full recovery usually takes about 1 week. Sometimes, diarrhea can last longer or stop and then come back.

Antibiotics are needed only for patients who are very ill or at high risk for severe disease, such as people with severely weakened immune systems, such as people with the blood disorders thalassemia and hypogammaglobulinemia, AIDS, or people receiving chemotherapy.

If taken early in the course of the illness, antibiotics such as erythromycin and azithromycin can eliminate the bacteria from the stool in 2 to 3 days and shorten the length of the illness.

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