Ban Mishu Allos

Campylobacter jejuni Infections: Update on Emerging Issues and Trends

Infection with Campylobacter jejuni is one of the most common causes of gastroenteritis worldwide; it occurs more frequently than do infections caused by Salmonella species, Shigella species, or Escherichia coli O157:H7. In developed countries, the incidence of Campylobacter jejuni infections peaks during infancy and again during early adulthood. Most infections are acquired by the consumption and handling of poultry. A typical case is characterized by diarrhea, fever, and abdominal cramps. Obtaining cultures of the organism from stool samples remains the best way to diagnose this infection. An alarming recent trend is the rapid emergence of antimicrobial agent--resistant Campylobacter strains all over the world. Use of antibiotics in animals used for food has accelerated this trend. It is fortunate that complications of C. jejuni infections are rare, and most patients do not require antibiotics. Guillain-Barré syndrome is now recognized as a post-infectious complication of C. jejuni infection, but its incidence is <1 per 1000 infections. Careful food preparation and cooking practices may prevent some Campylobacter infections.

Association between Campylobacter Infection and Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS), a neurologic disease that produces ascending paralysis, affects people all over the world. Acute infectious illnesses precede 50%-75% of the GBS cases. Although many infectious agents have been associated with GBS, the strongest documented association is with Campylobacter infection. The first line of evidence supporting Campylobacter infection as a trigger of GBS is anecdotal reports. The second line of evidence is serologic surveys, which have demonstrated that sera from GBS patients contain anti-Campylobacter jejuni antibodies, consistent with recent infection. Finally, culture studies have proven that a high proportion of GBS patients have C. jejuni in their stools at the time of onset of neurologic symptoms. Neurologic symptoms are more severe and more likely to be irreversible when GBS is preceded by C. jejuni infection. One of every 1058 Campylobacter infections results in GBS, and 1 of 158 Campylobacter type O:19 infections results in GBS.

The Economic Burden of Campylobacter-Associated Guillain-Barré Syndrome

Guillain-Barré syndrome (GBS) is an autoimmune disease characterized by acute neuromuscular paralysis. Of an estimated annual number of 2628-9575 US cases, 526-3830 are triggered by Campylobacter infection. Research objectives were to identify the lifetime consequences of GBS and, when possible, to quantify their economic burden. The cost-of-illness method was used to calculate annual societal resources spent on medical care and lost productivity due to illness or premature death from Campylobacter-associated GBS. Estimated total costs (in US

Recommended adult immunization schedule: United States, October 2007-September 2008

) of Campylobacter-associated GBS (

Restriction Fragment Length Polymorphism Analysis and Random Amplified Polymorphic DNA Analysis of Campylobacter jejuni Strains Isolated from Patients with Guillain-Barré Syndrome

0.2-

CAMPYLOBACTER JEJUNI INFECTION AS A CAUSE OF THE GUILLAIN-BARRÉ SYNDROME

1.8 billion) were added to previously estimated costs of campylobacteriosis (

Management of an outbreak of tuberculosis in a small community

1.3-

Workshop summary and recommendations regarding the development of Guillain-Barré syndrome following Campylobacter infection.

6.2 billion) for a total annual cost from Campylobacter of

DNA diversity of the wla gene cluster among serotype HS:19 and non-HS:19 Campylobacter jejuni strains

1.5-

Re: Potential role of lipopolysaccharides of Campylobacter jejuni in the development of Guillain-Barré syndrome

8.0 billion (1995 dollars). It is concluded that up to