# Campylobacter ## Guideline **Escherichia coli *****(or alternatively thermotolerant coliforms) can be used to indicate the possible presence of pathogenic***** Campylobacter*****. If explicitly sought,***** Campylobacter *****spp. should not be detected. If detected, advice should be sought from the relevant health authority or drinking water regulator.*** ## General description Thermophilic *Campylobacter* spp. are transmitted by the oral route, and cause gastrointestinal illness. Wild birds and poultry are the most important reservoirs of *Campylobacter.* Other domestic animals, such as pigs, cattle, dogs and cats, are also reservoirs of thermophilic *Campylobacter* organisms, and so meat, and particularly poultry products and unpasteurised milk, are important sources of *Campylobacter* infection. Milk may be contaminated with faeces or by secretion of organisms into the milk of cows with mastitis. Recent studies have shown that raw sewage frequently contains from 10 to 105 thermophilic *Campylobacter* organisms per 100 mL; high counts can be reduced by wastewater treatment processes. Thermophilic campylobacters have been found in crude sewage sludge, but were not detectable in digested conditioned sludge or filter effluent. Their occurrence in surface waters is dependent on rainfall, water temperature and the presence of water fowl. Several waterborne outbreaks caused by *Campylobacter* spp. have been reported in the past decade worldwide. The number of people involved ranged from a few to several thousand. Water was implicated in the only two of these outbreaks where *Campylobacter* was isolated from patients the main sources were found to be unchlorinated surface water and faecal contamination of water storage reservoirs by wild birds. Communities are at risk of outbreaks of campylobacteriosis from the consumption of unchlorinated or inadequately chlorinated surface waters. Contamination of drinking water reservoirs by excrement of water fowl should be controlled, particularly if *Campylobacter* contamination is suspected. Hygienic precautions should be improved in case the water is distributed without disinfection, or disinfection is interrupted. *Campylobacter* spp., like other bacterial pathogens, survive well at low temperatures, and can survive for several weeks in cold groundwater or unchlorinated tap water. The presence of thermophilic *Campylobacter* organisms in piped water supplies, whether treated or untreated, suggests a serious fault in the design or management of the system. Two closely related genera, *Helicobacter* and *Archobactor*, include species previously identified in the *Campylobacter* genus. Helicobacter pylori may be differentiated from *Campylobacter* spp. by a strong urease activity. It is a cause of gastritis in humans. ## Australian significance *Campylobacter* have been identified in some Australian water supplies, but there have been no reports of infections from drinking water in Australia. No information is available on *Helicobacter* spp. in Australian water supplies. ## Treatment of drinking water Provided the water has low turbidity, standard disinfection procedures are sufficient to prevent the spread of *Campylobacter* in distribution systems. ## Method of identification and detection *Campylobacter* are Gram-negative, slender, comma-shaped rods which show a characteristic corkscrew-like motion which can be easily seen by phase contrast microscopy. They also appear S-shaped and gullwinged when in pairs. They are microaerophilic, requiring a low oxygen tension (3–6%) for growth. The numbers of thermophilic *Campylobacter* spp. in water can be determined by concentration, followed by enrichment, isolation and confirmation (AS4276.19 2014). ## Health considerations Some of the 14 described species are pathogens for humans and animals (for example *C. jejuni, C. coli, C. fetus*), while others are considered to be nonpathogenic (for example *C. sputorum, C. concisus*) (Penner 1988). Most the members of the thermophilic group (growing at 42°C) of campylobacters cause enteritis in humans. In Australia, *Campylobacter* are very important bacterial causes of acute gastroenteritis. Several major outbreaks of *Campylobacter* enteritis have been linked to the ingestion of contaminated food, milk or water. ## Derivation of guideline *Campylobacter* in drinking water can cause acute gastroenteritis and should be absent from drinking water supplies. *** NOTE: Important general information is contained in PART II, Chapter 5 ### References AS4276.19 (2014). Australian Standard. Water microbiology: Examination for thermophilic *Campylobacter* spp. – Membrane filtration. Standards Australia, Sydney, NSW. Penner JL (1988). The genus *Campylobacter:* A decade of progress. *Clinical Reviews in Microbiology*,1, 157–172. --- # Agent Instructions: Querying This Documentation If you need additional information that is not directly available in this page, you can query the documentation dynamically by asking a question. Perform an HTTP GET request on the current page URL with the `ask` query parameter: ``` GET https://guidelines.nhmrc.gov.au/australian-drinking-water-guidelines/part-5/microorganisms/bacteria/campylobacter.md?ask= ``` The question should be specific, self-contained, and written in natural language. The response will contain a direct answer to the question and relevant excerpts and sources from the documentation. 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