Campylobacter Investigation

Update:
What is Campylobacter?
What are it's symptoms?
How long does it last?
How dangerous is campylobacter?

How is it treated?
Should I see my doctor?
How can I best protect my family?
How did this happen?
For more information


Updated: May 20, 2010, 4:30pm

The UCHD continues its epidemiological investigation of campylobacter in the Saratoga Springs area. With the assistance of the Utah Department of Health and Centers for Disease Control and Prevention (CDC), "Case Definitions" have been established. These are used to classify individuals for statistical reporting purposes, and gives public health the opportunity to find trends in disease, sources, etc.

Individuals are considered "Confirmed Cases" of this outbreak if they lived and/or visited the area since April 12th, have had symptoms consistent with campylobacter (diarrhea, vomiting) after April 13th, and have a laboratory test confirming campylobacter. Individuals are "Probable Cases" is they have all the above except the lab confirmation.

As of May 20th, the UCHD has reported 17 confirmed cases and 333 probable cases in connection with this outbreak. The UCHD is continuing the investigation, as well as notifying physicians of the outbreak and making recommendations for residents. The UCHD continues to be concerned about secondary infections, and would advise precaution for anyone who is or has been sick in the last 10 days (see link below).

If you believe you or your family members have been effected by this outbreak, please contact the UCHD Office of Epidemiology at 801-851-7037 or by emailing uchlth.lisag@state.ut.us.

This is current information as of May 20th, 3pm, and subject to change upon further investigation.

Updated: May 19, 2010, 5pm

The UCHD continues to work with UDOH, UDEQ, and Saratoga Springs on this issue. UCHD is continuing to investigate both symptomatic as well as lab reported cases, and are findings are still consistent with earlier information. We have 15 lab confirmed cases of campylobacter at this time. We have not been finding "new" cases, but individuals that were either a) sick previously and we are just receiving notice, or B) Secondary infections, where other members of the household were sick and apparently passed it to new members. This is secondary infection is the greatest concern of the UCHD at this point. For ideas how to protect your family, click here.

The City of Saratoga Springs is continuing to take water samples to test for coliform bacteria (a good preliminary indicator of contamination). They are also continuing to add chlorine to the drinking water supply to ensure safety. Water samples are also being collected and tested from the secondary water (pressurized irrigation) system.

Updated: May 17, 2010, 3pm

The Utah County Health Department (UCHD) is continuing to work with the City of Saratoga Springs, the Utah Department of Environmental Quality, the Utah Department of Health, and other public and private organizations to determine the cause of this campylobacter outbreak.

Since May 11th, 15 lab confirmed cases of campylobacter have been reported to the UCHD. We also have reports of many more individuals who are ill with symptoms consistent with campylobacter. The UCHD epistemology staff have been interviewing affected individuals to find a source of the disease. As of now the only common source among cases is the public water system.

On Thursday, May 13th, at the advice of the UCHD the City of Saratoga Springs issued a boil order for residents on the north side of the city. On Friday, May 14th, the city flushed the drinking or culinary water system and added chlorine to kill any lingering bacteria.

Samples were also taken from the system and tested for coliform bacteria -– a commonly used bacterial indicator for such things as e. Coli and campylobacter. Initial test results for coliform bacteria came back Saturday and were negative for bacteria, therefore the boil order was lifted.

The Utah County Health Department is continuing its investigation into the disease outbreak.

Campylobacter

Campylobacteriosis is an infectious disease caused by bacteria of the genus Campylobacter. Most individuals get over symptoms between 24 and 36 hours, but illness can last a week. If your symptoms are not showing improvement after three days, you should see your personal physician.

Symptoms include:  diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. Some infected persons do not have any symptoms.

In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.

How is it treated?
Almost all persons infected with Campylobacter recover without any specific treatment. Patients should drink extra fluids as long as the diarrhea lasts. In more severe cases, antibiotics such as erythromycin or a fluoroquinolone can be used, and can shorten the duration of symptoms if given early in the illness. Your doctor will decide whether antibiotics are necessary.
Should I see my doctor?
If you are experiencing severe symptoms, especially dehydration, or your symptoms are not showing improvement after three days, you should see your personal physician.
Precautions
Campylobacter is a bacteria passed by fecal-oral transmission. The UCHD is now most concerned about secondary infection ... individuals that are ill can very easily pass it to other close contacts if personal hygiene is neglected. The UCHD suggests the following to keep your family safe:
  • Wash hands regularly, dry with a paper towel, and use a hand sanitizer. Wash hands after using the restroom or changing diapers and before preparing food.
  • Individuals that are sick should avoid preparing food for others, especially ready to eat foods that will not be cooked.
  • Cook all food thoroughly, especially meat and poultry products.
  • Raw or unpasturized dairy products are known to commonly contain many bacteria, including campylobacter.
How did this happen?

City and county officials are still investing the cause of this outbreak, as well as the source of the disease. It is not clear yet where the bacteria came from. Campylobacter is typically a food-borne illness and is common in unpasteurized dairy products. It can also be passed in contaminated water, from animals-to-humans, as well as person-to-person.

One possibility is that a resident has cross contaminated the culinary system with their pressurized irrigation. The Utah County Health Department raises this concern due to the proxminity of the people effected, although extensive testing by Saratoga Springs has shown no contamination of either their culinary (drinking water) system nor their secondary (pressurized irrigation) system.

Saratoga Springs shuts their irrigation system off in the winter, and only recently turned it on. If an individual hooked their sprinklers or outside hose system to both the culinary water system as well as the secondary water system in an attempt to provide year round irrigation, this can cause a cross contamination. Even placing a valve between the systems doesn't guarantee they won't cross contaminate, and is unsafe and illegal.cross contamination graphic

 

For more information:

Centers for Disease Control and Prevention (CDC):
www.cdc.gov/nczved/divisions/dfbmd/diseases/campylobacter

Utah Department of Health (UDOH):
http://health.utah.gov/epi/diseases/campylobacter/index.html

Saratoga Springs City:
www.saratogaspringscity.com