What is Campylobacter infection?
Campylobacter infection, or campylobacteriosis, is an infectious disease caused by Campylobacter bacteria. It affects the stomach and intestines and is one of the most common diarrheal illnesses in the United States.
How common is Campylobacter infection?
CDC estimates Campylobacter infection affects more than 1.3 million people in the US every year. Most case are not part of recognized outbreaks and more cases occur in summer than in winter.
What are the symptoms of Campylobacter?
Symptoms include diarrhea (sometimes bloody), fever, and abdominal cramps. The diarrhea may be accompanied by nausea and vomiting. Symptoms usually begin 2-5 days after ingesting the Campylobacter bacteria and typically last one week.
How is Campylobacter spread?
The bacteria can be ingested from contaminated hands, objects, food and water. People who become infected with Campylobacter will have the bacteria in their feces (stool). If people do not properly wash their hands after using the restroom or changing diapers, and then handle food that others will eat or objects that others will put in their mouths (e.g., toys), they can spread the bacteria to other people. Other common sources of Campylobacter include:
- Raw or undercooked meat (especially poultry)
- Unpasteurized milk
- Pets, mainly puppies and kittens, can be infected and can spread the bacteria to you through feces
- Other animals such as cattle and chickens can also carry Campylobacter
When to call your healthcare provider
Contact your healthcare provider if you have diarrhea that has lasted for over 3 days, or if you have a high fever, have blood in your stool, or if you are becoming dehydrated from having diarrhea and/or vomiting.
How is Campylobacter diagnosed?
Campylobacter infection is usually diagnosed when a laboratory test detects Campylobacter in a stool sample.
How is Campylobacter infection treated?
Most people with Campylobacter infection recover without specific treatment. Patients should drink extra fluids as long as diarrhea lasts. Antibiotics may be needed for patients who are very ill or at high risk for severe disease, such as people with severely weakened immune systems.
How do I avoid Campylobacter infection?
- Take care when handling raw poultry and meats, and be sure to WASH YOUR HANDS afterwards. Wash cutting boards, counter tops, and cooking utensils thoroughly in order to clean up raw poultry and meat juices before preparing other food items.
- Cook meats thoroughly
- Do not consume unpasteurized milk or unpasteurized dairy products
- Wash hands after changing diapers
- Wash hands after changing a litter box or after close contact with animals
Is there anything special I need to know?
- Wash your hands after you use the bathroom
- Do not prepare food for others while ill
- Food handlers must be excluded from work until at least 24 hours after diarrhea has resolved and adequate hygiene can be maintained.
- Childcare workers - Children and staff members with campylobacteriosis who have diarrhea should be excluded until at least 24 hours after diarrhea has resolved. Parents of cases should be counseled not to take their children to another childcare center during this period of exclusion. Meticulous hand washing should be done after diaper changes and toileting children.
Why does public health investigate Campylobacter cases?
It is the responsibility of the local health department to investigate Campylobacter cases reported in the community.
Most people infected with Campylobacter are single, sporadic cases. However, sometimes there are outbreaks when two or more people become ill from the same source.
What is Cryptosporidium infection?
Cryptosporidium is a parasite known to cause illness that affects the stomach. The parasite can make both humans and animals sick. Cryptosporidium, or "Crypto" for short, can be found in water, food, soil or on surfaces or hands that have been contaminated with the feces of humans or animals infected with the parasite.
How common is Cryptosporidium infection?
Cryptosporidium is frequently the leading cause of waterborne disease outbreaks, linked to recreational water in the United States. The parasite is found in every region of the United States and throughout the world. People who are most likely to become infected with Cryptosporidium include:
- Children who attend childcare centers, including diaper-aged children
- Childcare workers
- Parents of infected children
- People who take care of other people with Cryptosporidium
- International travelers
- Backpackers, hikers, and campers who drink unfiltered, untreated water
- People who drink from untreated shallow, unprotected wells
- People, including swimmers, who swallow water from contaminated sources
- People who work with cattle and other livestock
- People exposed to human poop through sexual contact
What are the symptoms of Cryptosporidium?
Symptoms of Cryptosporidium infection generally begin 2 to 10 days (average 7 days) after being exposed to the parasite. Symptoms include:
- Watery diarrhea
- Stomach cramps or pain
- Dehydration
- Nausea
- Vomiting
- Fever
- Weight loss
Symptoms usually last about 1 to 2 weeks (with a range of a few days to 4 or more weeks) in people with healthy immune systems. Some people with Cryptosporidium will have no symptoms at all.
How is Cryptosporidium spread?
People must swallow or eat the parasite to become infected. Cryptosporidium is usually spread through the following:
- Drinking or swallowing water from swimming pools or hot tubs. Cryptosporidium is a very hardy parasite and can survive in treated water.
- People who become infected will have the parasite in their stool. Ill people who do not wash their hands after using the bathroom or changing diapers can spread the parasite.
- Cattle and some pets, including dogs and cats, can be infected and spread the parasite to you through their poop.
- Contact with an infected person’s poop during sexual activity can spread the parasite to others.
When to call your healthcare provider
Contact your healthcare provider if you have diarrhea that has lasted for over 3 days, or if you have a high fever, have blood in your stool, or if you are becoming dehydrated from having diarrhea and/or vomiting.
How is Cryptosporidium diagnosed?
Cryptosporidium infection is diagnosed when a laboratory tests detects Cryptosporidium in a stool sample.
How is Cryptosporidium infection treated?
For most people, symptoms will go away on their own within 1-3 weeks. It is important to drink extra fluids to avoid dehydration. People with chronic illnesses (i.e. AIDS/ HIV patients) may not be able to recover as quickly. Call your doctor if symptoms do not go away or become worse.
How do I avoid Cryptosporidium infection?
- Do not drink water from lakes, streams, rivers, etc. unless it has been treated to kill or remove Cryptosporidium.
- Do not swallow water from swimming pools or spas.
- Wash hands before preparing and serving food.
- Always wash your hands after using the bathroom.
- Always wash hands after changing diapers and toilet training.
Is there anything special I need to know?
- Do not prepare food for others.
- Stay home from work. Especially if your job involves handling food, caring for small children, or working with patients in a healthcare setting.
- Children who have Cryptosporidium should not go to child care settings—especially if they have diarrhea.
- Cryptosporidium can still be shed in poop even after diarrhea has stopped. Do not swim for up to 2 weeks after diarrhea stops.
Special Circumstances
- Food handlers - Food handlers should be excluded from work until at least 24 hours after diarrhea has resolved and adequate hygiene can be maintained.
- Childcare - Children and staff members with Cryptosporidium who have diarrhea should be excluded until at least 24 hours after diarrhea has resolved. Parents of cases should be counseled not to take their children to another childcare center during this period of exclusion.
Meticulous hand washing should be done after diaper changes and toileting children.
Why does public health investigate Cryptosporidium cases?
It is the responsibility of the local health department to investigate Cryptosporidium in the community. The health department keeps track of how many people are reported with the disease and works to limit the number of people exposed.
Most people infected with Cryptosporidium are single, sporadic cases. However, sometimes there are outbreaks when two or more people become ill from the same source. The health department monitors Cryptosporidium in an attempt to identify and stop outbreaks of the disease.
What is Giardia infection?
Giardia is a microscopic parasite that causes the diarrheal illness known as giardiasis.
How common is Giardia infection?
Approximately 450 cases of giardiasis are reported in Colorado each year. Cases occur more commonly in the summer and fall. Giardiasis has a worldwide distribution. Children are infected more frequently than adults. More cases occur in areas of poor sanitation and in institutions with children who are not toilet trained, such as child care centers.
What are the symptoms of Giardia?
Symptoms begin 3-25 days (usually 7-10 days) after ingesting the Giardia parasite. Symptoms include:
- Diarrhea and greasy stools (feces)
- Stomach cramping, bloating and passing gas
- Fatigue, loss of appetite and weight loss
- Symptoms may last 2-6 weeks, they may come and go, and occasionally last longer
How is Giardia spread?
Giardia is found in the stool of infected humans, wild animals and pets. Giardia spreads when infected people do not wash their hands thoroughly after using the bathroom or from having contact with ill people. People with Giardia infection who go swimming when they have diarrhea can contaminate recreational water such as lakes or rivers, as well as swimming pools. Animals with Giardia infection also can contaminate water. Giardia infection can come from swallowing contaminated water. Travelers to countries where Giardia is common can get infected as described above.
When to call your healthcare provider
Contact your healthcare provider if you have diarrhea that has lasted for over 3 days, or if you have a high fever, have blood in your stool, or if you are becoming dehydrated from having diarrhea and/or vomiting.
How is Giardia diagnosed?
Your healthcare provider will ask you to submit a stool sample and run laboratory tests to see if you are infected.
How is Giardia infection treated?
Most people with mild Giardia infection get better on their own. Medications prescribed by your doctor may shorten the illness.
How do I avoid Giardia infection?
- Practice good hygiene. Wash hands thoroughly with soap and water after using the toilet, before handling or eating food, after changing diapers.
- Avoid drinking untreated water from shallow wells, lakes, rivers, springs, ponds, and streams. Avoid swallowing recreational water as well.
- Be aware of risks associated with drinking water from certain areas when traveling.
- Protect others by not swimming if you are experiencing diarrhea.
- Wash and peel raw vegetables and fruits before eating.
Is there anything special I need to know?
- Wash your hands after you use the bathroom
- Do not prepare food for others while ill.
- Ill persons who work in food service or in child care should not return to work until 24 hours after diarrhea has stopped.
- Children who have Giardia should not go to child care settings until 24 hours after diarrhea has stopped.
- Do not go swimming when you have diarrhea.
Why does public health investigate Giardia cases?
It is the responsibility of the local health department to investigate Giardia in the community. The health department keeps track of how many people are reported to have the disease and works to limit the number of people exposed.
Most people infected with Giardia are single, sporadic cases. However, sometimes there are outbreaks when two or more people become ill from the same source. The health department monitors Giardia in an attempt to identify and stop outbreaks of the disease.
Larimer County Department Health and Environment is part of a Centers for Disease Control and Prevention monitoring system that studies what puts people at risk for getting Giardia.
What is Salmonella infection?
Salmonella are bacteria that can cause infections (illness) affecting the intestinal tract, urinary tract, bloodstream or other body tissues.
How common is Salmonella infection?
The Centers for Disease Control and Prevention estimates that Salmonella causes approximately 1.2 million illnesses and 450 deaths every year in the United States.
People at highest risk for severe illness from Salmonella infection are children <5 years, Adults >65 yrs, and people with weakened immune systems (for example due to HIV, diabetes, or undergoing cancer treatment).
Many Salmonella infections are not diagnosed or reported, so the actual number of cases may be much higher.
What are the symptoms of Salmonella?
Most people will develop symptoms about 6-72 hours after exposure to the bacteria.
Symptoms may include:
- Diarrhea
- Fever
- Abdominal cramps
Most illnesses with Salmonella will last 4-7 days; some infections may be severe and require hospitalization.
A small number of people may develop reactive arthritis as a result of a Salmonella infection.
How is Salmonella spread?
Salmonella is usually spread to people through eating contaminated food. Salmonella can be found in many places in our foods and our environment. The bacteria can be found in raw meats, eggs, and unpasteurized dairy products.
Salmonella infections may happen through handling/contact with certain animals or their feces (poop). Animals such as poultry (chicks), livestock, dogs, cats, and reptiles may carry Salmonella and spread it to people.
When to call your healthcare provider
Many Salmonella infections resolve on their own; however, if symptoms are not getting better within a few days, see your healthcare provider.
Infants, young children, elderly, or those with impaired immune systems may be more at risk for more serious illness—consult with your healthcare provider for recommendations.
If you think you (or your child) is becoming dehydrated from being ill, seek medical advice
If there is blood in the stool or vomit, consult with your healthcare provider
How is Salmonella diagnosed?
Your healthcare provider may ask you to submit a sample of your stool (poop) or other specimen for testing.
How is Salmonella infection treated?
If you are having vomiting or diarrhea, make sure you drink enough fluids to avoid becoming dehydrated.
Most cases of Salmonella resolve on their own; those at risk for complications or who have severe illness may need treatment with antibiotics. Your healthcare provider will determine if antibiotics are appropriate for your case.
How do I avoid Salmonella infection?
- Avoid eating raw or undercooked meats and eggs; use a food product thermometer to ensure that meats are thoroughly cooked.
- Do not cross-contaminate foods or kitchen work surfaces with raw meat juices.
- Avoid drinking raw (unpasteurized) milk or consuming foods made with unpasteurized milk.
- Wash your hands before eating or preparing food, after using the restroom, or after activity where your hands become soiled.
- Wash hands after feeding, playing with, or caring for animals.
- Wash fruits and vegetables before eating them.
Is there anything special I need to know?
If you are working in food service, healthcare, or childcare; or you have a child that has Salmonella and attends childcare, please consult with your local public health agency for guidance on when it is safe to return to work/childcare.
Even after symptoms resolve, you may still be shedding Salmonella bacteria in your stool, so practice good hand washing.
Why does public health investigate Salmonella cases?
It is the responsibility of the local health department to investigate Salmonella in the community. The health department keeps track of how many people are reported with the disease and works to limit the number of people exposed.
Most people infected with Salmonella are single, sporadic cases. However, sometimes there are outbreaks when two or more people become ill from the same source. The health department monitors Salmonella in an attempt to identify and stop outbreaks of the disease.
Larimer County Department of Health and Environment is part of a Centers for Disease Control and Prevention monitoring system that studies what puts people at risk for getting Salmonella
What is Shiga toxin-producing Ecoli (STEC) infection?
Shiga toxin-producing E. coli are bacteria that can cause severe illness and even death. Some E. coli are harmless and live in human digestive tracts; however, certain E. coli can cause illness.
How common is STEC infection?
CDC estimates that there are 265,000 infections each year in the US. Colorado has averaged about 214 cases per year (from 2013-2017). Many STEC infections may not be reported since some people may not seek medical care when they are ill, or may not be tested for their illness.
What are the symptoms of STEC?
Most people will have symptoms appear in 3-4 days after being exposed to the source of STEC; however, symptoms could appear in as short as 1 day or as long as 10 days following exposure.
Symptoms of infection with STEC may include:
- Stomach cramps
- Diarrhea
- Bloody diarrhea
- Vomiting
- Fever
Illness may range from mild to life threatening.
In some cases (~5-10%), people diagnosed with STEC may develop a complication known as hemolytic uremic syndrome (HUS) which may lead to kidney failure, permanent damage or death. Very young children and the elderly are more likely to develop severe illness.
How is STEC spread?
Illness from STEC could be from eating food that has been contaminated, consuming unpasteurized milk or products made with unpasteurized milk, drinking contaminated water, swallowing lake water or other untreated water , contact with livestock (especially if you have contact with livestock poop) including petting zoos, or contact with feces of people infected with STEC.
When to call your healthcare provider
Contact your healthcare provider if you have diarrhea that has lasted for over 3 days,or if you have a high fever, have blood in your stool, or if you are becoming dehydrated from having diarrhea and/or vomiting.
How is STEC diagnosed?
STEC can be diagnosed by testing your stool in a laboratory.
How is STEC infection treated?
Keeping hydrated is important if you have STEC. Antibiotics usually are not prescribed for this infection; check with your provider to see what is recommended. Antidiarrheal agents (such as Immodium) should not be used to treat STEC without consulting your health care provider, since they may make the illness worse.
How do I avoid STEC infection?
- WASH YOUR HANDS!
- After using the restroom or changing diapers
- Before preparing food
- After contact with animals or their environments
- Cook meats thoroughly; use a thermometer to check if the food has been cooked to a high enough temperature. Handle raw meats carefully so that the juice does not contaminate other surfaces or foods; wash hands, counters, cutting boards and utensils after they touch raw meat.
- Avoid raw milk and unpasteurized dairy products and unpasteurized juices
- Avoid swallowing water when swimming
Is there anything special I need to know?
For STEC cases that attend childcare or for those that work in healthcare, childcare, or food service, your local health department can give you advice on when it is safe for you to return to work or for your child to return to a childcare center.
Good handwashing is important during the time when you have symptoms, as well as in the week following your illness.
Why does public health investigate STEC cases?
Public Health may contact you to see if it is possible to identify the source for your illness and to give you information on how to not spread the infection to others. They will ask you about possible exposures like travel history, foods eaten, animal and water exposure. All information collected during the interviews is confidential.
What is Shigella infection?
Shigella is a bacteria that causes a disease called shigellosis.
How common is Shigella infection?
Shigella bacteria can cause severe illness in infants, the elderly, or people with weakened immune systems. Travelers to developing countries, young children and men who have sex with men are at highest risk of infection.
In the U.S., the CDC estimates that there are 500,000 cases of shigella every year.
What are the symptoms of Shigella?
People who get a Shigella infection will usually begin to have symptoms of illness about 1-2 days after encountering the bacteria.
Symptoms include:
- Diarrhea (sometimes bloody),
- Fever
- Stomach pain
- Feeling the need to poop even when bowels are empty
Symptoms usually last 5-7 days, but can sometimes persist for weeks.
Some people may not have symptoms at all (but can still pass the bacteria to others).
How is Shigella spread?
Shigella is very contagious and just a few bacteria can make people sick. Shigella can be spread by people getting germs on their hands and then touching their food or their mouth or by eating food that was prepared by someone who is sick with Shigellosis. Other sources may be from changing diapers of an ill child or caring for someone who is sick with Shigella; swallowing recreational water while swimming (ex: lake, river); or having exposure to stool during sexual contact with someone who is sick or has recently been sick with Shigella.
When to call your healthcare provider
Contact your healthcare provider if you have fever, bloody diarrhea, severe stomach cramping, if you become dehydrated, or if symptoms do not resolve.
How is Shigella diagnosed?
Your healthcare provider can order laboratory tests to identify which germ has caused your illness.
How is Shigella infection treated?
Most people will recover on their own without treatment in about 5-7 days; make sure to have adequate fluids to prevent dehydration. Healthcare providers may prescribe antibiotics for people who are severely ill. If your healthcare provider prescribes antibiotics, and you are not getting better within a few days, notify your provider.
People with Shigella should not use anti-diarrheal medications (ex: loperamide/Immodium) as they may make symptoms worse
How do I avoid Shigella infection?
- Reduce the chance of getting Shigella by regular hand washing with soap and water before preparing or eating food,
- After changing diapers or assisting others with toileting
- Avoid swallowing water from ponds, lakes, or other recreational water
- When traveling, follow safe food and water guidelines (Only drink bottled, boiled or chemically treated water; only eat foods that are freshly cooked and served hot or fruit that you can peel yourself.)
- Avoid having sex with those who have, or recently have had, a diarrheal illness.
Is there anything special I need to know?
Do not prepare food for others if you are ill with Shigella.
People who have Shigella and work in child care, food service, or healthcare industry are more likely to spread their illness to others if they work while they are ill. Please contact your local health department to discuss when it is safe for you to return back to work.
Stay home from school, daycare, or work until your health department says it is okay to return.
If you are ill with Shigella do not go swimming while you have diarrhea.
If you have Shigella, do not have sex for one week after your diarrhea is gone.
Why does public health investigate Shigella cases?
It is the responsibility of the local health department to investigate Shigella in the community. The health department keeps track of how many people are getting the disease and works to limit the number of people exposed.
Sometimes there are outbreaks when two or more people become ill from the same source. The health department monitors Shigella in an attempt to identify and stop outbreaks of the disease.
Laboratories and healthcare providers are required to report cases of Shigella to the local or State health department. If you have been reported as having a Shigella infection, the health department will likely contact you to try to identify the source of your illness and to help you prevent spreading the infection to others.
