Preventive measures: To protect against Campylobacter infections, it is important to cook meat thoroughly, especially poultry meat, and to consistently follow kitchen hygiene during food preparation to avoid cross-contamination. Raw milk (including "milk from the farm" or "preferential milk") should be boiled before consumption. Vulnerable groups of people, especially infants, young children, pregnant women, and the elderly and immunocompromised, should generally avoid eating raw foods of animal origin, including raw milk and raw minced meat, e.g. ground pork or minced pork. Note: In USA, chicken is treated with chlorine and is largely free of Camphylobacter.
An important general measure for prophylaxis of transmission of Campylobacter infection is washing hands with soap and water after each visit to the toilet, after contact with suspected contaminated items (e.g. diapers), utensils and surfaces in the kitchen, and before preparing meals. Hand washing does not lead to complete elimination, but to a significant reduction of the bacterial concentration on the hands.
Measures for individual illness: For the duration of their illness, patients should remain at home and follow the hygiene measures listed.
Hospitals and other health care facilities: Measures to prevent the spread of Campylobacter infections from person to person can be found in the recommendations of the Commission for Hospital Hygiene and Infection Prevention (KRINKO) "Infection Prevention in the Care and Treatment of Patients with Communicable Diseases". In addition to the basic hygiene measures that must always be applied, spatial accommodation in an isolation room is recommended in cases of profuse diarrhoea due to Campylobacter enteritis.
Communal facilities (according to § 33 IfSG, e.g. kindergartens, schools, homes): According to § 34 para. 1 IfSG, children who are looked after in communal facilities and who have not yet reached the age of 6 and who have contracted or are suspected of having contracted infectious gastroenteritis are not allowed to enter the rooms used for the operation of the communal facility, are not allowed to use the facilities of the communal facility and are not allowed to participate in events of the communal facility until a further spread of the disease is no longer to be feared by them according to medical judgement. Re-admission for children ill/suspected of being ill with infectious gastroenteritis who have not reached 6 years of age is 48 hours after clinical symptoms have resolved. For further information, see the RKI recommendations for re-admission to community facilities according to § 34 IfSG.
The restriction of activity or attendance at the communal facility applies until, according to medical judgement, further spread of the disease is no longer to be feared. The medical judgement can be the judgement of the attending physician or a physician of the responsible public health department. The medical opinion may be given orally. Section 34 IfSG does not require a written certificate of the medical judgement, but this may nevertheless be expedient for the protection of all parties involved.
According to § 34 para. 7 IfSG, the competent authority may, in agreement with the public health authority, allow exceptions from the prohibitions mentioned in § 33 IfSG for the establishments mentioned in § 33 IfSG, if measures are or have been taken to prevent the transmission of the listed disease.
Food establishments and institutions for communal catering: According to § 42 para. 1 IfSG, persons suffering from or suspected of suffering from infectious gastroenteritis may not work or be employed
- a) in the manufacture, handling or placing on the market of the foodstuffs referred to in Section 42(2) (see below) if they come into contact with them in the process, or
- b) in kitchens of restaurants and other establishments with or for communal catering.
The foodstuffs referred to in Section 42(2) IfSG are:
- meat, poultry meat and products thereof
- milk and milk-based products
- fish, crustaceans or molluscs and products thereof
- Egg products
- baby and infant food
- Ice cream and semi-ice cream products
- Bread, pastry, cakes, biscuits and other bakers' wares with fillings or toppings that are not baked or heated through
- Delicatessen, raw vegetable and potato salads, marinades, mayonnaises, other emulsified sauces, nutritional yeasts
- Sprouts and germ buds for raw consumption and seeds for the production of sprouts and germ buds for raw consumption.
Resumption of activity is possible after symptoms have subsided under certain conditions. Since the excretion of Campylobacter may continue for a longer period of time (see "Duration of contagiousness"), increased attention should be paid to strict adherence to adequate hand hygiene for a period of about 4 weeks after the cessation of symptoms in order to avoid direct or indirect contamination of food. Affected persons should not work in food hygiene sensitive areas during this period. Special regulations for excretors of Campylobacter spp. do not exist, in contrast to excretors of Shigella, Salmonella, enterohaemorrhagic Escherichia coli and Choleravibriones, according to § 42 para. 1 sentence 1 IfSG.
Reference to EU Regulation 852/2004 on the hygiene of foodstuffs: According to Annex 2, Chapter VIII ("Personal Hygiene") No. 2, Sentence 1 of Regulation (EC) No. 852/2004, which contains general food hygiene regulations for food business operators, persons suffering from or carrying a food-borne disease, as well as persons with, for example, infected wounds, skin infections or lesions or diarrhoea, are generally prohibited from handling food and from entering areas where food is handled if there is a possibility of direct or indirect contamination.
Contact handling: No special measures are required for contact persons as long as they do not show enteritic symptoms.
Measures in case ofoutbreaks: In case of outbreaks it is important to identify the source of infection or the transmitting vehicle quickly in order to prevent further spread of the disease. This requires close cooperation between human and veterinary facilities. If there is a suspicion of transmission through certain foodstuffs, the public health department is obliged under § 27 IfSG to inform the competent food monitoring authority without delay. If transmission via animals is suspected, the public health department should inform the competent veterinary office.
Legal basis (obligation to report according to IfSG): According to § 7 Abs. 1 IfSG, direct or indirect evidence of intestinal pathogenic Campylobacter spp., as far as it indicates an acute infection, has to be reported by name to the public health department. Furthermore, according to § 6 Para. 1 No. 2 IfSG, the suspicion of and illness from acute infectious gastroenteritis must be reported:
- if the person concerned handles food or is employed in communal catering facilities (e.g. kitchens, restaurants) (see measures for individual illnesses), or
- if two or more similar diseases occur for which an epidemic connection is probable or suspected.
The reports must be submitted to the public health department no later than 24 hours after they become known. In § 8 IfSG the persons obliged to report are named (https://www.gesetze-im-internet.de/ifsg/__8.html). Section 9 IfSG specifies the information that may be included in the notification to the health authority by name (https://www.gesetze-im-internet.de/ifsg/__9.html).
Obligation to notify according to IfSG: According to § 34 para. 6 IfSG, managers of community facilities have to notify the responsible public health department immediately if children under the age of 6 who are cared for in their facility are infected with infectious gastroenteritis or are suspected of being infected.
Transmission: In accordance with § 11 Para. 1 IfSG, the public health department only transmits cases of illness or death and evidence of pathogens to the competent state authority that meet the case definition in accordance with § 11 Para. 2 IfSG.