Hawaii a hotbed
of bacterial illness

Health Department reports
Hawaii has top rate
of infections

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By Helen Altonn
Star-Bulletin staff

Hawaii has the highest rate in the nation of infections with Campylobacter, the most common cause of bacterial food-borne illness in the United States, the state Health Department reports.

An Epidemiology Branch study on risk factors for the illness shows it's caused here by eating commercial chicken or taking antibiotics for an unrelated problem.

The Health Department said reports in Campylobacter infections have increased significantly in the past decade, with 834 cases last year. Many more cases occur that aren't diagnosed, the department said.

About 2.5 million people -- about 1 percent of the U.S. population -- are infected every year with C. jejuni, the Health Department said. It causes mild illness with diarrhea, abdominal pain, vomiting and fever. More serious conditions may follow in some cases, resulting in reactive arthritis, Guillain-Barre Syndrome and death.

Economic consequences of the illness in medical expenses and lost productivity are considerable, the Health Department pointed out.

Dr. Paul Effler, state epidemiologist, said, "The study was initiated because, given Hawaii's high rates of infection, we felt it was important to try and identify the major risk factors for Campylobacter illness so that we can develop strategies to prevent such infections in the future."

He said, "The association with commercially prepared chicken has never been reported in the United States, but investigators in New Zealand have seen it there."

A federal grant from the Centers for Disease Control and Prevention supported the study, published in the April 1 issue of the Journal of Infectious Diseases.

Contamination with Campylobacter is believed to occur in the slaughtering process.

Effler said the association of C. jejuni infection with commercially prepared chicken is important because the relatively high number of persons reporting the exposure means even a slightly increased risk from that source could result in many infections.

Also, he said, previous strategies for controlling Campylobacter usually focused on chicken cooked in the home, rather than commercially.

He said working with restaurants will require adequate resources for public health agencies to identify and correct food handling violations.

Consumers are advised to thoroughly cook poultry, with all parts reaching 165 degree for at least 15 seconds, and avoid recontamination of the poultry after cooking.

Effler said the finding that prior antibiotic use is connected with Campylobacter illness supports recommendations for judicious use of antibiotics.

"Antibiotics have the ability to disrupt the body's normal defenses against gut infections," he said.

"If the antibiotics are really needed to treat an infection, then that's a small risk to take. But if the antibiotics are being taken unnecessarily, we are potentially exposing ourselves to other infections, creating more problems."