2 comments — live from bluesky
Exposure ≠ infection ≠ disease
We often talk about “Campylobacter infection” as though it were a single event.
But there are several steps:
exposure → colonisation/infection → symptoms → clearance/persistence → possible sequelae
In many high-income settings, #Campylobacter is familiar as an acute gastroenteritis:
🤒 diarrhoea, abdominal pain, fever usually resolving within days.
But the cases we diagnose are only the visible part of the biology.
In high-burden settings, #Campylobacter can be detected repeatedly in children without diarrhoea.
In MAL-ED, ~85% of children across eight low-resource settings had experienced at least one Campylobacter-positive stool by their first birthday.
📝 journals.plos.org/plosntds/art...
no diarrhoea ≠ no effect.
Repeated/subclinical #Campylobacter infection has been associated with intestinal inflammation, increased permeability and poorer linear growth in young children.
📝 journals.plos.org/plosntds/art...
And carriage isn't always brief.
In a later MAL-ED analysis, almost half of children experienced at least one episode defined as persistent #Campylobacter infection during their first two years of life.
📝 www.thelancet.com/journals/ecl...
For some people, the story doesn't end when the acute infection clears.
#Campylobacter is associated with several post-infectious complications, including Guillain–Barré syndrome (GBS) a rare autoimmune neuropathy that can follow C. jejuni infection.
🏥 www.mayoclinic.org/diseases-con...
GBS also shows us that strain biology matters.
Certain C. jejuni surface structures can resemble human nerve gangliosides. The immune response generated against the bacterium can then cross-react with peripheral nerves.
So two #Campylobacter infections do not carry the same risk.
A more common longer-term consequence is post-infectious irritable bowel syndrome.
In one large cohort of culture-confirmed #Campylobacter cases, around 21% of respondents without pre-existing IBS met criteria for PI-IBS 6–9 months later.
📝 www.nature.com/articles/s42...
Why does one exposure produce no symptoms, another severe diarrhoea, and another a lasting complication?
Probably some combination of:
🦠 bacterial genotype
🧬 bacterial dose & diversity
👤 host genetics/immunity
🦠 microbiome
🌍 repeated exposure/environment
👶 age and prior infection
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