Group 7: Maggie O’Neill, Hannah Manning, Allyson Smith, Caroline

Heathcock

Traveler’s Diarrhea 
Campylobacter jejuni 
Campylobacter jejuni is a bacteria that causes humans and animals to
become violently ill; those infected with C. jejuni bacteria can contract traveler’s diarrhea,
which is the most common travel-related illness.
This is not often a life-threatening disease, but it
can be if not treated properly. Some of the more
serious symptoms of traveler’s diarrhea include
frequent, violent diarrhea, often watery and
bloody, nausea, fever, and vomiting. This can lead
to extreme dehydration and loss of essential
minerals that human bodies need to function.
Therefore, if not given proper fluids, fatality is not
out of the question.

Contraction 
Traveler’s diarrhea through C. jejuni is contracted
through the oral-fecal route, often by consuming
contaminated food or water.

Who does it affect? 

Travelers’ diarrhea (TD) remains a prevalent illness impacting individuals both inside of the
United States and individuals visiting developing countries. Most studies conducted up to this
point have focused on individuals on vacation or away on business for a short duration of
time. This study included the cases of long term travelers, specifically military personnel
compared to non-military personnel” who also contracted traveler’s diarrhea. There is a
decline in the number of cases among short term travelers having contracted traveler’s
diarrhea, while the number of cases among long term travelers remains constant. This
 
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change among short term travelers could be due to increased awareness and
prevention tactics, but long term travelers have a harder time maintaining this tactics.
The results of the study found that Sixty-two percent of tested (69% military personnel and
34% nonmilitary personnel) cases were due to bacterial pathogens, with enterotoxigenic ​E.
coli​, enteroaggregative E​ . coli​, and C
​ ampylobacter ​predominating. The data shows 36.3
cases per 100 people per month, with the highest rates in Southeast Asia, Latin America
and the Caribbean, and the Middle East. Scientist found that C ​ ampylobacter, especially in
South East Asia) ​ is the most common pathogen causing TB when comparing all pathogens
linked to TD.

Prevention and Protection

Many vaccines have been tested in various stages of development to combat Traveler’s
Diarrhea caused by Campylobacter jejuni. Several of these vaccines showed no proof of
protection against traveler’s diarrhea once in the Phase II human testing area; the
frontrunner of the C. jejuni vaccines right now, however, is a capsule-conjugate vaccine,
which utilizes TI-2 antigens that do not cause strong immune reactions and link them with
carrier proteins; this stimulates a greater immune response and increases the production of B
memory cells to create more antibodies upon subsequent infection. This vaccine seems to be
very promising, as capsule-conjugate vaccines have a good history of being effective and
safe; the vaccine specifically for C. jejuni is still in Phase 1 testing, so there is no current
evidence of how effective the vaccine is on humans, what the side effects would be, and
how much the vaccine helps in prevention of diarrhea. In the preclinical phase, however,
they tested two groups of non-human primates -- 14 monkeys were given the vaccine and
10 were not as a control group. The efficacy of the vaccine in this testing was very
promising. 100% (14/14) of the primates who were given the vaccine showed significant
protection, with no diarrhea, while 70% (7/10) of the primates who were not given the
vaccine developed diarrhea. This preclinical testing indicates an
extremely good chance that this conjugate vaccine is immunogenic
and will be effective in preventing traveler’s diarrhea caused by C.
jejuni in humans.

Until a vaccine is fully developed and approved health professionals

recommend that you be diligent in educating yourself. Discover what
areas around the world are high risk for contracting bacterial
pathogens linked to TD. Always wash your hands with soap and

 
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clean water. Do not eat or drink food from an unknown, unreliable source. Above all
make sure you are protecting yourself and your body.

Conclusion? 
A vaccine is currently in production, with no data yet to suggest the level of preventable
cases, but it can be said that a vaccine would drastically lowers the number of cases
reported by long term travelers​.

References
1)

“Campylobacter (Campylobacteriosis).” ​Centers for Disease Control and Prevention​, Centers

for Disease Control and Prevention, 6 Aug. 2019,​ ​www.cdc.gov/campylobacter/index.html​.

C: The page was last reviewed October 2, 2017. This topic was reviewed very recently and
therefore works for this topic, especially because it is a disease and typically symptoms and facts
about it does not change.
R: The source was all fact based and did not use any bias when talking about the disease. The
author used several other sources such as the CDC and the NCEZID. The source informed the
public about what this disease is and how to treat it.
A: The author works for the CDC publishing company and therefore is a very reliable source.
P: The purpose is to inform the public about the symptoms and the prevention of this disease.
There was no bias about this issue.

2)

Maue, Alexander C. “A Capsule Conjugate Vaccine Approach to Prevent Diarrheal Disease

Caused by Campylobacter Jejuni.” ​Taylor & Francis Online,​ Taylor & Francis, 14 Mar. 2014,
www.tandfonline.com/doi/full/10.4161/hv.27985​.

C: This article was published in 2014, which is a little old for my taste. The information in it,
however, is very thorough and well searched and after searching the internet for updated
information, this information seems to be the most up to date regarding the creation of this
vaccine.

 
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R: I find this source very reliable. It is on Taylor & Francis online which is an international
company that publishes academic journals. Because it is in an academic journal and was
peer-reviewed and is a primary source, I find the information to be reliable and accurate.
Additionally, there were no advertisements on the website and Maue’s references were
extensive.
A: Alexander C. Maue is an avid researcher who does a lot of research regarding vaccines
surrounding the different types of bacteria that cause Traveler’s Diarrhea. He has done several
studies with the University of Missouri and with the Naval Medical Research Center, which is
very well-renowned.
P: The purpose of this article was to inform about a new vaccine to protect against Traveler’s
Diarrhea caused by C. jejuni that is about to enter human testing. It elaborates on the preclinical
trials and how previous attempts at creating a vaccination were approached. Additionally, the
article touches on where vaccination attempts for C. jejuni might go in the future.

3)

Olson, Scott, et al. “Travelers' Diarrhea: Update on the Incidence, Etiology and Risk in Military
and Similar Populations - 1990-2005 versus 2005-2015, Does a Decade Make a Difference?”
Tropical Diseases, Travel Medicine and Vaccines,​ BioMed Central, 15 Jan. 2019,
www.ncbi.nlm.nih.gov/pubmed/30675367​.

C: The study was approved and published in January of 2019. Since this is a recent article, it is
also very relevant, however the study compares data from 2005 to 2015. Covering the span of a
decade, the data is comprehensive and very detailed. However, it would be more current if
statistics from the past 3 years had been included.
R: The study contains numerous references, data tables, and charts to support its findings. It is
rooted in facts and converse the contraction of travelers diarrhea abroad and within the U.S.
A: The authors of the study consists of a four notable and reputable scientists who are respected
within their community, well educated, and specialists in their field. However, they are all
citizens and scientists of the United States, a scientist who lives abroad and can speak to more
specific case studies in his or her region.
P: The purpose is to raise awareness among the public that if although short term travelers
contract traveler’s diarrhea, long term travelers are at greater risk due to the duration of their
visit and the prolonged exposure to bacterial pathogens.

 
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