Interventions Applied at Retail, Consumer, Restaurant and Catering Settings to Reduce the Levels of <i>Campylobacter</i> spp.

FSA Research and Evidence Lay summaryThis review looks at interventions to reduce Campylobacter, bacteria which are a common cause of food poisoning, found on chicken sold in shops, cooked at home, or prepared in restaurants or catering settings.Cooking is by far the most effective way to kill Campylobacter.Heating chicken all the way through to 70°C or more reduces the number of bacteria within minutes.Chilling and freezing interventions can help reduce the number of bacteria, but they cannot make the chicken meat completely safe on their own.Their impact depends on how long the chicken is stored for and how many bacteria it was contaminated to begin with.Freezing chicken for more than three weeks tends to reduce bacteria the most.Chilling has mixed results: keeping chicken in the fridge for up to three days does not have much effect, while chilling for more than a week often is not practical as the meat will go off.A major risk of Campylobacter illness comes from cross-contamination, when bacteria from raw chicken spread to hands, utensils, cutting boards or other foods and is eaten.Studies suggest that this is potentially the most common way people get ill, followed by eating undercooked chicken.Research also shows that many people believe they are following good kitchen hygiene, but in practice, things like proper handwashing with hot water and soap do not happen as often as stated.Educational campaigns can improve food safety behaviours, but the effect does not usually last long.Longer-term approaches, such as teaching good food habits early in life and reinforcing them regularly through public health messages, may create more lasting change.Mathematical models can help identify the most important steps to reduce Campylobacter risk, but their predictions still need to be checked in real-life scenarios. Executive summaryThis systematic review discusses interventions to reduce the levels of Campylobacter spp. in retail, consumer, restaurant and catering settings in relation to chicken meat, focusing on three main intervention typescooking, chilling and freezing, and one risk factor -cross-contamination.Cooking remains the most reliable intervention, particularly at temperatures at or above 70°C, which consistently eliminate Campylobacter within minutes.Refrigeration and freezing offer moderate reductions but are not sufficient as standalone interventions.Their effectiveness is influenced by storage duration and initial contamination levels, with freezing for more than 3 weeks offering consistently larger reductions in bacterial levels compared to chilling.The effects of refrigeration vary widely -for three days or less in particular, while longer periods of more than seven days may be impractical.Consumer handling of raw chicken poses a significant risk of Campylobacter cross-contamination, with modelling studies predicting crosscontamination as the main pathway for campylobacteriosis (rather than undercooking).Observational studies reveal a gap between reported and actual hygiene behaviours, with proper handwashing (hot water and soap) inconsistently practiced.Short-term educational interventions improve behaviour temporarily, but sustained change may require a different approach such as early food safety education and continuous reinforcement through public health messaging.Modelling studies can guide prioritisation of interventions for risk reduction, but the predictions need validation with experimental studies.Campylobacter was the most common bacterial pathogen (9.3 cases per 1000 person-years in the community, and 1.3 General Practice consultations per 1000 person-years), and the most identified pathogen Interventions Applied at Retail, Consumer, Restaurant and Catering Settings to Reduce th… FSA Research and Evidence (13%), in the Out of General Practice Presentation study forming part of the second Infectious Intestinal Disease project in the UK (Tam et al., 2012).While laboratory-confirmed campylobacteriosis remained relatively steady at approximately 100 cases per 100,000 population between 2014 and 2023 (UKHSA, 2024), recently the UK Health Security Agency (UKHSA) reported that notification rates in England have risen from 60,055 cases in 2023 to 70,352 cases in 2024, or approximately 120 cases per 100,000 (UKHSA, 2025).This Food Standards Agency (FSA) report focuses on interventions to control Campylobacter at retail, restaurants, catering establishments and consumer kitchens.Commercial kitchens in the UK are expected to adhere to strict standards, including 4 Cs (cleaning, cooking, chilling, and crosscontamination), and food safety and hygiene requirements when preparing food, with extra consideration given to the preparation of raw meat including poultry (Dephna, 2021;FSA, 2018; GOV.UK, n.d.).The FSA provides guidance on handling and preparing food safely in the kitchen environment (FSA, 2023).For consumers, advice focuses on everyday behaviours to reduce illness, such as hand washing, thorough cooking, chilling, and avoiding cross-contamination (FSA, 2023).Answers to common home myths are also provided (FSA, 2024).Guidance for food businesses, including retailers, is available (FSA, 2024; UK Government, 2025).This guidance includes encouragement to implement a Food Safety Management System based on principles of Hazard Analysis and Critical Control Points (HACCP), with procedures such as cleaning schedules, inspections, and staff training.Cold temperature interventions, such as chilling and freezing, are widely used in poultry processing to control or prevent the increase of Campylobacter spp., other pathogens and spoilage organisms (Dogan et al., 2021;James et al., 2006;Leone et al., 2024). .The lack of cold shock proteins such as CspA, which help bacteria survive exposure to low temperatures (Hur et al., 2022), may explain the particular susceptibility of Campylobacter to chilling and freezing interventions.These cold temperature interventions are applied at different processing stages, including slaughterhouse, cutting and processing plants, retail, consumer, restaurants and catering.The effects of chilling and freezing are collectively discussed in this report.Cross-contamination remains a major food safety concern.The risk persists in domestic kitchens, restaurants, catering, and other food establishments because harmful bacteria can easily transfer from raw poultry to ready-to-eat foods, utensils, hands and surfaces during food preparation.This is because most of the Campylobacter is present at high levels on the surface of the raw chicken (Luber et al., 2006;MacDonald et Interventions Applied at Retail, Consumer, Restaurant and Catering Settings to Reduce th… FSA Research and Evidence