The U.S. Centers for Disease Control reports that on June 29, 2011, the Wyoming Department of Health was notified of two laboratory-confirmed cases of Campylobacter jejuni enteritis among persons working at a local sheep ranch.

During June, two men had reported onset of symptoms compatible with campylobacteriosis. Both patients had diarrhea, and one also had abdominal cramps, fever, nausea, and vomiting. One patient was hospitalized for 1 day. Both patients recovered without sequelae. During June, both patients had participated in a multiday event to castrate and dock tails of 1,600 lambs. Both men reported having used their teeth to castrate some of the lambs. Among the 12 persons who participated in the event, the patients are the only two known to have used their teeth to castrate lambs. During the multiday event, a few lambs reportedly had a mild diarrheal illness. Neither patient with laboratory-confirmed illness reported consumption of poultry or unpasteurized dairy products, which are common sources of exposure to C. jejuni. The patients resided in separate houses and did not share food or water; none of their contacts became ill.

Both patients provided stool specimens for laboratory testing; C. jejuni was isolated from each. The pulsed-field gel electrophoresis (PFGE) patterns of the isolates were indistinguishable when restricted separately by two enzymes, SmaI and KpnI. This PFGE pattern had never been reported among 667 specimens from which C. jejuni was isolated in Wyoming and is rare in CDC's PulseNet*database, with a frequency of 0.09% (8 of 8,817). The low frequency of this PFGE pattern suggests that both patients were infected from a common source.

Animals at the ranch included sheep, cattle, horses, cats, and dogs; none were ill during the site visit on October 19 when investigators obtained fecal samples from five lambs. C. jejuni was isolated from two lambs; one isolate had a PFGE pattern indistinguishable from the two human isolates. C. jejuni is transmitted via the fecal-oral route; this is the first reported association of C. jejuni infection with exposure during castration of lambs. The PFGE pattern identified in these cases had not been associated with animal exposure. Ranch owners and employees were advised to use standardized, age-specific techniques for lamb castration (e.g., Burdizzo, rubber rings, or surgery) and to wash their hands thoroughly after contact with animals.