April increase in cases of diarrhoea linked to school holidays and visits to petting farms
Every year during April, Public Health England sees a rise in cases of a diarrhoeal illness caused by a bug called cryptosporidium.
Cryptosporidium is a parasite that can be found in soil, water, food or on any surface that has been contaminated with human or animal faeces.
Anyone can get cryptosporidiosis but it is most common in children aged between 1 and 5 years old. The peak in cases in the spring is partly associated with children handling animals and feeding lambs at petting farms and not washing their hands properly afterwards.
To help avoid unnecessary illness, Public Health England (PHE) wants to remind everyone visiting farms to wash their hands thoroughly using soap and water after they have handled animals and before eating or drinking.
Between January and May 2013 there were 11 outbreaks of cryptosporidiosis associated with petting farms across England affecting around 150 people. Over the past 20 years, an average of around 80 cases* of cryptosporidium infection linked to visits to petting farms have been reported to PHE each year.
The symptoms of cryptosporidiosis are typically watery diarrhoea and stomach pains. There is no specific treatment for the illness which is usually self-limiting, although it is important that anyone with the illness keeps hydrated.
Cryptosporidium is only one of a number of bugs that can be found in a farm environment that can cause illness. Others include a strain of ‘E. coli’ known as Vero cytotoxin producing ‘Escherichia coli’ (VTEC) and salmonella.
The seasonal increase in cases of VTEC linked to animal contact is usually between March and October. An infection with VTEC can cause a range of symptoms from mild gastrointestinal illness or in serious cases it can lead to bloody diarrhoea which can cause serious illness. Between 2010 to 2012 there were 40 people affected with VTEC linked to petting farms. There were no cases linked to outbreaks in 2013.
Dr Bob Adak, head of gastrointestinal diseases at PHE, said:
Around 2 million people visit farm attractions each year so the number of people who become ill is proportionally quite small. However, these cases of illness could be easily avoided by practicing good hand hygiene.
Any contact with farm animals carries a risk of infection because of the microorganisms - or germs - they naturally carry which are invisible to the naked eye. People may be tempted to use hand gels and wipes during a farm visit and after touching animals but these are not suitable for removing the sort of germs found on farms and it is very important to remember not to rely on these for removing germs on the hands.
By being aware and by doing these simple things we can help to avoid illness and enjoy a fun day out.
Owners and managers of farm attractions are also strongly recommended to make use of the Industry Code of Practice on how to protect visitors and staff from illness, to ensure they are doing enough to comply with the law. Teachers and others who organise visits for children at farm attractions should be encouraged to read the guidance aimed at them and farms should ensure that they have adequate signage reminding visitors about the important of hand washing after touching the animals or their surfaces.
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Notes to Editors
- ‘E. coli’, Salmonella and Cryptosporidium live in the gut of the animals so people can get infected within the farm setting mainly in 2 ways – either by touching animals in the petting and feeding areas or by coming into contact with animal droppings on contaminated surfaces around the farm. These harmful bacteria can get accidentally passed to your mouth by putting hands on faces or fingers in mouths before washing them thoroughly. It only takes a small number of the bacteria to cause infection.
- There is a second annual peak in cases of cryptosporidium and this tends to occur after the summer holidays in September and is related to travel.
- *Data from review of 55 outbreaks of intestinal disease at petting farms between 1992 and 2009. Gormley et al (2011). Transmission of Cryptosporidium spp. at petting farms, England and Wales. Emerging Infectious Diseases
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Public Health England, Department for Environment, Food and Rural Affairs, and Department of Health have produced advice for the public on how to enjoy farm visits safely: ‘Avoiding infection on farm visits
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A summary of the guidance found in the leaflet is as follows:
- do not put hands on faces or fingers in mouths while petting animals or walking round the farm
- do not kiss farm animals nor allow children to put their faces close to animals
- do not eat or drink while touching animals or walking round the farm. This includes not eating sweets, crisps or chewing gum
- do not eat anything that has fallen on the floor
- do not use gels or wipes instead of washing hands with soap and water. Gels and wipes do not remove ‘E. coli’ O157 that is in dirt
- do wash your hands thoroughly with soap and water after you have touched animals, fences or other surfaces in animal areas
- do wash your hands thoroughly with soap and water before eating or drinking
- do remove and clean boots or shoes that might have become soiled and clean pushchair wheels. Then wash your hands thoroughly with soap and water
- do supervise children closely to ensure that they wash their hands thoroughly
- do eat and drink in picnic areas or cafes only
- Updated guidance ‘Preventing or controlling ill health from animal contact at visitor attractions – Industry Code of Practice’ can be found on the Farming and Countryside Education website
- Public Health England’s mission is to protect and improve the nation’s health and to address inequalities through working with national and local government, the NHS, industry and the voluntary and community sector. PHE is an operationally autonomous executive agency of the Department of Health.
www.gov.uk/phe Follow us on Twitter @PHE_uk
UKHSA press office: National Infection Service
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Image courtesy of David Powell, used under creative commons.