Infectious diseases

Infectious diseases

This page tells you about infectious diseases notification and our investigation service.

Infectious diseases

The law requires doctors to notify us and the health authority of cases of certain infectious diseases.

To protect public health, we investigate cases of food-related infectious disease:

  • to find, if possible, the cause
  • minimise the risk of infection
  • consider links between individual cases
  • investigate with commercial food procedures any links with cases or outbreaks
We work closely with the Public Health England and neighbouring authorities, especially when an outbreak occurs.

E. coli 0157
What is it?
E.coli are a group of bacteria that dwell in the intestines of people and animals. Most types are harmless, but one type, 0157, produces a poison that can cause serious illness.

What are the symptoms?
Symptoms may include diarrhoea (blood is commonly present), high temperature and shivering, severe stomach pain, and you may stop passing urine.

How did I catch it?
Eating or drinking anything containing the E.coli.0157 bacteria. As it comes from animals, eating food that is raw or undercooked, and unpasteurised milk, could be the causes. Other sources are infected people, or through handling infected animals.

How long does it last?
The illness usually starts one to six days after eating contaminated food. The length of time varies, but it can last several weeks.

How is it treated?
Antibiotics are not prescribed for this illness. Therefore, it is important to keep drinking fluids to stop dehydration, and take plenty of rest. If diarrhoea persists, especially if blood or mucus is present, return to your doctor. Hospital treatment is sometimes necessary for more severe symptoms.

Can I give it to someone else?
Yes, it is possible to pass the illness on, so you should take every precaution to prevent this from happening. Good personal hygiene reduces the risk of transferral.

When can I go back to work/school/nursery?
You must not work if you are ill. If you work with food, attend school or care for vulnerable people, you will be asked to provide further faecal specimens before returning. You must still maintain good personal hygiene when you return.

What can I do to prevent getting it again?
Food:
  • If you are ill, avoid preparing food.
  • Ensure all meats are thoroughly cooked, with no pink meat present.
  • Don’t spread the organism from raw to ready-to-eat food such as cold meats/salad.
  • Clean and disinfect worktops after preparing raw meat.
  • Ensure your fridge/freezer is working properly. The temperatures should be 1-4ºC and minus 18ºC respectively.
Everyone in the household should take care to wash their hands properly with soap and rinse them under running water after using the toilet and:
  • after clearing up diarrhoea
  • after nursing ill people
  • after handling laundry or changing nappies
  • before cooking or eating
  • during the preparation of food
Antibacterial soap is an additional precaution.

How to avoid infection when visiting leisure farms?
Current opinion is it should be assumed all cattle, sheep, goats and deer carry E.Coli.0157 and it is found in other animals, such as birds. Effective hand washing after contact is therefore, essential.

What should leisure farms do?
Farmers are directed to the Health and Safety Executive’s website that contains guidance on avoiding ill health at open farms.

Further information can be found on the Public Health England website. Alternatively, you can contact us. 

Please see below for general information on cleaning up and prevention.
Salmonella

What is it?
Salmonella are bacteria often found living in food. With more than 2,000 types, salmonella is one of the most common causes of food poisoning.

What are the symptoms?
You may have suffered:

  • severe diarrhoea
  • headaches
  • abdominal pain
  • high temperatures
  • vomiting
The illness usually starts 12 to 36 hours after eating contaminated food. Symptoms do not necessarily show in all people who have eaten the same food.

How did I catch it?
The usual way is eating or drinking anything containing salmonella bacteria. As it can be found in the intestines of wild and domestic animals, as well as humans, it can be caught by eating foods like:
  • raw/undercooked meat, poultry and eggs
  • unpasteurised milk
  • contaminated water
You can also get it from:
  • infected people, especially if they handle food
  • handling infected animals including farm animals, pets, reptiles and amphibians

How long does it last?
It can last for several days or weeks, and in some cases months, as the person becomes a temporary carrier.

How is it treated?
In most cases, symptoms clear without treatment; although to help poorly young children and elderly people recover their doctor may prescribe antibiotics. It is important to keep hydrated with drinking water, diluted squash and clear fluids.

Can I give it to someone else?
It is possible, but rare. Good personal hygiene reduces the risk of passing it on.

When can I go back to work/school/nursery?
You should stay away until sickness and diarrhoea has stopped for 48 hours. You must still maintain good personal hygiene when you return. Consult your doctor if symptoms persist.

Please see below for general information on cleaning up and prevention.

Viral gastroenteritis

What is it?
Also known as ‘winter vomiting disease’ this illness is caused by a number of different viruses including rotavirus, norwalk and noroviruses.

What are the symptoms?
Symptoms vary but include:

  • diarrhoea, often watery
  • nausea
  • vomiting, which may be projectile
  • stomach pain and cramps
  • headaches
  • fever
Symptoms appear, usually around 12 to 48 hours post infection.

How did I catch it?
The most common sources are:
  • infected people (especially in groups)
  • vomit or faeces of infected people
  • airborne spread
  • eating or drinking anything contaminated, particularly raw and undercooked foods like shellfish

How long does it last?
Symptoms can last several days, but are usually gone after one or two days.

How is it treated?
There is no specific treatment for the virus, but it is important to keep hydrated and take plenty of rest.

Can I give it to someone else?
Yes, sneezing, coughing, diarrhoea and vomiting can spread the virus like an aerosol and contaminated hands can spread the virus, so hand washing is vital. Indirectly, contaminated surfaces such as toilet seats, handles, taps and switches can transfer the virus. These should be cleaned regularly.

When can I go back to work/school/nursery?
Because these viruses spread easily, you should avoid work, school, nursery or social gatherings for 48 hours after the diarrhoea has stopped.

Please see below for general information on cleaning up and prevention.

Cryptosporidium

What is it?
Cryptosporidium is a microscopic parasite found in contaminated water.

What are the symptoms?
The symptoms may vary, but yours may have included:

  • diarrhoea–profuse and watery
  • stomach pain and cramps, feeling bloated
  • headache
  • flu-like symptoms with aching limbs
  • weight loss
How did I catch it?
The illness can be caught from:
  • drinking untreated water from streams, rivers, lakes
  • infected people
  • infected animals

How long does it last?
Symptoms can start between one to 12 days after becoming infected, and can last up to three weeks.

How is it treated?
There is no specific treatment for cryptosporidium. It is important to take plenty of rest and drink plenty of fluids. If you are concerned about the severity of your symptoms, or the length of time you have been ill, return to your doctor.

Can I give it to someone else?
Yes, as the organism appears in faeces, unwashed hands can spread infection.

When can I go back to work/school/nursery?
Stay away until the diarrhoea has stopped for 48 hours. You must still maintain good hygiene upon your return.

Please see below for general information on cleaning up and prevention.

Dysentery (shigella)

What is it?
Dysentery is an infectious disease of the large intestine, of which there are two types: amoebic, which is rare in Britain but can be contracted when travelling, and bacterial dysentery, the most common which is also known as ‘shigella’. It is highly contagious.

What are the symptoms?
The symptoms vary, but may include:

  • mild or severe diarrhoea, often containing blood and/or mucous
  • vomiting
  • stomach cramps
  • fever
How did I catch it?
Very easily, it only takes a small number of bacteria to cause infection. You may have caught it from:
  • another infected person
  • drinking or eating contaminated food/water

How long does it last?
Symptoms usually start between six hours and three days after becoming infected and the illness may last for up to two weeks.

How is it treated?
It is important to keep drinking to stop dehydration. If you are extremely poorly, return to your doctor.

Can I give it to someone else?
Yes, infection can happen easily if you don’t practice good hygiene. As the organism appears in faeces, hands that are unwashed after using the toilet or changing nappies can spread infection.

When can I go back to work/school/nursery?
You should stay away until the diarrhoea has stopped for 48 hours. Those who care for vulnerable people will be asked to provide further faecal specimen. You must still maintain good personal hygiene when you return.

Please see below for general information on cleaning up and prevention.

Listeria

What is it?
A bacteria commonly found in vegetation, water, soil, dust, mud and silage. It is also found in the faeces of infected humans and animals.

What are the symptoms?
Most people may have mild flu-like symptoms, or show no symptoms at all. For the very young or elderly, pregnant women and those already suffering illnesses, the symptoms can be severe:

  • fever
  • headache
  • sickness
  • diarrhoea
  • miscarriage or still-birth
The symptoms may take up to 70 days to develop; on average it is usually three weeks.

How did I catch it?
The usual way is eating or drinking something containing listeria bacteria, such as:
  • unpasteurised milk
  • soft cheese made from unpasteurised milk
  • contaminated vegetables
  • ready-to-eat meals that require heating

How long does it last?
The illness may last for seven to 10 days depending on the individual.

How is it treated?
In most cases, symptoms clear without treatment. Vulnerable people may be prescribed antibiotics. It is important to keep drinking to stop dehydration.

Can I give it to someone else?
While possible, this is rare. Good personal hygiene reduces the risk of transferral.

When can I go back to work/school/nursery?
You should wait until your symptoms have stopped for 48 hours. You must still maintain good personal hygiene when you return.

Please see below for general information on cleaning up and prevention.

Staphylococcus aureus

What is it?
Staphylococcus bacteria cause food poisoning by producing toxins in food. They are found on the skin and hair of most people and in infected cuts, spots and boils.

What are the symptoms?
The symptoms but may include:

  • severe nausea or vomiting
  • diarrhoea
  • stomach cramps

Symptoms usually start two to six hours after consumption of the bacteria and can be very severe.

How long does it last?
Symptoms last between 12 hours and two days.

How is it treated?
There is no specific treatment, but it is important to keep hydrated and taking plenty of rest.

Can I give it to someone else?
Direct spread is unusual, but as the organism is present on human skin and hair, and unwashed hands can spread the infection.

When can I go back to work/school/nursery?
Do not return until the diarrhoea has stopped for 48 hours. You must still maintain good personal hygiene when you return. Children should not return to school until symptoms have stopped.

Please see below for general information on cleaning up and prevention.

Suspected food poisoning

What is it?
Food poisoning is a general term given to illness that occurs after eating anything contaminated with germs or poison. A single episode or diarrhoea, or vomiting in a 24-hour period, may not be considered as such.

What are the symptoms?
You may suffer from:

  • diarrhoea (frequent loose motions)
  • nausea and vomiting
  • stomach pains
  • fever
The occurrence of the symptoms can vary from a few hours to a few days depending on the cause.

How did I catch it?
The usual way is eating or drinking anything containing the bacteria or toxins produced by certain bacteria and viruses.

You can also get it from:
  • infected people, especially in food handling
  • handling infected animals
  • eating contaminated food
  • drinking contaminated water

How long does it last?
The illness can last for several days or weeks and, in some cases, months as the person becomes a temporary carrier.

How is it treated?
In most cases, symptoms clear without treatment. To help poorly young children and elderly people recover, their doctor may prescribe antibiotics. If symptoms persist or become severe seek medical advice.

Can I give it to someone else?
It is possible to pass the illness on. Good personal hygiene will reduce the risk of passing it on to others.

When can I go back to work/school/nursery?
Do not return to school or work until symptom free for 48 hours. If you handle food in the course of your work, you must inform your employer.

Please see below for general information on cleaning up and prevention.

Hepatitis A

What is it?
An infection of the liver caused by a virus, it is more common in children, but adults can be infected if they have not been previously exposed. Following this type of hepatitis, you are immune to further attacks.

What are the symptoms?
It is generally a mild illness and often there are no symptoms, especially in children, but can include:

  • jaundice
  • diarrhoea and vomiting
  • dark-coloured urine
  • upper stomach pain
  • fever

How did I catch it?
The virus is shed in the faeces of an infected person. It can get onto the hands after going to the toilet, so hand washing is essential, as the virus can spread by direct contact with another person, or by contaminating food.

Outbreaks of hepatitis A can occur in nurseries, play groups and infant schools. Immunoglobulin may be offered to prevent the spread of illness among child and adult contacts in the community.

How long does it last?
Anywhere up to 40 days, you are most infectious just before symptoms show and one week afterwards.

What should I do?
If you are a food handler and you, or members of your household have hepatitis A, you must inform your employer and avoid preparing/serving food while symptomatic. It is vital to wash your hands.

Can I give it to someone else?
Maximum infectivity is just before the symptoms show and for the few days after onset of jaundice. Most people are non-infectious after the first two weeks of jaundice.

When can I go back to work/school/nursery?
Do not return to work or school until one week after symptoms or jaundice occur. This applies to children attending nurseries.

Please see below for general information on cleaning up and prevention.

Legionella

What is legionnaires' disease?
Legionnaires' disease is a type of pneumonia caused by a bacterial infection.

What are the symptoms?
The range of symptoms include a 'flu-like' illness with muscle aches, tiredness, headache, loss of appetite, dry cough and fever, leading on to pneumonia.

How serious is the disease and how common is it?
It is a rare, but serious illness. Deaths may occur in approximately 10 to 15% of otherwise healthy individuals and the number of reported deaths may be higher in certain groups, such as those with weakened immune systems.

Why is it called legionnaires' disease?
An outbreak occurred in Philadelphia in 1976 among people attending a state convention of the American Legion, which led to the naming of the disease. Subsequently, the bacterium causing the illness was identified and named Legionella Pneumophila.

Is this a new disease?
No. While the bacterium causing the disease was only identified in 1976, cases have been confirmed as far back as 1947 and some probably also occurred before then.

How widespread is the disease?
Cases have been reported from all industrialised countries and are increasing in most countries annually. Between 400 and 550 cases have been reported in England and Wales in recent times – however, around one third of these were infected outside of England and Wales as a result of travel.

Where are legionella bacteria found?
Bacteria are widely distributed in the environment and have been found in ponds and rivers. Problems arise when they contaminate man-made water systems.

How is legionnaires' disease acquired?
The infection is not contagious but can spread through the air from a contaminated water source. Breathing in the bacteria from a contaminated water system is the usual route of infection. Aspiration can be the source of infection in rare cases.

Who gets legionnaires' disease?
All ages can be affected but it mainly affects people over the age of 50 years and men more than women. Heavy smokers are also at risk from the disease.

How soon do symptoms occur?
The incubation period ranges from two to 10 days, typically five to six days. In rare cases, some people may develop symptoms as late as three weeks after exposure.

What is the treatment?
Antibiotics against the infection are effective in treating the disease.

How is it diagnosed?
A rapid diagnosis can be made by testing a urine sample from the patient.

What should I do if I think I have legionnaires' disease?
If you believe you have this infection, inform your doctor, so the appropriate investigations can be started.

How is legionnaires' disease prevented?
The UK has strict regulations to ensure water systems used for air cooling or for use in commercial, tourist and other buildings or settings are maintained to standards that minimise risk from the disease and do not harbour bacteria that cause Legionnaires' disease.

If you are an employer, or someone in control of premises, you must understand the health risks associated with legionella.

Please see below for general information on cleaning up and prevention.

How to clean up
  • When cleaning contaminated surfaces, wear rubber gloves and take care.
  • Scoop up loose materials using an improvised scraper, or paper towel.
  • Rinse down a WC bowl – don’t use a sink that is used for food prep or washing.
  • Wash what is left on the surface with warm soapy water.
  • Pour down a WC bowl afterwards.
  • Clean all equipment used with dilute bleach (one egg cup in a small bucket of warm water).
  • Wash fouled sheets/clothing immediately, ensuring not to touch the dirty parts.
  • Wash on a hot wash as soon as possible.
Household hygiene is extremely important. Disinfect the WC area, particularly the flush handle, basin taps and light switches. Pour bleach around the toilet bowl and into the basin trap. Ensure everyone uses their own towel and face cloth.
How to prevent getting it again
  • If you are ill, avoid preparing food. 
  • Ensure all meats are thoroughly cooked, with no pink meat present.
  • Don’t spread the organism from raw to ready-to-eat food such as cold meats/salad.
  • Clean and disinfect worktops after preparing raw meat.
  • Ensure your fridge/freezer is working properly. The temperatures should be 1-40C and minus 180C respectively.
Everyone in the household should take care to wash their hands properly with soap, and rinse them under running water after using the toilet and:
  • after clearing up diarrhoea
  • after nursing ill people
  • after handling laundry or changing nappies
  • before cooking or eating
  • during the preparation of food
Antibacterial soap is an additional precaution.