INFECTIOUS DISEASES
FACT SHEETS
Introduction to Health Protection
A Health Protection Team are responsible for the surveillance, investigation and control of communicable disease
and non-infectious environmental hazards. An outbreak is defined either as two or more linked cases of the same
illness or when the observed number of cases exceeds the number expected. All suspected outbreaks should be
reported to the Health Protection Specialist in your area.
There are specific diseases that require the diagnosing doctor to notify to the Health Protection Team under Public
Health Legislation. If you are in any doubt you should contact the Health Protection Specialist for your area.
Ayrshire and Arran NHS Board
Greater Glasgow NHS Board
Greater Glasgow NHS Board
Public Health Specialist
Boswell House, 10 Arthur St
Ayr KA7 1QJ
Tel : 01292 885829
Fax : 01292 885890
E mail : HamiltonL@aapct.scot.nhs.uk
Health Protection Nurse Specialist
Dalian House PO Box 15327
350 St Vincent Street
GLASGOW G3 8YZ
Tel: 0141 201 4917
Fax: 0141 201 4950
E -mail:monica.maguire@gghb.scot.nhs.uk
Health Protection Nurse Specialist
Dalian House PO Box 15327
350 St Vincent Street
GLASGOW G3 8YZ
Tel: 0141 201 4909 Fax: 0141 201
4950
Email:vincent.mckeown@gghb.scot.n
hs.uk
Health Protection Scotland
Lanarkshire NHS Board
Nurse Consultant Infection Control
Health,
Clifton House
Clifton Place Glasgow G3 7LN
Telephone:0141 300 1165
E-mail joan.sneddon@hps.scot.nhs.uk
Public Health Infection Control Nurse
14 Beckford Street
HAMILTON ML3 0TA
Tel: 01698 206351 Fax: 01698 424316
E-mail: jean.kerr@lanarkshire.scot.nhs.uk
Please Note:
The following fact sheets must be read respecting the health status
of individuals and with the consideration to any individual risk assessments.
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INFECTIOUS DISEASES
FACT SHEETS
Contents List
001 Chicken Pox
002 Clostridium Difficile
003 Common cold
004 Crabs
005 Fleas
006 Glandular Fever
007 Headlice
008 Hepatitis A
009 Hepatitis B
010 Hepatitis C
011 HIV/AIDS
012 Influenza (Flu)
013 Meningitis
014 M.R.S.A
015 Scabies
016 Shingles
017 Tetanus
018 Toxoplasmosis
019 Tuberculosis
020 E-Coli 0157#
021 Legionnaires` Disease
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Fact sheet – 001
Chicken Pox
What is Chicken Pox
It is a contagious illness, common in children. Someone who has had chicken pox gains immunity for
life. However, the virus can return as Shingles in later life. Usually the condition runs its course
without complication.
What are the Symptoms
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Prior to rash, person may feel unwell and have a temperature
Rash beginning on body and face which spreads to limbs
Itchy red spots which develop into blisters within hours
Blisters turn into scabs after couple of days with new blisters appearing after 3-6 days
Illness lasts 7-10 days in children and longer in adults, who can feel very unwell.
How is it Spread
 By direct contact with broken blisters when rash is present
 By airborne droplets. A person is infectious for about 3 days before the rash appears.
What is the Incubation Period
 The incubation period is 10-20 days
How to Prevent Infection
 This is difficult as condition is infectious before any signs are obvious
 Particular care should be taken to prevent contact with blisters when rash is present.
Treatment
 Normally the condition runs its course without treatment, although lotions or tablets may be given
to control the itch.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 002
Clostridium Difficile
What is Clostridium Difficile
It is a bacteria which can live in the bowel without causing any harm. If the normal bacteria in the
bowel alter, Clostridium Difficile can multiply and cause diarrhoea. This commonly occurs as a result
of antibiotics or other medication and can affect elderly people while in hospital.
What are the Symptoms
 Unexplained diarrhoea, especially if client on antibiotic treatment.
How is it Spread
 It is not a risk to healthy people, including children
 It can spread in vulnerable people by airborne infection or hand to mouth contamination.
What is the Incubation Period
 Uncertain. Infectious only while diarrhoea persists.
How to Prevent Infection
 Encourage good personal hygiene on part of sufferer
 Universal Precaution should be practised by staff at all times.
Treatment
 Certain antibiotics may be stopped
 In severe diarrhoea, another antibiotic may be prescribed for 7-10 days
 Relapses may occur and should be notified to the GP.
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Fact sheet – 003
Common Cold
What is a common cold?
A cold is an infection of the nose and upper airways caused by a virus. Many different viruses can
cause a cold. This is why colds recur, and immunisation against colds is not possible. Children tend to
have more colds than adults as adults have built up immunity to many viruses.
What are the symptoms?
The common symptoms are a blocked (congested) nose, a runny nose, and sneezing. The symptoms
tend to be worse at first and then usually ease gradually over the next few days. It may be difficult to
sleep due to a blocked nose. You may feel generally unwell and tired, and you may develop a high
temperature (fever). Sometimes there is a mild sore throat, hoarseness and a cough. A build up of
mucus behind the eardrums may cause dulled hearing or mild earache. The symptoms particularly
cough, tend to be worse in smokers. The symptoms usually last for a week.
How is it spread
The viruses responsible for colds are spread from person to person as droplets in the air. Sneezing or
coughing produces more droplets and helps to spread the infection. Touching infected surfaces, such as
door handles or when shaking hands, and then passing the virus from the hands to the mouth is another
route of infection for viruses.
What is the Incubation Period
Infected people can spread the viruses from two days before the symptoms of the illness start and up to
four days afterwards. Colds can occur all year round but are more common in the winter months. On
average, adults catch two to three colds each year. School age children can have twelve or more colds
in a year.
Prevention
There are a few steps that can be taken to help prevent colds and flu:
 Isolation of people with colds and flu to prevent it spreading to other people, only if practical.
 Regular hand washing and immediate disposal of used tissues.
 A healthy lifestyle – a balanced diet, rich in fruit and vegetables, and regular (preferably daily)
physical activity, if appropriate to health status.
 Not smoking – smokers are more likely to catch colds.
Treatment
There is no magic cure for the common cold. Antibiotics, which treat bacterial infections, do not work
on viruses. Sometimes the symptoms take up to two weeks to clear fully. The most useful treatments to
ease symptoms whilst your immune system clears the virus are: paracetamol, aspirin or ibuprofen,
which will ease fever, sore throats, aches and pains. Pharmacists can give over-the-counter advice.
Children under 16 years should not be given aspirin.
A fever may cause you to lose extra body fluid by sweating which may lead to mild dehydration
making you feel more tired and give you a headache. Drink enough fluids to prevent dehydration (hot
drinks are often soothing too). There is little evidence that other 'cold remedies' do much good but some
people find them useful particularly at bedtime. As some remedies may contain paracetamol, extra care
should be taken to ensure the maximum safe dose is not exceeded. Safe use instructions should be
observed at all times.
If symptoms do not start to ease within a few days, or if you suspect that a complication is developing,
please consult your GP or NHS Direct (confidential helpline) for advice.
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Fact sheet – 004
Crabs
What are Crabs
Crabs or Pubic Lice are one of three lice found to attack the body. Crabs are mainly found in pubic
hair, but can sometimes be found in the underarm, eyebrows and eyelashes. Adult lice are
approximately 1.2mm in diameter and can be seen on close inspection.
What are the Symptoms
 Intense itching mainly around the genital area.
How is it Spread
 Being sexually active with an infected person
 Sharing bedding or clothing with an infected person
 Physical contact of items, including toilet seat (this isn’t common but can happen).
What is the Incubation Period
 1 week from infection until eggs hatch
 Lice live up to 30 days but need a constant supply of blood.
How to Prevent Infection
 Avoid sexual intercourse with contaminated persons
 Good personal hygiene at all times.
Treatment
 Crabs are treated with a prescribed drug (in form of shampoo)
 One treatment usually kills all of the bugs
 All clothing and bedding should be washed in hot water.
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Fact sheet – 005
Fleas
What are Fleas
Fleas are a small parasite which attack animals, however, in the event that the animal is away for an
extended period, fleas will bite humans. Bites are normally noticed around the waist, ankle, armpits,
knees or elbows.
What are the Symptoms
 Rash
 Itch
 Hives
How is it Spread
 They only bite humans when animals are not available
 They jump.
What is the Incubation Period
 Instant, spots appear as soon as bitten.
How to Prevent Infection
 Use of insecticides
 Professional extermination may be necessary in some cases.
Treatment
 Insecticides
 Flea collar sprays
 Calamine lotion may help relieve the itching.
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Fact sheet – 006
Glandular Fever
What is Glandular Fever
Glandular Fever is a viral infection, generally attacking the lymph nodes.
What are the Symptoms
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Swelling and tenderness of lymph nodes
Fever
Headache
Sore throat
Loss of appetite.
How is it Spread
 Through close contact with an infected person, i.e.: kissing
 It can also be spread through contact with nasal/throat discharge.
What is the Incubation Period
 The incubation period is variable – may be several weeks.
How to Prevent Infection
 Practise Universal Precautions
 Avoid contact (saliva) with anyone who is known to be infected by this virus.
Treatment
 Rest is the only advice given for the treatment of this infection.
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Fact sheet – 007
Headlice
What are Headlice
Headlice are small parasites that live on the scalp. They bite through the skin and suck out blood to
survive. The louse lays eggs called “nits”, which appear similar to dandruff, that stick to the hair shaft.
They can be seen further down the hair shaft the longer they have been present.
What are the Symptoms
 Intense itching of the scalp
 Lice on scalp or on clothes
 Eggs on the hair shaft.
How is it Spread
 Through close contact with an infected person. They are only spread by head to head contact.
What is the Incubation Period
 Week to hatch
 Adults can live for 30 days, however, they die without constant blood supply.
How to Prevent Infection
 Good personal hygiene
 Avoid head to head contact
Treatment
 Prescribed shampoo and bone combing hair
 Wash bedding, clothing, etc. Separate from other laundry
 Sterilise all brushes and combs.
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Fact sheet – 008
Hepatitis A
What is Hepatitis A
Hepatitis A is a virus, which can cause inflammation of the liver. It is carried in the bowel movements
of an infected person and spreads through contact with faeces.
What are the Symptoms
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Some people may feel flu-like, others may have no symptoms
Tiredness and a general feeling of unwell
Jaundice (yellowing of skin and eyes)
Fever and abdominal pain
Loss of appetite and diarrhoea
Diagnosis is confirmed by blood test.
How is it Spread
 Through touching an infected person’s stool (e.g.: during personal care) then eating or drinking
using hands
 Drinking water or eating uncooked meat contaminated by infected stool
 Eating food prepared by someone who has touched infected stool
 Through anal sex with an infected person
What is the Incubation Period
 The period from being infected and developing symptoms is usually 4 weeks.
How to Prevent Infection
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Wash hands thoroughly after using the toilet and before preparing or eating food
Always wear gloves where contact with faeces is possible
Drink bottled water and take care with food when in another country
Immunisation (if identified through a specific risk assessment).
Treatment
 Most people get well on their own after a few weeks
 Bed rest for several days and refraining from alcohol until well may be required
 Medication may be prescribed by the GP.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 009
Hepatitis B
What is Hepatitis B
Hepatitis B is a virus, which can cause inflammation of the liver. It is spread by contact with an
infected person’s blood, semen or other body fluid.
What are the Symptoms
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Some people may feel flu-like, others may have no symptoms
Tiredness and a general feeling of unwell
Jaundice (yellowing of skin and eyes)
Fever and abdominal pain
Loss of appetite and diarrhoea
Diagnosis is confirmed by blood test.
How is it Spread
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Through sharing needles, etc, or being pricked by a needle from an infected person
Through unprotected sexual intercourse with an infected person
From infected mother to baby in the womb or at delivery
Through sharing razors, toothbrushes, etc with an infected person
Through tattoos or body piercing with dirty equipment.
What is the Incubation Period
 From the time of exposure to the onset of the disease is 2 to 6 months.
How to Prevent Infection
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
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Practice Universal Precautions at work
Avoid unprotected sexual intercourse with high risk or numerous partners
Avoid sharing any personal items such as razors, toothbrushes, etc, with an infected person
Ensure all open wounds are covered
Immunisation (if identified through a specific risk assessment).
Treatment

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There is no specific treatment for acute Hepatitis B, but GPs will sometimes use anti-viral drugs
In rare cased, damage to the liver will result in surgery being required
Most people with acute Hepatitis B recover in a few weeks
People with the chronic form of the disease are more at risk form complications and present an
infection risk to others.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 010
Hepatitis C
What is Hepatitis C
Hepatitis C is a virus, which can cause inflammation of the liver. It is a blood borne infection, which
means it spreads through blood to blood contact.
What are the Symptoms
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Some people may feel flu-like, others may have no symptoms
Tiredness and a general feeling of unwell
Jaundice (yellowing of skin and eyes)
Fever and abdominal pain
Loss of appetite and diarrhoea
Diagnosis is confirmed by blood test.
How is it Spread
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Through sharing needles, etc, or being pricked by a needle from an infected person
Through unprotected sexual intercourse
From infected mother to baby in the womb
Through sharing razors, toothbrushes, etc with an infected person
Through tattoos or body piercing with dirty equipment
People receiving blood transfusions prior to 1991 may have been at risk.
What is the Incubation Period
 This appears to be variable.
How to Prevent Infection



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Practice Universal Precautions at work
Avoid unprotected sexual intercourse with high risk or numerous partners
Avoid sharing any personal items such as razors, toothbrushes, etc, with an infected person
Ensure all open wounds are covered.
Treatment
 Regular check-ups are required as not everyone shall require urgent treatment
 Treatment where required is provided by hospital or GPs.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 011
HIV/AIDS
What is HIV/AIDS
HIV is a virus, which attacks the immune system, leaving the body vulnerable to a variety of lifethreatening diseases. The virus, which can result in AIDS, has been found in the blood, sexual fluids
and breast milk of infected people.
What are the Symptoms
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Unexplained fatigue, weight loss and headaches
Swollen glands, sore throats and coughs
Fever (over 10 days)
Excessive sweating (especially night sweats)
Mouth sores.
How is it Spread
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Through sexual intercourse (including Oral, Vaginal and Anal Sex)
Sharing needles
Blood transfusion (all blood is now tested so this is very rare)
Mother to child-before or during birth or by breast milk
Sharing toothbrushes and razors with infected people.
What is the Incubation Period
 HIV is detectable in the blood 12 weeks after exposure to infection. This is known as the “window
period”
 HIV results in AIDS, which can take up to 10 years before any symptoms are noted.
How to Prevent Infection
 Practice Universal Precautions at work
 Do not have unprotected sexual intercourse with:
 Someone who is HIV positive
 A known IV drug user
 Multiple partners
 Do not share needles
 Avoid exposure to blood of HIV sufferers
 Ensure all cuts or damaged areas of skin are covered (plasters)
 Wear gloves where contact with blood and body fluids is inevitable.
Treatment
 There is no cure for AIDS at this time, however, treatments are available to improve the quality of
life for those suffering from the infection.
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Fact sheet – 012
Influenza
What is Influenza
Influenza, or the flu, is a viral infection affecting the respiratory tract.
What are the Symptoms
Symptoms of the flu include fever, runny nose, stuffed up nose, fatigue, headache, cough, sore throat,
vomiting, diarrhoea, and achy muscles and joints. The symptoms are similar to colds but the muscle
aching is usually more severe and the fatigue may last for a few weeks after the illness has cleared up.
Keep in mind that these are flu-like symptoms. If you have any of these symptoms, it doesn’t
necessarily mean you’re afflicted with influenza. If one suspects influenza, it would be a good idea to
visit the doctor.
How is it Spread
Influenza is spread when an infected person sneezes or coughs around other people. Particles are
passed through the air where they will infect those in contact. If an infected person uses a telephone,
the infection can also be passed on to the next person to use the phone. Since the infected person may
not know they have influenza, they can touch many items without realizing they have passed the virus
along to others.
Complications of flu
Not only is the flu contagious, but if not treated, it could be dangerous to vulnerable people. To most
healthy adults, flu can be just like a nasty cold. However, young children, the elderly and people with
certain chronic medical conditions are susceptible to potentially serious complications. These are
mostly related to a bacterial infection of the lungs (pneumonia) or of the ears, nose and throat.
Incubation Period
It takes one to four days - on average two days - for a person exposed to the flu virus to develop
symptoms
Prevention
Infected people can take measures to prevent spreading the virus to others by covering their mouth and
nose when they cough or sneeze, disposing of used tissues immediately and by washing hands
frequently. Infected people should minimise contact with other people. Alcohol and cigarettes or other
tobacco products can lower one’s immunity therefore an infected person would be well advised to stay
away from these products. Where it does not impose other health problems then a balanced diet, rich in
fruit and vegetables, and regular (preferably daily) physical activity should be undertaken. If symptoms
persist or the influenza gets worse, it’s best to see a doctor.
A Flu jab may be freely available by contacting your local Health Centre. Having a flu jab each year
can significantly reduce the chance of catching flu. The elderly, pregnant and very young are especially
urged to protect themselves in this manner. It's also recommended that those with compromised
immune systems or chronic ailments, such as asthma, get the shot each year.
Treatment
There’s no cure for influenza. For adults, paracetamol, aspirin or ibuprofen can help to relieve fever
and pain. Always follow the instructions carefully and take care to stay within the safe daily doses.
Aspirin should not be given to children under 16 years old. Contact your GP for further advice or
alternatively Pharmacists, who can give advice on over-the-counter flu remedies. In addition, the NHS
Direct (confidential helpline) is available for 24 hour advice.
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Fact sheet – 013
Meningitis
What is Meningitis
Meningitis can be Bacterial or Viral in nature. There is no link between the two diseases although the
symptoms can be similar at the outset. The viral form of Meningitis is not life threatening, but the
bacterial form is more dangerous and can be fatal.
What are the Symptoms
 Severe headache with vomiting
 Feeling feverish
 Stiff neck, back and joint pains
Seek immediate emergency medical help for the following symptoms:
 Rash of tiny red bruises which don’t fade under pressure (the glass test)
 Severe dislike of light
 Disorientation and coma.
How is it Spread
 Through prolonged, close contact with an infected person.
What is the Incubation Period
 The important thing to stress is that the disease can develop rapidly, sometimes within a matter of
hours.
How to Prevent Infection
 Most cases are isolated, however, children and young adults are more at risk
 Immunisation is available for certain strains of the disease.
Treatment
 Treatment will be dependent on the type of Meningitis, but early intervention is essential.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 014
MRSA
What is MRSA - Methicillin Resistant Staphylococcus Aureus
MRSA is a strain of staphylococcus aureus bacteria, which is resistant to commonly used antibiotics.
Staphylococcus aureus are bacteria which usually do no harm, and which are normally found in the
nose, mouth and in skin folds of the armpit, groin etc. by up to 40% of the population without causing
any harm in normal healthy people. However, if it enters the body of an already weak or ill person it
can be very harmful.
What are the Symptoms
 MRSA affects people in two different ways; colonisation or infection.
 Colonisation: When no signs or symptoms are displayed, however, the person is a carrier of the
bacteria. Many health care workers carry MRSA.
 Infection: Where MRSA is causing an infection , e.g., an abscess or wound infection that is red,
hot and inflamed with discharge. It can also cause a urinary tract infection.
How is MRSA Spread
 Through direct person to person contact, especially where there is skin damage, catheters and drips
 Certain skin conditions which shed particles, or inefficient cleaning of dust particles can also spread
MRSA.
What is the Incubation Period
 It is difficult to specify exact time scales, however, it would appear that contamination, within
hospital settings is very quick, and signs are evident within hours.
How to Prevent Infection
 The practising of Standard Universal Precautions is essential for the prevention and spread of
MRSA
 Masks and gowns/aprons should also be used when working within 3 feet of clients with MRSA
pneumonia
 Disposable masks, gowns./aprons, gloves should be disposed of immediately after use
 Laundry should be washed as normal in a hot (65 degrees) wash.
Treatment
 MRSA will often be treated by a specific antibiotic such as Vancomycin.
Contact the Health Protection Specialist for further advice.
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Fact sheet – 015
Scabies
What is Scabies
Scabies is an infectious itchy skin condition caused by a tiny mite burrowing under the skin.
What are the Symptoms
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


Itching (worse at night), especially of the hands, feet and male genitalia
Thin pencil lines on the skin, often between fingers or toes
Rash
Abrasions of the skin (from scratching and digging).
How is it Spread
 Through prolonged, direct skin to skin contact with an infected person
 Sharing bedding and clothing with an infected person.
What is the Incubation Period
 Eggs mature after around 21 days, resulting in an intense itch
 Mites die around 30 days but if untreated the eggs laid within this time will hatch.
 How to Prevent Infection
 Avoid sharing bedding or clothes of infected people
 Ensure use of gloves when handling infected people/items.
Treatment
 Treatment of infected person with prescribed creams/lotion
 Treatment of all family members/those in intimate contact at same time
 Change and launder all bedding and clothing. Leave for 24 hours then launder as normal.
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Fact sheet – 016
Shingles (Herpes Zoster)
What is Shingles
It is a painful condition affecting only a limited area of skin. It is caused by the Chickenpox virus.
What are the Symptoms




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A very painful, blistering rash affecting one area or side of the body
Localised pain or tenderness prior to the rash appearing
General debility and exhaustion with aches, pains and sometimes mild fever
Depression is often a feature of Shingles
Residual pain may continue indefinitely after the initial illness.
How is it Spread
 You cannot catch Shingles from someone with the condition or chickenpox
 Shingles is a reactivation of a previous chickenpox infection
 The risk is that someone who has not had chickenpox, could catch that from contact with weeping
Shingles sores.
What is the Incubation Period
 Shingles cannot be spread, therefore there is no incubation period.
How to Prevent Infection
 Not much can be done to avoid Shingles, as the virus lies dormant within the body
 Universal Precautions must be practised in personal care, to avoid contact with blister fluid
 BUPA recommend that staff that are immuno-suppressed, are pregnant or planning to be pregnant, or
who have not had chickenpox should not work with clients with Shingles.
Treatment
 A doctor should see all Shingles cases especially when the face or eye is affected. Analgesia and rest
are the primary treatments
 Occasionally, specialist opinion may be sought
Further attacks of Shingles are possible, especially when the sufferer’s immune system is run down.
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Fact sheet – 017
Tetanus
What is Tetanus
Tetanus (or “lockjaw”) is a bacterial disease that affects the nervous system.
What are the Symptoms
 Muscular stiffness in the jaw and then the neck, with difficulty in swallowing
 Rigidity of abdominal muscles
 Spasms, sweating and fever.
How is it Spread
 The organism, which is commonly found in soil, enters the body through a wound
 It is not transmitted from person to person.
 What is the Incubation Period?
 This is normally around 8 days, but may range from 3 days to 3 weeks.
How to Prevent Infection
 Keep Tetanus vaccinations up to date
 Take extra precautions when working with or in proximity to soil, wearing covered shoes and gloves.
Treatment
 Wounds are thoroughly cleaned and dead tissue removed
 Depending on the previous immunisation record of person, a further booster, antitoxin or antibiotics
may be given.
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Fact sheet – 018
Toxoplasmosis
What is Toxoplasmosis
It is a common, tiny parasite that can live in the cells of most mammals and birds. Cats are the main host
of this parasite that can be transmitted to humans.
What are the Symptoms
 Many infected people display no symptoms with diagnosis only being made by blood test
 Some people will develop swollen lymph nodes in the neck or under arms, accompanied by exhaustion
and a slight fever
 Occasionally, eye complaints can occur
 Newborn children, infected in the womb, however, can develop serious illnesses.
How is it Spread
 By eating undercooked meats from an infected animal
 Failing to wash hands between emptying cat litter and eating
 Children eating objects contaminated by infected soil.
What is the Incubation Period
 This is currently unknown.
How to Prevent Infection





Wash hands after handling raw meat or vegetables
Take extra precautions when working with or in proximity to soil, wearing covered shoes and gloves
Make sure that all meat is well cooked
At work, pregnant women should not empty or clean cat litter trays
Any worker engaged in the above must wear gloves and wash hands thoroughly.
Treatment
 Often treatment is not required as infected people may carry Toxoplasmosis, without harm or
symptoms
 Specialists using drugs deal with cases, which do require treatment.
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Fact sheet – 019
Tuberculosis
What is Tuberculosis
Tuberculosis (TB) is an infectious disease that usually affects the lungs, although it can affect any part of
the body. Whilst anyone can catch TB, some groups of people are more at risk than others. These include
people who:
 Live in the same household – or have been in close, lengthy contact – with someone with infectious
TB or live in poor, unhealthy conditions
 have been in prison, are addicted to drugs or misuse alcohol
 have lived, worked or stayed for a long time in a country with a high rate of TB, such as south-east
Asia, sub-Saharan Africa and some countries in eastern Europe
 are the children of parents or grandparents whose country of origin has a high rate of TB
 are unable to fight off infection due to illness or treatment or do not eat enough to stay healthy
What are the Symptoms
Although TB is not easily caught, everyone should be aware of the symptoms of the disease so that they
can seek treatment as soon as possible. The most common symptoms are:
 Chronic or persistent cough lasting over several weeks
 Coughing up blood
 Fever or sweating (especially at night)
 A general and unusual sense of tiredness and being unwell
 Loss of appetite and loss of weight for no obvious reason
All of the above may also be signs of other problems but if you have them and are worried, talk to a doctor
or nurse at your local surgery or clinic, or phone NHS 24 helpline.
How is it Spread
TB can only be caught directly from someone with infectious TB in their lungs or throat. Although TB is
spread through the air when an infected person coughs or sneezes, it takes close and lengthy contact with
that person to catch the disease. So it is unlikely that you’ll catch TB on the bus or train from a casual
cough or sneeze. Not everyone with TB of the lungs is infectious, and as long as they are taking proper
treatment, most people that were infectious, become non-infectious quickly. Spitting is unpleasant but it is
unlikely to spread TB. The Line Manager, Infection Control Key Worker (if available) and the Health and
Safety Manager must be informed immediately of any staff coming into contact with TB at work.
How to Prevent Infection
The most important and effective way to prevent TB spreading in this country is to diagnose people with
the disease as soon as possible and make sure they have a full course of correct treatment. There is a
vaccine (BCG) that has been in use for many years to help protect against TB. This works best to prevent
the more serious forms of TB in children. However, the vaccine does not prevent TB in all cases so you
still need to be aware of the signs and symptoms.
Treatment
TB can be treated with special antibiotics. Once the treatment starts, you will begin to feel better after
about two to four weeks. The treatment has to be continuous for at least six months otherwise TB may
return in a form that is resistant to the usual drugs and much more difficult to treat. If TB is not treated
properly, it may lead to death.
Contact the Health Protection Specialist for your area for further advice.
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Fact sheet – 020 (Page 1 of 2)
E. Coli O157
What is E. coli O157?
Most E. coli bacteria found in the human intestine are harmless but E. coli O157 can cause severe illness in
some humans particularly in children under five and in the elderly.
E. coli O157 is commonly carried in the bowels of a variety of domestic and wild animals including cattle,
sheep, rabbits etc. It normally causes no illness in animals but it is found in their faeces. E. coli O157
infected animal faeces may be washed off fields into private water supplies during heavy rain.
Outbreaks of E. coli O157 have been associated with contaminated food e.g. meat, unpasteurised or poorly
pasteurised milk or milk products including cheese, butter and yoghurt.
Only a very small number of the bacteria need to be swallowed by a vulnerable individual in order to cause
infection.
What are the symptoms?
The incubation period may be between 1 and 14 days but commonly it is between 2 and 5 days. Not
everyone who is infected with E. coli O157 will experience symptoms. Symptoms include:





Fever
Diarrhoea - sometimes with blood
Abdominal pain/cramps
Nausea and/or vomiting
General malaise
Symptoms usually settle fairly quickly but a small number of infected individuals may develop:




Severe bloody diarrhoea
Severe stomach cramps
Poor urinary output
Dehydration
These symptoms require prompt medical attention.
How does E. coli O157 spread?
1. Swallowing the bacteria
 during and/or after direct contact with infected animal faeces e.g. spraying slurry or caring for
infected animals
 during and/or after indirect contact with infected animal faeces e.g. from clothing contaminated
with cattle faeces, during picnics or BBQ’s in the countryside
 when eating raw or undercooked meat contaminated with the bacteria.
 when drinking or eating unpasteurised (raw) or poorly pasteurised milk or milk products which
are contaminated with the bacteria e.g. cheese.
 on unwashed vegetables or fruit fertilised with infected manure
2. Drinking rural or private water supplies contaminated with infected faeces
3. Person to person spread can occur within families or community groups e.g. in a school when there is a
breakdown in hygiene practices.
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What precautions do I have to take?
1. Thorough hand washing taking care to clean the fingertips and between the fingers.






after
handling raw meat
handling animals
changing nappies
visiting the toilet
Outdoor work or recreational activities
Handling clothes that are dirty from outdoor
work or recreational activities
and before




cooking
handling food
eating
feeding the young or elderly
2. Ensure that all foodstuffs derived from animal sources are thoroughly cooked.
3. Do not drink unpasteurised (raw) milk or milk in bottles where the tops have been pecked by birds.
4. Do not use the same chopping board or kitchen surface or knife for raw meat and then for other
foodstuffs without first washing it thoroughly to prevent cross contamination.
5. Store cooked meat at the top of the fridge and uncooked meat at the bottom.
6. Thoroughly wash all salad vegetables and fruit before consumption
7. Remove any clothing contaminated with animal faeces (e.g. wellington boots, overalls) when entering
your house and then wash your hands.
Private Water Supplies
Occasionally rural / private water supplies are subject to contamination with E. coli O157. If you have a
private water supply:
 Cover and/ or fence off your supply so that animals can not get to it.
 Divert rain water run off so that it cannot contaminate your supply.
 Make local farmers aware of your supply to avoid contamination by farming activity.
 Always make sure that your supply is well maintained.
 If the water becomes discoloured after heavy rainfall then boil all drinking water or use another
source of water.
Specialist information can be obtained from your local Council’s Environmental Health Department.
Will I need treatment?
Medication available from chemists to stop diarrhoea should not be used because this can also lead to a
more severe illness. Oral antibiotics are not recommended for individuals with E. coli O157 because they
can irritate the lining of the bowel, which can lead to a more severe illness. Your local Health Protection
Team will advise when cases can return to work, school, playgroup etc.
If you have any concerns or questions regarding E. coli O157, contact your GP or the Health Protection
Specialist in your area.
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Fact sheet – 021 (Page 1 of 2)
Legionnaires` Disease
What is Legionnaires` Disease?
Legionnaires' disease is a type of pneumonia. It was named after an outbreak of severe
pneumonia which affected a meeting of the American Legion in 1976. It is an uncommon but
serious disease.
The illness occurs more frequently in men than women. It usually affects middle-aged or elderly
people and it more commonly affects smokers or people with other chest problems.
Legionnaires' disease is uncommon in younger people and is very uncommon under the age of
20.
About half the cases of legionnaires' disease are caught abroad. The other half are the result of
infections acquired in the UK.
How do people get it?
The germ which causes legionnaires' disease is a bacterium called Legionella pneumophila.
People catch legionnaires' disease by inhaling small droplets of water suspended in the air which
contain the Legionella bacterium. However, most people who are exposed to Legionella do not
become ill.
Legionnaires' disease does not spread from person to person.
Where does it come from?
The bacterium which causes legionnaires' disease is widespread in nature. It mainly lives in
water, for example ponds, where it does not usually cause problems. Outbreaks occur from
purpose-built water systems where temperatures are warm enough to encourage growth of the
bacteria, eg in cooling towers, evaporative condensers and whirlpool spas (tradename Jaccuzi)
and from water used for domestic purposes in buildings such as hotels.
Most community outbreaks in the UK have been linked to installations such as cooling towers or
evaporative condensers which can spread droplets of water over a wide area. These are found
as part of air-conditioning and industrial cooling systems.
What measures are there to control legionnaires` disease?
To prevent the occurrence of legionnaires' disease, companies which operate these systems
must comply with regulations requiring them to manage, maintain and treat them properly.
Amongst other things, this means that the water must be treated and the system cleaned
regularly.
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What are the symptoms?
The symptoms of legionnaires' disease are similar to the symptoms of the flu:






high temperature, feverishness and chills;
cough;
muscle pains;
headache; and leading on to
pneumonia, very occasionally
diarrhoea and signs of mental confusion
How is it treated?
The illness is treated with an antibiotic called erythromycin or a similar antibiotic.
What to do

If you develop the above symptoms and you are worried that it might be legionnaires'
disease, see your general practitioner.

Because it is similar to the flu, it is not always easy to diagnose. A blood or urine test will
be helpful in deciding whether an illness is or is not legionnaires' disease. When doctors
are aware that the illness is present in the local community, they have a much better
chance of diagnosing it earlier.

If you suspect that you may have got the illness as a consequence of your work then you
are advised to report this to your line manager, as well as your health and safety manager.
There is a legal requirement for employers to report cases of legionnaires' disease that
may be acquired at their premises to the Health and Safety Executive.
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