Cryptosporidiosis: symptoms, spread, treatment and prevention in the UK

UKHSA describes cryptosporidium as a parasite, a tiny organism, found in the intestines and faeces of infected humans and animals. It may contaminate lakes, streams and rivers, swimming pools, untreated or poorly treated water, food (especially raw milk and fresh produce) and objects such as farm gates and outdoor boots and clothing.

The UKHSA blog describes it as a microscopic parasite that can cause an unpleasant and sometimes dangerous illness. For most people it is a self-limiting diarrhoeal illness; for people with weakened immunity it can be serious.

UKHSA says anyone can get cryptosporidiosis, but others at risk include people who handle infected livestock or their faeces, those exposed to human faeces through caring such as changing nappies or toileting young children, people who drink from untreated, unprotected water supplies or swallow contaminated recreational water, and those who travel to countries where these exposures are likely.

It says you can get it directly from another person or animal by touching faeces, for example when changing a nappy or petting a lamb and putting your hands near your mouth without washing them thoroughly. You can also get it by swimming in or drinking contaminated water, and occasionally from contaminated food such as unwashed or unpeeled vegetables or salads, or raw milk.

UKHSA notes it can be a serious illness in people whose immune systems are not working properly.

UKHSA lists the symptoms and says that as they are similar to many other tummy bugs, the only way to know you have cryptosporidium is for a doctor to ask for a faeces sample to be tested in a laboratory.

• Profuse watery diarrhoea.

• Stomach pains.

• Nausea or vomiting.

• Low-grade fever.

• Loss of appetite, which can lead to dehydration and weight loss.

• A pattern where you seem to get better and then it returns a couple of days later before you fully recover.

Diarrhoea that is severe, bloody or lasts longer than a few days, signs of dehydration such as a dry mouth, very dark urine or dizziness, and any diarrhoeal illness in a baby, young child or someone with a weakened immune system should be discussed with a GP or NHS 111. UKHSA says the only way to confirm it is a laboratory stool test requested by a doctor.

UKHSA says you should tell your employer you have had cryptosporidiosis if you work with vulnerable groups such as the young, the elderly or those in poor health, or if you handle food. In an outbreak, UKHSA says it provides advice on controlling spread and looks for the source of infection.

UKHSA says there is no specific treatment for cryptosporidiosis and that most people with a healthy immune system will recover within one month. It is important to drink plenty of fluids as diarrhoea or vomiting can lead to dehydration and the loss of important sugars and minerals.

People with weakened immune systems can be ill for longer and may need specialist care in hospital. The UKHSA blog says it is important to be hygienic at home to avoid spreading the infection.

UKHSA says cryptosporidiosis is highly infectious, so you need to be very clean around the home for at least 48 hours after symptoms stop. The steps it lists are below.

• Wash hands thoroughly with soap and warm water before preparing and eating food, after handling raw food, after using the toilet or changing a nappy, and after contact with animals.

• Wash all dirty clothes, bedding and towels on the hottest possible cycle of the washing machine.

• Give everyone their own towel and clean toilets, flush handles, taps and basins after use with detergent and hot water, then a household disinfectant.

• Do not swim, or take your child swimming, while you have diarrhoea and for 2 weeks after it has stopped.

• Do not prepare food for others until you have been symptom-free for at least 48 hours.

• Stay off work or school until free from diarrhoea or vomiting for 48 hours.

UKHSA advises everyone to wash hands thoroughly, help young children to wash their hands properly, wash and peel fruit and vegetables, avoid drinking untreated water, avoid ice or tap water in countries where the water might be unsafe, and avoid swallowing water in lakes and swimming pools.

It stresses hygiene on farm visits: washing hands after any contact with animals and eating only in designated areas. The UKHSA blog adds that in the unusual case of an outbreak affecting UK drinking water, you should follow the advice of the local water company, which will usually involve boiling water for drinking and cooking.

Most cases are managed at home with fluids and hygiene advice. A GP can arrange a stool test through the NHS laboratory service, and UKHSA and local health protection teams handle outbreaks.

Private GP services can arrange stool testing, but results, public health notification and advice about returning to work or school follow the same national guidance.