The Northland DHB has issued a reminder of the importance of hand hygiene following an increase in the number of cases of gastrointestinal infections, in particular cryptosporidium, E. coli O157 (VTEC), and campylobacter in the region.

Cryptosporidium is a parasite found in the gut of humans and animals, symptoms including diarrhoea, nausea and stomach pain, and sometimes vomiting and fever. Symptoms will usually appear within seven days of exposure, but can occur anywhere from one to 12 days.

People become infected by ingesting the parasite from contact with animals' faecal matter, by drinking contaminated water or touching their mouths with contaminated hands. Complications are rare, but it is unpleasant, and easily spread.

The most common Escherichia coli, VTEC, can cause serious illness with varying symptoms that often include severe stomach cramps, diarrhoea (often bloody) and vomiting. Most people recover within five to seven days, but while some infections are very mild, others can be severe, and even life-threatening. Campylobacteriosis, another enteric infection, is an illness of variable severity with symptoms including abdominal pain, fever and watery diarrhoea, sometimes bloody. The most common source of infection is contaminated food, typically undercooked poultry or unpasteurised milk.


Cross-contamination from raw meat to other foodstuffs may occur via hands, utensils, chopping boards or incorrect storage. The consumption of faecally-contaminated water and direct contact with farm or domestic animals are common routes of transmission.

"We usually see more cases at this time of year as lambing and calving can increase people's exposure to this protozoa and other bacteria that can cause gastroenteritis-type illnesses," Northland DHB medical officers of health said.

"The best way to avoid illness is good hand hygiene practices, involving washing your hands with soap and water for 20 seconds and drying them thoroughly with a clean towel. This is especially important after working with animals and before eating.

"Anyone working with livestock should change out of their work clothes before going about routine family or non-farm-related activities."

Those infected with cryptosporidium/VTEC or campylobacter should stay away from work, school and preschool until symptom-free for 48 hours, and should avoid using public swimming pools for two weeks after symptoms have gone.

While most people infected with any of these diseases recover without intervention, recovery can take weeks. Patients are advised to seek further medical advice if they are not recovering.

The DHB's advice is to:

- Assume that all cattle, sheep and goats are infected, even if they look clean and healthy.


- Wash hands after touching an animal, before eating or drinking, and after removing clothing and shoes worn on a farm.

- Supervise children closely to ensure they wash their hands properly after contact with animals.

- Cook meat thoroughly. Ground beef and meat that has been needle-tenderised should be cooked to a temperature of at least 70C. Use a thermometer, as colour is not a very reliable indicator of 'doneness'.

- Avoid raw milk, unpasteurised dairy products, and unpasteurised juices (like fresh apple cider).

- Prevent cross-contamination in food preparation areas by thoroughly washing hands, surfaces, cutting boards and utensils after they touch raw meat;

- Avoid swallowing water when swimming or playing in lakes, ponds, streams, swimming pools and backyard 'kiddie' pools.