Handwashing key to reducing infection risk from farm visits

15 December 2010

A Health Protection Agency (HPA) review has found that there were 55 outbreaks of gastrointestinal disease linked to petting farms between 1992 to 2009 in England and Wales, according to research published in Emerging Infectious Diseases today.

Although the overall risk of infection is low in light of the millions of farm visits each year, these outbreaks - over a 17 year period - led to 1,328 people becoming infected, of whom 113 were hospitalised. Illness ranged from mild through to severe diarrhoea and occasionally more serious conditions.

The majority of these outbreaks were caused by E. coli O157 (55 per cent) or Cryptosporidium (42 per cent). Outbreaks of cryptosporidiosis occurred more often in springtime whereas outbreaks of E. coli O157 infection occurred more often in mid to late summer, especially in August.

People of all ages became ill in these outbreaks but children under the age of 10 were disproportionally affected because they are vulnerable to serious illness from these infections, particularly E. coli O157. Children under the age of five are also more likely to pick up these infections because their personal hygiene is not as well developed - for example at that age they are more prone to sticking fingers, thumbs or toys into their mouths. Contributory factors reported in the outbreaks included direct contact with pre-weaned animals - such as lambs, calves and kid goats - or direct contact with the animal faeces of animals such as cattle, sheep and goats.  Inadequate hand washing facilities at the farms was another important factor.

Other risk factors recorded in the study included bottle feeding lambs, thumb sucking by children and reliance on sanitiser hand gels instead of hand washing, which are not effective in killing bugs such as E. coli O157 or Cryptosporidium. 

Lead author Dr Fraser Gormley, an epidemiologist from the department of gastrointestinal, emerging and zoonotic Infections at the HPA said: "Visiting a farm is an enjoyable and educational experience for many people, particularly children. But it's important to remember that contact with farm animals carries a risk of infection because of the microorganisms - or germs - they naturally carry.

"Avoiding direct contact with animals and their droppings is the surest way of avoiding infection but appropriate awareness of hygiene and supervision of children by parents and teachers will help to ensure that children do not become ill as a result of farm visits.

"Handwashing is the single most important prevention step in reducing transmission of gastrointestinal infections after handling animals and it's crucial that hand washing in young children should be supervised, especially after touching or petting animals or their surroundings on a visit to a farm.  Visitors should also be made aware that using sanitising gels is not a substitute for washing hands with soap and hot water and drying them, as gels may fail to remove contamination in the way that soap and running water can. However it is likely that using sanitising gels following handwashing with soap and water may provide extra benefit."

Study co-author Dr Bob Adak, head of epidemiological services in the department of gastrointestinal, emerging and zoonotic infections at the HPA, said: "We know that visits to petting farms have grown exponentially in recent years and while the risk of developing an infection is very low, this research comes as a reminder that it can happen and it's vitally important that parents and carers are aware that contact with farm animals can lead to illness.

"The Health and Safety Executive has also published guidance for those running and visiting petting farms on practical steps to reduce the risks to visitors of ill health."

ENDS

Notes to editors:

Gormley et al. Transmission of Cryptosporidium spp. at petting farms, England and Wales http://www.cdc.gov/ncidod/eid/ Emerging Infectious Diseases. 2010.

Cryptosporidium is a protozoan parasite, which can be transmitted through contact with soil, food, water or surfaces that have been contaminated with infected human or animal faeces. The most common symptom is watery diarrhoea, which can range from mild to severe. Cryptosporidiosis is most common in children aged between one and five years, but it can affect anyone. People with weak immune systems are likely to be most seriously affected.

Escherichia coli (E. coli) are common bacteria which live in the intestines of warm blooded animals. There are certain forms, or strains, of E.coli which are normally found in the intestine of healthy people and animals without causing any ill effects. A number of E. coli strains cause illness but E. coli O157 is associated with more serious illness. For the majority of people the infection is usually self limited and clears within seven days, but children under five are vulnerable to more severe illness. Symptoms can range from mild through to severe diarrhoea, to a serious condition called haemolytic uraemic syndrome (HUS) that affects the blood, kidneys and in severe cases, the central nervous system.

A leaflet detailing advice for the public on avoiding infection on farm visits can be found on the HPA's website: http://www.hpa.org.uk/web/HPAwebFile/HPAweb_C/1270122184581

The Health and Safety Executive's guidance for those running and visiting petting farms can be found on the HSE's website: http://www.hse.gov.uk/pubns/ais23.pdf 

For media enquiries please contact the HPA press office on 0208 327 6647/7097/7751 or out of hours the duty press officer on 0207 200 4400.

Last reviewed: 15 December 2010