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The UK Health Security Agency (UKHSA) has warned people over travel to Cape Verde after dozens of Britons fell ill with stomach bugs while there.
Since 1 October, the agency has identified 118 cases of shigella and 43 of salmonella linked to trips to the West African archipelago.
While most people recover within a week, four British people have died within months of contracting stomach bugs while on holiday there.
The warning comes ahead of the February half term, when a greater number of British holidaymakers are expected to travel to the popular winter destination.
Shigella and salmonella are both bacterial infections that affect the gut and can cause symptoms including diarrhoea, fever and stomach cramps.
Though many who are infected make a full recovery, young children, elderly people, pregnant women and people with existing conditions or a weakened immune system can experience severe symptoms and suffer potentially life-threatening complications.
The two bacteria are spread through contact with contaminated faeces, either directly through person-to-person transmission or indirectly from unclean food, water or surfaces.
People travelling to Cape Verde are advised to:
- eat food that is freshly prepared, fully cooked and served piping hot
- drink bottled or boiled water and avoid ice in drinks
- use bottled or boiled water when brushing your teeth
- only eat fruit you've peeled yourself
- avoid salads that may not have been washed in clean water
"Taking a few simple precautions against traveller's diarrhoea and food poisoning can make all the difference," Dr Gauri Godbole, the UKHSA's deputy director for gastrointestinal infections and food safety, said.
"The best way to avoid gastrointestinal infections, including shigella and salmonella, or passing them to others, is simply by washing your hands regularly and thoroughly with soap and water or alcohol gel – particularly after using the toilet, changing nappies, and before eating or preparing food."
The UKHSA said the majority of shigella cases were among people who had been to the Santa Maria and Boa Vista areas of Cape Verde.
Santa Maria is a resort town on Sal Island, while Boa Vista is the cape's most easterly island. The archipelago typically sees temperatures of around 25C in February.
Dr Damien Tully, an associate professor at the London School of Hygiene and Tropical Medicine, previously told the BBC that outbreaks of shigella were "not unusual, particularly in busy hospitality settings where large numbers of people are eating and sharing facilities".
He said buffet-style catering can increase the risk and be a "breeding ground" for bacteria and viruses.
Mark Ashley, 55, of Bedfordshire, Elena Walsh, 64, from Birmingham, Karen Pooley, 64, of Gloucestershire, and a 56-year-old man from Watford all died last year after contracting stomach bugs while in Cape Verde.
They are four of six Britons who died after holidaying there since January 2023, all of whose families are now making personal injury claims against package holiday firm Tui.
Ashley's wife Emma said she had raised concerns over the hygiene standards at the resort she and her husband had stayed at on Sal.
Meanwhile, Walsh's son Sean expressed concerns about the hygiene standards at the hotel where they had stayed.
Tui has said it was investigating the claims, but declined to comment further while legal proceedings were active.
Cape Verde was struck by Hurricane Erin last August, damaging water and sanitation infrastructure. In its wake, the World Health Organization assessed there was a greater risk of disease from contaminated water and carrier insects.
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