An outbreak of a waterborne disease in Devon has prompted urgent warnings for residents to boil their tap water. 

At least 22 cases of cryptosporidiosis disease have been confirmed in and around the town of Brixham in South West England.

But what is the parasite that is making people sick, what are the symptoms of being infected with it and how serious can it be?

What is cryptosporidiosis disease?

Cryptosporidiosis is the disease caused by the parasite cryptosporidium.

Often shortened to crypto, infections can be caused by drinking contaminated water or swallowing contaminated water in swimming pools or streams.

It can also be acquired through contact with the faeces of infected animals or humans.

What are the symptoms?

The symptoms of cryptosporidiosis include:

• profuse watery diarrhoea
• stomach pains
• nausea or vomiting
• low-grade fever
• loss of appetite

How long does it last?

Most people develop symptoms within one to 12 days of picking up the parasite.

Symptoms usually last for about two weeks, but can last up to six weeks or longer when the immune system is not working properly.

During the illness, you might think you are getting better but the illness returns a couple of days later before you fully recover.

How serious is it?

Most people recover, but in people with severely weakened immune systems it can cause severe disease and can be fatal.

Serious cases and death used to be more common, according to Paul Hunter, professor in medicine at the University of East Anglia (UEA).

This is because before effective antiretroviral treatments were introduced for HIV/AIDS, people living with these illnesses would not recover if they picked up cryptosporidiosis.

Who is most at risk of serious illness?

People with weak immune systems are at greater risk of serious illness. This includes:

• people on some immunosuppressive drugs, for example cancer or transplant patients
• people with untreated HIV/AIDS
• malnourished children

Does it need treatment?

There is no specific treatment for cryptosporidiosis.

It important to drink plenty of fluids as diarrhoea or vomiting can lead to dehydration, according to advice from the UK Health Security Agency (UKHSA).

You might also want to talk to a pharmacist about oral rehydration sachets to help replace the sugar, salts and minerals the body has lost.

Dr Lincoln Sargeant, Torbay’s Director of Public Health, said anyone with “severe symptoms like bloody diarrhoea” should contact NHS 111 or their GP.

Severe cases may require hospital treatment.

How do you know if you have crypto?

The symptoms of crypto are similar to other stomach bugs, so the only way to know for sure if you have it is for your doctor to send a sample of your faeces to be tested in a laboratory.

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How can you stop the illness spreading?

If you are ill, stay away from nursery, school or work while you have symptoms, and for at least 48 hours after they stop.

You should also avoid swimming for two weeks after being unwell.

You should not prepare food for anyone else until 48 hours after diarrhoea has stopped.

Make sure you’re using good handwashing practices too, washing your hands thoroughly when handling food and after using the toilet.

The UKHSA also advises washing bedding and towels on the hottest possible cycle.

The inquiry into how nurse Lucy Letby was able to murder babies at a hospital in Chester will begin to hear evidence in September. 

Lawyers for the families of Letby’s victims told a preliminary hearing that the inquiry should be live streamed to the public to prevent the spread of “grossly offensive” conspiracy theories.

Letby was sentenced to 14 whole-life orders after she was convicted of murdering seven babies and attempting to murder six others while working on the neo-natal unit at the Countess of Chester Hospital in 2015 and 2016.

At the preliminary hearing, inquiry chair Lady Justice Thirlwall heard submissions on whether the hearings should be publicly broadcast.

Peter Skelton KC, on behalf of the families of six babies, said Letby’s crimes continued to be the subject of conspiracy theories online.

“One of the most effective antidotes to those theories and the damage they cause will be to see and to hear the people involved in the hospital give a true and comprehensive account of the facts,” he said.

But Andrew Kennedy KC, representing the Countess of Chester, said there was a “high level of anxiety” from staff at the prospect of giving evidence which was live streamed.

He said: “If a witness is concerned about live-streaming then if we can remove that concern we can, we would suggest, encourage candour, frankness and openness.”

Richard Baker KC, representing some of the other families, said: “Their desire in this case is for change and so that others do not experience what they have experienced.”

They were “saddened” and “concerned” at the suggestion the lack of transparency might continue, he said.

Lady Justice Thirlwall will give her decision on whether the hearings will be broadcast at a later date.

She had begun the proceedings with a pause for reflection on the “lives lost”, “injuries sustained” and “suffering” of the families.

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The hearing was told 188 requests for information had been made to individuals including midwives, nurses, doctors, managers and members of the hospital board.

The inquiry hearings are scheduled to begin on 10 September at Liverpool Town Hall.

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The parents of the babies will be among the first to give evidence.

Counsel to the inquiry Rachel Langdale KC told the hearing: “There are no sides. It is a search for the truth.”

Last month Letby asked the Court of Appeal for permission to mount a full legal challenge to her conviction. Judges are due to rule on this at a later date.

The former nurse is due to face a re-trial next month on one charge of the attempted murder of a baby in February 2016.

More than two dozen staff at a prison in Kent were “deliberately poisoned” with the drug spice, a union has said.

Workers were allegedly given the narcotic by “prisoners working in the staff canteen” at HMP Swaleside in Kent, the Criminal Justice Workers Union said.

Spice, a synthetic cannabinoid, can cause dizziness, breathing difficulties, chest pain, seizures and paranoia, according to the NHS website.

Some 25 staff were “poisoned” at the men’s high-security jail, union official Andy Hamlin said.

Nine ambulances attended and an emergency incident unit was set up “within the establishment”, Mr Hamlin added.

Five people were taken to hospital last week, he said, although South East Coast Ambulance Service said three had needed hospital treatment.

While it is not unusual for prisoners to be working in staff canteens, they are expected to be “low-risk”, Mr Hamlin commented.

That “clearly hasn’t happened in this case”, he added, and is calling for a “full investigation”.

HM Prison and Probation Service “must do more to protect the health and safety of its staff”, he said.

It is understood that none of the those affected were in a critical condition and all have since been discharged from hospital.

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A Prison Service spokeswoman said: “A number of staff were taken ill following an incident at HMP Swaleside last week but have all now returned to work.

“There is an ongoing investigation and it would be inappropriate to comment further at this stage.”

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A South East Coast Ambulance Service spokesman said: “I can confirm that South East Coast Ambulance responded to a medical incident at HMP Swaleside in Eastchurch, Sheerness, after being called at approximately 2.10pm on Thursday 9 May.

“Ambulance crews attended and worked alongside the prison medical team to assess and treat a number of patients at the scene before three were taken by ambulance to hospital for further checks.”

Kent Police said officers attended to assist the ambulance service.