What Infections Spread in Health and Social Care?

In health and social care settings, infections can move quickly between people due to close physical contact, shared spaces, and vulnerable groups. Infections can come from bacteria, viruses, fungi, or parasites. Understanding which ones spread and how they do so helps everyone to keep people safe.

Why Infections Spread Easily

Care homes, hospitals, clinics, and supported living services often involve individuals with weakened immune systems. Crowded environments, frequent contact, and shared equipment increase the risk of germs passing from person to person.

People may visit with minor symptoms or none at all but still carry infections. Staff and visitors can also unknowingly bring germs in.

The Most Common Infections

Some infections appear far more often in these settings. Let’s take a closer look at each type, how it is passed on, and the usual symptoms.

Respiratory Infections

Influenza (Flu)

Flu viruses spread easily through droplets in the air. Coughing, sneezing, or even talking can send tiny droplets from one person to another. Touching a surface with flu germs and then touching your mouth or nose can cause infection.

Symptoms include:

• Sudden high temperature
• Aches and pains
• Sore throat
• Fatigue
• Dry cough

The Common Cold

Colds spread much like the flu, mostly through droplets and direct contact. They are very infectious, especially in winter. While they usually cause mild illness, vulnerable people can become more seriously unwell.

Symptoms often include:

• Runny or blocked nose
• Sore throat
• Sneezing
• Mild fever

COVID-19

COVID-19 continues to affect health and social care. For how it spreads and how to avoid catching and spreading it, see the NHS COVID-19 page and the national infection prevention and control manual (England).

Common symptoms are:

• Persistent cough
• Loss of taste or smell
• High temperature
• Breathing difficulties

Other Respiratory Viruses

• Respiratory syncytial virus (RSV) usually causes cold-like symptoms but can sometimes be serious for babies and older adults. See the NHS RSV page.

Gastrointestinal (Stomach and Bowel) Infections

Norovirus

Norovirus is a stomach bug that spreads very easily through close contact with someone who has it and by touching surfaces or objects with the virus on them. See the NHS norovirus page and follow your organisation’s outbreak procedure.

Symptoms include:

• Sudden vomiting
• Diarrhoea
• Stomach cramps
• Mild fever

Clostridioides difficile (C. diff)

This bacterium lives in the gut and can take over when antibiotics kill the usual “good” bacteria. It is passed in stool so careful cleaning and hand hygiene are crucial.

Symptoms:

• Watery diarrhoea
• Fever
• Stomach pain

Salmonella and Campylobacter

Food-borne bacteria like Salmonella and Campylobacter can cause illness linked to undercooked or contaminated food.

Symptoms may include:

• Stomach cramps
• Diarrhoea
• Vomiting
• Fever

Hepatitis A

Hepatitis A is a liver infection that is spread in the poo of an infected person. Most people get better within a few months. See the NHS hepatitis A page.

Symptoms:

• Jaundice (yellow skin/eyes)
• Tiredness
• Fever
• Nausea

Skin and Soft Tissue Infections

MRSA (Meticillin-resistant Staphylococcus aureus)

MRSA is a bacterium that lives on skin, especially in the nose, armpits, or groin. If it gets into wounds or the bloodstream, infections can become difficult to treat.

Symptoms vary but might include:

• Red, swollen skin
• Pus-filled wounds
• Fever (if severe)

MRSA can pass through direct contact with skin, shared towels, or medical equipment.

Scabies

Tiny mites burrow into the skin, causing severe itching and a bumpy rash. Scabies spreads through close skin contact. See the NHS scabies page.

Symptoms:

• Intense itching
• Rash, especially between fingers

Ringworm

This fungal infection causes circular rashes with clear edges. For how it spreads and what to do, see the NHS ringworm page and follow your organisation’s procedure.

Varicella Zoster Virus (Chickenpox and Shingles)

Chickenpox occurs mostly in children, but older adults may suffer with shingles. The virus can spread through direct contact with blisters or droplets from coughs and sneezes.

Symptoms:

• Itchy, spotty rash
• Blisters
• Shingles – pain followed by a band of blisters

Urinary Tract Infections (UTIs)

UTIs often affect people using catheters or those unable to use the toilet easily. These infections happen when bacteria from the gut enter the bladder or kidneys.

Symptoms include:

• Burning pain when urinating
• Passing urine more often
• Cloudy or strong-smelling urine
• Confusion (especially in older adults)

Blood-Borne Viruses

Hepatitis B and C

These viruses pass through blood and body fluids. In care settings, this might happen through accidental needle injuries. Follow your organisation’s sharps and needlestick procedure, and see the NHS hepatitis B page and the NHS hepatitis C page.

Both cause liver problems and may not show symptoms straight away. Long-term infections can become serious.

Human Immunodeficiency Virus (HIV)

HIV is not passed on through everyday contact. Staff follow standard infection control procedures for blood spills and sharp objects. See the NHS HIV information and the national infection prevention and control manual (England).

Other Bacterial Infections

Tuberculosis (TB)

TB is an infection that usually affects the lungs and can be serious if not treated. See the NHS TB page. In England, TB is a notifiable disease: see the UKHSA notifiable diseases guidance.

Symptoms:

• Persistent cough
• Weight loss
• Night sweats
• Fever

Group A Streptococcus (GAS)

Group A Strep can lead to scarlet fever, throat infections, and sometimes, more serious illnesses.

Symptoms depend on the condition:

• Sore throat
• Red rash (scarlet fever)
• Severe pain or swelling (if more serious)

Fungal Infections

Fungi affect skin, nails, lungs, or even the whole body if the immune system is weak. Common examples include:

• Athlete’s foot
• Oral thrush (white patches inside the mouth)
• Fungal nail infections

Parasitic Infections

Gastrointestinal Parasites

Parasites such as Giardia or Cryptosporidium can cause stomach and bowel infections. See the NHS conditions pages.

Head Lice

While mainly seen in schools, head lice can affect care homes if unnoticed. They are picked up by head-to-head contact. See the NHS head lice page.

Antibiotic-Resistant Infections

A growing concern in health and social care is the rise of germs that antibiotics cannot kill easily, called “antibiotic-resistant”. MRSA is the best known, but there are others.

Extended-spectrum beta-lactamase (ESBL) bacteria

These bacteria can cause infections in the urinary tract or blood and may not respond to many antibiotics.

Vancomycin-resistant Enterococci (VRE)

Enterococci are bacteria found in the gut. Some enterococci are resistant to certain antibiotics, which can make infections harder to treat. See the national infection prevention and control manual (England).

How Infections Spread

There are several ways infections move between people and objects in health and social care services:

• Airborne: Through coughs, sneezes, or talking
• Direct contact: Skin-to-skin, touching wounds, or body fluids
• Indirect contact: Using shared equipment, towels, or surfaces
• Bloodborne: Needle injuries, cuts, or exposure to contaminated blood
• Faecal-oral: Hands contaminated with stool, then touching food or mouth

High-touch surfaces like door handles, light switches, and remote controls can harbour germs. Shared equipment, such as blood pressure monitors, lifts, or wheelchairs, needs cleaning between users.

Unsafe practice during personal care, poor handwashing, and lapses in cleaning can easily lead to outbreaks.

Who Is At Higher Risk?

Several groups are more likely to become seriously unwell from infections:

• Older adults
• Babies and young children
• People with underlying conditions, such as diabetes
• Those with weak immune systems, like cancer patients
• People recovering from surgery or wounds
• Individuals using invasive equipment, such as catheters or feeding tubes

Staff also face higher risks, especially if they work with more than one person.

Common Signs of Infection

Picking up infections quickly helps to stop them spreading. Some general signs to look for are:

• Increased or unexplained temperature
• New cough or sore throat
• Diarrhoea or vomiting
• Redness, swelling, or pus
• New pain or confusion

Older people may become confused or more tired before other obvious signs appear. If someone seems seriously unwell, follow your organisation’s procedure, and call 999 if anyone is in immediate danger. Symptoms are described on the NHS conditions pages.

Preventing Infection in Health and Social Care

Keeping germs away is everyone’s job in care settings. Some key steps protect people most at risk:

• Hand hygiene, following your organisation’s procedure and the national infection prevention and control manual (England)
• Cleaning and disinfecting shared surfaces and equipment
• Using personal protective equipment as your risk assessment and organisation’s procedure require
• Safe disposal of sharps and waste
• Keeping those who are unwell away from others if possible

Training staff on how infections spread and spotting early signs keeps everyone safer.

Outbreaks

An outbreak means more cases than usual of a certain infection in a setting. Care providers act quickly to stop further spread.

Follow your organisation’s outbreak procedure and contact your local health protection team. In England, see the UKHSA notifiable diseases guidance and the national infection prevention and control manual; other UK nations have their own guidance.

Partnership between care teams, families, and the local health protection team helps stop small problems becoming much bigger.

Comparison of Infections Common in Health and Social Care

Infection Type	Examples	How It Spreads	Common Symptoms
Respiratory	Flu, COVID-19, RSV	Airborne, droplets	Cough, fever, sore throat
Gastrointestinal	Norovirus, C. diff	Faecal-oral, direct contact	Diarrhoea, vomiting, cramps
Skin/Soft Tissue	MRSA, Scabies, Ringworm	Direct/indirect contact	Rash, sores, itching
Urinary Tract	UTIs, ESBL bacteria	Catheters, contact	Pain, frequency, fever
Blood-borne	Hepatitis B/C, HIV	Needles, blood	Often symptomless, fatigue
Fungal	Thrush, Athlete’s foot	Contact	White patches, itching
Parasites	Head lice, Giardia	Direct, faecal-oral	Itching, diarrhoea

Final Thoughts

Infections can affect anyone, but care settings bring higher risks. Knowing which infections spread, how to spot them, and what stops them spreading benefits everyone using health and social care. Following clear routines, like handwashing, cleaning, and spotting early signs, reduces the spread and keeps people safe.