Elena Walsh could not wait to go on a family holiday to celebrate her impending retirement and her son’s engagement.
On August 1 last year, she flew to Cape Verde in west Africa on a £5,000 Tui package holiday with her husband Patrick, their son Sean and their future daughter-in-law Gemma.
But shortly after arriving, Walsh, 64, contracted a stomach bug. Within days, she was dead. The pain in her stomach had become so bad that she was taken to hospital, where local doctors thought she had appendicitis and attempted to remove her healthy organ. Her husband, who was waiting outside the operating theatre, heard her “crying out in pain”.
“The last words she shouted was ‘you’re hurting me, you’re hurting me’,” Patrick, 60, said from the family home in Birmingham. “That’s the last of her.”He broke down in tears as he recalled his wife’s traumatic final moments.
Elena Walsh with her husband, Patrick, and son Sean
A post-mortem examination in the UK found nothing wrong with Walsh’s appendix. It concluded she had died of heart failure and listed gastroenteritis as a secondary cause of death.
The Walsh family are not alone in losing a loved one in Cape Verde.
A Sunday Times investigation has found that three other Britons died within three months of Walsh after falling ill in Cape Verde and receiving poor medical care in local hospitals.
Karen Pooley, 64, Mark Ashley, 55, and David Smith, 54, whose name has been changed, died of various medical complications — including gastroenteritis, fractured bones and heart failure —sustained while holidaying in the west African country. They were all staying in a Riu hotel, a Spanish chain with six resorts in Cape Verde, when they first fell ill.
Karen and Andrew Pooley
COURTESY OF THE POOLEY FAMILY
All four had underlying but manageable health conditions. Their families have questioned whether Cape Verde was safe for them to visit given its quality of healthcare, which the Foreign Office calls “very basic and limited”.
Tui and Riu Hotels said they were “deeply saddened” by the deaths and offered their “heartfelt condolences to the families affected”.
Our investigation found:
The islands have twice been gripped with an outbreak of a highly contagious illness, which most recently afflicted hundreds of tourists in the final months of 2025.Government officials in Cape Verde have held emergency talks with hotels and are investigating “standing water sources” and pest control action.Families claim local hospitals are in a poor condition and one was likened to a war zone.Tui is still selling package holidays to Cape Verde. The Sunday Times visited during the peak of the recent outbreak and was not told how to stay safe or about the illness sweeping the islands.
Paradise islands
Sitting in the Atlantic 350 miles to the west of Senegal, the ten islands that make up Cape Verde offer sunshine and warm temperatures all year round.
Over the past two decades, their popularity as a holiday destination has surged. The islands of Sal and Boa Vista have proven particularly attractive to tour operators, which pitched them as cheaper alternatives to the Caribbean.
Visitor numbers have grown rapidly from 115,000 in 2000 to 981,000 in 2024, and Britons account for 36 per cent of them.
All-inclusive packages are particularly popular and Tui is the largest provider. A reporter from The Sunday Times booked a Tui package holiday to Cape Verde for five nights, checking into the Riu Karamboa on December 3.
The hotel has six restaurants and serves meals throughout the day. Guests help themselves at buffets and much of the food is kept on hot plates. At one of the outdoor restaurants, flies surrounded the food and drink dispensers.
During the warm week in December, throngs of happy European tourists filled the 900-bed resort and enjoyed its five swimming pools, two swim-up bars, water park and private beach access.
Little did they know that Cape Verde was in the midst of an outbreak of a contagious pathogen that would leave holidaymakers severely unwell. Nor did they know that those who went to the local medical clinic claimed it was chaotic.
Mass sickness
Santa Maria, on the island of Sal
PETER ADAMS/GETTY IMAGES
Late last year, several European countries noticed a rise in positive tests for shigella, a bacterial infection that causes severe diarrhoea, fever and stomach cramps.
It is caused by contaminated faeces and is transmitted from food, water or person to person. In most cases people can recover without medical care, but for those with existing medical conditions it can become serious.
“It can be quite a nasty bacterium,” Brendan Wren, a professor at the London School of Hygiene and Tropical Medicine, said. “It’s invasive … so it can be a killer in some cases. Most of the time, it goes away within two or three days.”
European health officials established that the majority of people presenting with shigella had recently returned from Cape Verde.
In December, the European Centre for Disease Prevention and Control (ECDC) reported increases in shigella from the Netherlands, Sweden, Ireland and France. The UK Health Security Agency recorded 137 cases between October and December — 80 per cent of patients had recently returned from Cape Verde.
One was Jess Richards, 31, who suffered from severe sickness days into her honeymoon at the Riu Palace Santa Maria in October. After returning to the UK, Richards tested positive for shigella and was paid £4,000 in damages by Tui, which denied all liability. She accused the tour operator of “ruining my honeymoon” and not warning her about the risk of illness.
“I was never made aware before I went that something was going on. There was never an email. There’s nothing in the hotel,” she said. “Don’t go [to Cape Verde]. Your health and the money in your pocket is not worth ever ever putting yourself in that kind of risk.”
On December 15, the Foreign Office warned British tourists travelling to Cape Verde about shigella. In fact, it was the second outbreak on the islands.
The first outbreak
In November 2022, the ECDC had spotted a spike in shigella cases on Cape Verde, including 23 cases from UK citizens in the previous 12 months.
A few weeks later, Jane Pressley, 62, from Lincolnshire, arrived at the Riu Palace Santa Maria. Days into her holiday, she fell ill with symptoms of gastric illness, lawyers allege, and died three weeks after coming home.
Pressley’s widower is one of 300 claimants now suing Tui in the High Court. All stayed in the Riu Palace Santa Maria in 2022 and fell ill either during or after their trip, it is alleged. Some were diagnosed with E.coli, salmonella or shigella.
In the claim filed last year, they allege that Tui breached its duties and obligations under the Package Travel Regulations 2018 and other laws by failing to provide safe food, drink and hotel facilities. Tui is contesting the allegations and it denies liability on several grounds, including that there are many potential causes of gastric illness which can arise through no fault of the company or its suppliers.
A spokeswoman for Riu Hotels said random samples were collected from food and kitchen staff every month in Cape Verde and no presence of shigella had been detected.
Jatinder Paul, a lawyer representing the claimants, described the repeated sickness of tourists in Cape Verde as “nothing short of a scandal”.
“The number of holidaymakers to Cape Verde being struck down with serious and debilitating gastric illnesses is truly staggering,” Paul, from the firm Irwin Mitchell, said. “I’m used to supporting holidaymakers who have fallen ill at resorts across the globe, but I’ve never seen repeated and continued illness outbreaks at the same resorts on such a scale over such a period of time.”
But some families whose relatives fell ill say that the problems on Cape Verde go beyond the outbreak.
The four fatalities
When Elena Walsh travelled to Cape Verde in August she had been managing a heart problem for 12 years but was signed off as fit to travel by her cardiologist.
Several days into the stay at the Riu Cabo Verde on Sal, Walsh’s husband Patrick was “violently sick” and their son’s girlfriend, Gemma, had a bad stomach. Both recovered.
A few days later, Walsh was overcome by a sudden wave of nausea and rushed away to be sick. When she re-emerged, her son said it looked like she had “turned the shower on, [she was] dripping in sweat.” Walsh immediately returned to her room “cramped, bent over double in pain”.
Overnight her condition worsened and she was taken to the local clinic, Clinitur, where doctors misdiagnosed her with appendicitis. Clinitur is one of only two private Verdean clinics recommended on the Foreign Office website. She was moved to the state-run Hospital Regional Ramiro Figueira for surgery.
Walsh was given an epidural for pain relief but her family heard her crying out. A spokesman for the hospital said “no patient undergoes any surgical intervention without being properly anaesthetised”.
On the first incision, Walsh had a heart attack and the operation was stopped. She never regained consciousness. Her cause of death was recorded as ischemic heart disease and coronary artery atherosclerosis. Acute gastroenteritis and attempted appendectomy were listed as secondary causes.
The hospital said it “deeply regrets what happened and extends its deepest condolences to the bereaved family”.
By the time Pooley, Smith and Ashley arrived for their holiday in Cape Verde, it was in the grip of a second outbreak.
While none of them tested positive for shigella or other pathogens, they all showed symptoms of gastric illness. They went on to suffer other medical complications and their primary causes of death are not related to gastric infection. Some families claim they asked for their relatives to be tested, but local medics said they did not have the facilities to do so.
David and Rachel Smith (who requested her husband’s identity remain anonymous) stayed at the Riu Karamboa. The couple from Chester had enjoyed a holiday there a year earlier.
Smith, a lawyer who had diabetes, listened to history podcasts next to the pool, and Rachel went for morning swims. But ten days in, the father of two had become so unwell with diarrhoea and nausea that his wife was running around the hotel screaming for a doctor.
He was taken by ambulance Clinica Boa Esperança, the other clinic recommended by the Foreign Office, and Rachel followed in a taxi. When she arrived, she found Smith “in loads of pain” and screaming “I want my wife”. Doctors told Rachel that he had gastroenteritis.
In the early hours of November 8, doctors sedated Smith and decided he needed to be flown by air ambulance to Tenerife for better care. Rachel was told she needed their passports. She returned to the hotel to collect them, but shortly after she arrived, at 2.45am, the clinic called to say Smith had died following a cardiac arrest.
Medical notes from the clinic diagnosed him with heart failure, cardiogenic shock and gastroenteritis.
“What [he] went through in those last few hours, and his death, that was horrendous … I will never get those images out of my head, ever,” Rachel said. “I was left to deal with this totally alone. Tui was nowhere to be seen.”
Her son, 26, has taken his father’s death particularly badly, Rachel said. “He has been robbed of his father, his best friend, and his goodbye. It’s a loss he will carry for the rest of his life.”
His daughter warned others not to go to Cape Verde and alleged that Tui was “putting people in a really vulnerable position” by selling holidays to the islands.
The families of Pooley, who had cerebral palsy, and Ashley, who had diabetes, raised similar safety concerns.
‘War zone’
Pooley and her friend Corinne Hibbert arrived at the Riu Funana on October 7. A few days in, Hibbert, 59, suffered a fever, diarrhoea and vomiting. (She would be diagnosed with shigella by her GP when she returned home.)
Though unwell, Hibbert was determined to enjoy her holiday. She and Pooley set off on an excursion on October 11, but during the trip Pooley, who had been in “the shape of her life”, started to feel unwell and returned early to the hotel.
That night as she rushed to the bathroom, Pooley slipped and was in agony. Hibbert spent two hours trying to get her off the floor.
In the morning, Pooley was taken by ambulance to Clinitur, the clinic that treated Walsh. She was diagnosed with a fractured femur, a serious injury that generally requires surgery within 48 hours. Over four days, Pooley received no such operation.
Karen Pooley with her son James
COURTESY OF THE POOLEY FAMILY
“We were not confident in the days leading up to Mum’s death that she was in a competent and up-to-standard medical facility,” James, her son, said. He recalled his mother describing the clinic as “a war zone” to him over the phone. “In the background of all the calls, you could just hear constant retching. You could hear people in pain,” James said.
Pooley’s insurers advised that she be flown home and operated on at Gloucestershire Royal Infirmary, but the plans took several days to organise as the insurers struggled to make contact with the clinic, the family claimed.
Eventually her evacuation was scheduled for October 16. When the doctors arrived, they said she urgently needed to be taken to Tenerife, where she was admitted to intensive care soon after arriving. She died in the early hours of October 17. Her primary causes of death were septic shock, heart failure, kidney failure and a femur fracture.
“When you book a holiday, you don’t expect to go and then your friend comes home in a box,” Hibbert said, fighting back tears. “If we had gone somewhere else, maybe she would still be here.”
About a kilometre down the coast, Ashley, a father of two, was on a Tui holiday at the Riu Palace Santa Maria with his wife, Emma.
They had been frequent customers of Tui and Riu, travelling with both brands all over the world. But two days in, Ashley began suffering from similar symptoms to Pooley and Hibbert.
Mark Ashley with his family
The couple sought help from Clinitur, but Emma said that when they arrived she had “never seen anything so horrific in all my life. People were going in, all the Riu [wrist] bands on, from the different hotels, on drips.” Emma later showed mild symptoms of a stomach bug too.
Ashley, a self-employed forklift driver, managed to return to the UK on October 17, but his condition deteriorated; he lost a significant amount of weight and told his family he was struggling to breathe.
After calling in sick to work, Ashley woke up on November 9 with conjunctivitis and the following day he had a fever and started vomiting again. On November 11, he showed signs of confusion at home and collapsed. He was taken to Luton & Dunstable Hospital and died shortly after arriving.
At the point of writing, the cause of Ashley’s death is inconclusive and a British coroner has sent his body for further tests.
Emma said his death had ruined her life. “I’ve lost the man I’ve been with for 40 years. My children have lost him. He’s never going to walk [our daughter] down the aisle, or meet his grandchildren, all because of a holiday,” she said. “Something is seriously wrong over there.”
Following the Foreign Office warning about shigella on Cape Verde, new guidance appeared on the TravelHealthPro website which uses information from the Department of Health and Social Care. It advises travellers to wash their hands often, eat only piping hot food that has been recently prepared, and avoid swallowing water from untreated swimming pools. It advises those with ongoing health conditions, the elderly, pregnant women or young children to seek medical advice if they fall ill.
Following the four deaths, government officials in Cape Verde organised a “high-level meeting” on December 18, which was attended by a representative of Riu Hotels.
“Local authorities and business leaders identified critical areas for immediate action, including the elimination of standing water sources and the implementation of intensive pest control plans to combat the proliferation of flies and mosquitoes,” a spokeswoman for Riu said.
“Riu Hotels and Resorts will continue to work closely with the local government and health authorities to ensure the destination continues to offer the highest standards of wellbeing to all its guests.”
A spokeswoman for Tui said: “While we cannot comment on individual cases, customer safety remains at the heart of our operations. With industry-leading standards and robust measures in place, we are committed to ensuring customers are protected wherever they are.
“Tui follows FCDO advice for all destinations and, through our global health and safety management programme, conducts investigations in co-operation with hotel partners and relevant authorities.”
A spokesman for Clínica Boa Esperança said it “extends its deepest condolences” to Smith’s family and that it has a “commitment to clinical quality”. A spokesman for Clinitur said it treats all patients “with dedication, care, rigour and professionalism”.
