Objective: Traditional Samoan tattooing is a significant and valued cultural practice. Any tattooing carries a risk of complications, including the potential for serious bacterial infection. We discuss the complex nature of the public health investigation into two cases of serious bacterial infection following traditional tattooing occurring in the same region in New Zealand within a six-week period.
Approach: Description of two cases of life-threatening cellulitis (one with necrotising fasciitis) related to traditional Samoan tattooing and presentation of findings from the public health investigation. Discussion of the complex legal and cultural issues that arose.
Conclusion: Our paper illustrates the potential for serious bacterial infection by tattooing when performed in a non-sterile manner. There are gaps in the regulatory framework available in New Zealand to address the public health risks of unsafe tattooing practices.
Implications: It is important to balance the fundamental right to perform the traditional cultural practice of tattooing with the need for meticulous infection control. Reducing the risk of infection will require working in partnership with the community to develop acceptable standards and guidelines and to improve the regulatory framework.