LEGIONELLA
SPAIN 1999
Outbreak of legionnaires' disease associated with a spa resort in Spain
 

An outbreak of legionnaires' disease has been identified in north east Spain among people who stayed in the natural spa resort of Cestona in the province of Guipúzcoa between 1 and 22 May 1999.
The first case was diagnosed on 20 May. By 31 May 1999, two confirmed cases had been diagnosed by legionella urine antigen detection test, there were six suspected cases, and 35 people were being investigated. Local health authorities have established that 432 people were staying in the resort during the period under investigation. Six visitors were from other European Union countries, four from the United Kingdom (UK) and two from Portugal - none of these is known to have become ill.
All people who may have been exposed have been identified and are being investigated for legionella infection.

The spa resort was closed on 22 May. The regional public health director of País Vasco (Basque Country) has informed all doctors and the general public. The coordinating centre of the European Working Group on
Legionella Infections (EWGLI) was informed of the outbreak in order to follow up the possible British and Portuguese cases and will be notified officially when all the details of the cases have been obtained for reporting purposes.
The regional surveillance unit, in collaboration with the National Centre for Epidemiology, has begun an epidemiological and environmental investigation to identify the source of the outbreak. Legionella pneumophila serogroup (sg) 1 has been recovered from water samples taken in the spa resort.


These virtues were what gave rise to Cestona Spa,  whose healing waters were discovered in 1760, when  some of the Marquis de San Millan´s dogs were cured  of scabies after bathing in small pools of warm water.

The waters, called "guesalaga" (salt waters)  were officially declared to be beneficial to the  health in 1792, and in 1804 Cestona Spa was  opened and tourism in the Basque Country  began.

The province of Guipuzcoa has a long spa  tradition. At one point there were as many as 11  public spas in the area, of wich only Cestona spa  is still open today.

The original 1804 bathhouse, built directly  over the spring itself, has been renovated  and modernised and continues to offer  hydroterapy tratments, while the Grand   Hotel, so emblematic of the spa, dates from                   1893.
After the great floods of 1893, Cestona  Spa´s services and installations underwent  a vigorous process of renovation. The latest  hydrotherapeutic and spa technology was  installed, putting Cestona on a level with the  most famous European spas.