Seems the Vics are going over board on their outbreaks of late
29th April 2000

MELBOURNE GOES BLOODY MAD ON LEGIONELLA
HOW MANY MORE MUST DIE

LEGIONNAIRES' KILLS 2

18 March 2001

The Age

According to this story, emergency health teams were mobilised yesterday to test buildings across central Melbourne's legal precinct - one-and-a-half city blocks - after the death of two men from legionnaires' disease, with another three ill.

Public health officials went into action, notifying building owners and demanding they call in specialists to disinfect air-conditioning systems as a precaution against the Legionella bacteria.

The story says that the action was taken after a positive test was recorded in an air-conditioning tower of the 12-storey Douglas Menzies Chambers, on the corner of William and Little Bourke Streets - but for a different bug than the one that killed the men.

One of the dead was the owner of the building's ground-level Illia restaurant, Peter Black, 53, from Hawthorn East, who died on Thursday after falling ill on March 6.

The other man was a 43-year-old Berwick sales manager, who became ill on February 28 and was treated by his GP, but died on March 5.

He had visited the William and Little Bourke Street area during the incubation period in February.

Both men were found to have Legionella in autopsies conducted by the Coroner's Office, which is now checking all deaths from pneumonia-type symptoms.

Victoria's acting chief health officer, Dr John Carnie, is urging anyone who has been near 180 William Street and is suffering respiratory symptoms to consult a doctor and request a test.

The danger period is believed to be from mid-February to the first week of March. The block affected is bounded by Queen, Lonsdale, Gresham and Bourke Streets.

Thousands of city workers are in the area daily, including almost all Melbourne's barristers and others who work in the County, Magistrates, and Supreme and Federal Courts.

Victorian Bar Council chairman Mark Derham, QC, was quoted as saying the council "believed all responsible precautions have been taken at this stage.

We have notified all our tenants of the detection of the Legionella bacteria.

The story says that although Human Services Victoria was notified of the Berwick man's death on March 7, it sprang into action only yesterday after a connection was made between all the cases.

Dr Carnie was cited as saying the air-conditioning towers at Douglas Menzies Chambers were tested on March 2, and on March13, the results showed Legionella at a rate of 1000 colony-forming units per millilitre.

But the Legionella was type 2-14, whereas the deaths and the illnesses had been caused by Legionella type 1.

However, he said circumstantial evidence of the death of the cafe owner, and the proximity of the other patients to it, and the ability of Legionella levels to go up and down, pointed to the problem being in that building.

Dr Carnie said the towers were heavily disinfected on March 13, again on March 14, then resampled by the building's owners on Friday and again by the Human Services Department yesterday.

He said the building was no longer a public health risk.

There have been three deaths and 30 cases of legionnaires' disease in Victoria this year. Last year, there were 247 cases and 11 deaths, and, in 1999, 64 cases and five deaths.

Dr Carnie added that Victoria had the world's most stringent regime for legionella testing, with new regulations recently put in place.

A third man, 44, from Dandenong North, who delivers food, became ill on February 26. He was admitted to Dandenong Hospital on March 4 and discharged on March 14. Human Services was notified on March 9 that he had legionnaires'. The man is now recovering at home. 

A related story says that the Illia restaurant was deserted yesterday. Dead leaves and a Four 'n' Twenty pie wrapper had blown into the locked doorway.

Three empty green plastic crates were stacked up outside.

A quiet street. Just what you would expect on any grey autumn Saturday. But this was no normal day.

 Another story says that since last year's Legionella outbreak at the Melbourne Aquarium, legionnaires' disease has been wreaking havoc on buildings across Melbourne. There have been three deaths this year.

Yesterday's fatalities bring the toll from the disease to 14 in the past two years. Since April last year there have been contaminations in the cooling towers of the aquarium, the Department of Defence in Bourke Street, City West Water, Collingwood Football Club, Royal Melbourne Hospital, the Melbourne Museum and The Age.

The aquarium outbreak was by far the worst incident - two people died and more than 100 were infected. 

FEBRUARY 2000????
OH MY

MAXINE McKEW: Legionnaires` disease is a debilitating condition which can prove fatal for one in six people who contract it. Across Australia, the number of people falling victim to the legionella bug is on the rise -- so far this year, some 400 people have fallen ill.

In the main, it's caught from contaminated air conditioning cooling towers. According to one expert, most cases of legionella could be prevented merely by introducing tighter regulations for cooling towers. But so far, State health departments have been slow to crack down. Jacinta Tynan reports.

JACINTA TYNAN: This is the bacteria which causes legionnaires` disease. It's found in most water systems -- even rainwater in low counts. But if it goes unchecked, it can breed rapidly and pose a major public health risk.

DAVID CHRISTIE: I had massive headaches, aching from head to foot, and a fair bit of abdominal pain.

NEWS BULLETIN: Today, the Health Department confirmed seven Sydneysiders have recently contracted it...

JACINTA TYNAN: Right now, the incidence of legionnaires` disease is on the rise across Australia. Almost 300 people contracted legionnaire's last year. Already this year, there has been a 40 per cent increase. Most of the cases are attributed to the poor maintenance of cooling towers.

CLIVE BROADBENT, LEGIONNAIRES` CONSULTANT:
Surveys that I've carried out of cooling towers show that it's present in at least 50 per cent of cooling towers, but that's no great surprise.
What is a surprise is if the counts are allowed to increase.

JOHN MIHAJLOVSKI: Symptoms? Flu, temperature -- very high temperature 39, 40, 41 -- and like five days I don't remember nothing. After that...

JACINTA TYNAN: John Mihajlovski is one of the victims of Australia's largest outbreak of legionnaire's. Nineteen people contracted the disease in Melbourne's industrial suburb of Thomastown last year.

The Victorian Health Department confirmed the source of the outbreak was several contaminated cooling towers -- part of air conditioning systems in the nearby industrial complex.

DR GRAHAM ROUCH, VICTORIAN CHIEF HEALTH OFFICER: We investigate every single case of legionnaire 's disease. We take it seriously because outbreaks can occur, they can catch us unaware and we can do quite a lot to prevent them.

JACINTA TYNAN: But according to one legionella expert, not enough is being done to minimise the spread of legionella.

CLIVE BROADBENT: This is 100 per cent preventable. We know the cause is equipment and that that equipment can be kept in a hygienic condition, so there's absolutely no excuse, really, for any cases.

JACINTA TYNAN: Clive Broadbent has worked in the air conditioning industry for more than 40 years. He has made recommendations to two State governments to toughen the regulations on water cooling systems but those are yet to be implemented.

In 1996, Clive was commissioned by the New South Wales Department of Health to draft new regulations on cooling systems. But he says his recommendations have been ignored.

CLIVE BROADBENT: I think it's just too long to wait, really. I mean, governments should be seen to be right up with the latest in Australian standards and helping people.

JACINTA TYNAN: It means the legislation hasn't been revised since it was introduced in 1991.

STEPHEN CORBETT, New South Wales HEALTH DEPARTMENT: Well, I'd say it's not an unreasonable time for review of such a complex piece of legislation. It's pretty much a standard interval for review of a complex piece of legislation. It's not just dealing with legionella, it's dealing with a whole range of public health issues. We're about to issue a discussion document for the most current review and we hope to have the process completed early next year.

JACINTA TYNAN: As a result, recent scientific evidence on the use of chemicals known as biocides, to disinfect cooling towers, has been overlooked. But of greatest concern is the issue of maintaining the towers.

Under the current code, cooling towers in New South Wales must be cleaned and inspected every three months.

But it's a system of self-regulation which isn't monitored by the Health Department.

STEPHEN CORBETT, New South Wales HEALTH DEPARTMENT: There are 15,000, approximately, probably a lot more by now, cooling towers in New South Wales.

It is a very large regulatory problem.

Now, if we were to devote resources to inspecting and testing every one of those towers, it would be an enormous task for what is, in fact, quite a small risk.

JACINTA TYNAN: The New South Wales Government does have the power to prosecute building owners and managers who fail to maintain their cooling towers.

With a maximum penalty of $50,000, or six months in prison, the aim is to encourage individual operators to ward off legionella, but so far, no-one has ever been prosecuted.

STEPHEN CORBETT, New South Wales HEALTH DEPARTMENT: You should remember, though, that prosecution is really only the last resort in the regulatory scheme that we have in place.

We would issue certificates of warning if we found a cooling tower not to be complying and that's usually sufficient to improve practice in a particular location.

CLIVE BROADBENT, LEGIONNAIRE'S CONSULTANT: I can certainly vouch for the fact that there are people who should have been prosecuted when you go around in the normal course of a day's work and see cooling towers that are not being properly maintained.

JACINTA TYNAN: In 1997, Clive Broadbent advised the Victorian Government on an updated and much stricter code of practice to control legionella.

But Victoria still adheres to a set of guidelines which were written 10 years ago.

While the guidelines are under review, the Health Department claims the increase in legionella outbreaks is due to improved diagnosis.

DR GRAHAM ROUCH, VICTORIAN CHIEF HEALTH OFFICER: A number of years ago, a new test became available which can find the presence of the products of the bacteria in the urine of a patient.

This is a very elegant test and is now able to show clinicians the presence of legionnaire's disease much sooner than could otherwise be done.

JACINTA TYNAN: Cooling tower auditor Tony Debeck believes governments have grown complacent about legionella control. The former environmental health officer with New South Wales Health wants to see governments get tougher on building owners and managers. What effect would it have if the government was to take on Clive Broadbent's advice?

TONY DEBECK: I believe that the water cooling systems within New South Wales would be far better maintained and there would be less cases of legionnaire's disease within the community.

JACINTA TYNAN: Even after New South Wales and Victoria review their legionella laws, it will still be up to individual owners to monitor their own cooling towers, but that's no guarantee of protection.

Factory manager David Christie has always been diligent with the maintenance of his cooling towers, but he still contracted legionnaire's disease last October. Where do you think you got legionnaire's from?

DAVID CHRISTIE: Look, I don't really know. In my line of business, you know, I can imagine I'm going to a lot of places, day in, day out, and it would be very hard, I guess, to trace. The only thing the Health Department told me was just the fact that I was a one-off person that got it -- it is very hard to trace.

JACINTA TYNAN: Other States don't have guidelines or codes of practice for legionella control, but follow the lead of New South Wales and Victoria. Clive Broadbent says it is up to those States to set a better example.

CLIVE BROADBENT: It doesn't send the right message and therefore, I do believe New South Wales Health ought to lift its act a little and certainly be seen to be doing the right thing and that will send a message through the industry.

Major outbreaks of Legionnaires? disease (causative agent, Legionella spp.) occurred in Australia during the 1980s and early 1990s. The putative sources were primarily heat rejection systems of the recirculating cooling water type (cooling towers).
These outbreaks prompted engineers to carry out field studies on which to base improved design and maintenance practices for such heat rejection systems. Health authorities introduced regulations and guidelines to encourage owners to establish and maintain hygienic conditions in these and other systems.
Central to this progress is the recognition that Legionella is essentially a biofilm organism and that it prefers the surfaces of warmer parts of systems for growth. This is particularly so if there are deadlegs in the system or accumulations of sediment.
Biocidal water treatment approaches must therefore take biofilm control into account. A recent Australian innovation is the preparation of a national performance-based regulatory standard to complement earlier standards that are of a prescriptive nature. The aim of this new standard is to allow alternative strategies that may not necessitate system shutdown for regular cleaning yet provide for an equivalent level of system hygiene. The standard requires that a risk assessment strategy be implemented involving identification of performance indicators and control and monitoring of parameters likely to move beyond stipulated limits.

Abstract....................................Don't count on chemicals to kill the bacteria

THE ideal breeding conditions for legionella bacteria are water plus sunlight, heat, slime, pollutants
and corrosion - all of which are found in air-conditioning systems.
The growth of bacteria can be stopped by proper maintenance and the use of special chemicals, known as biocides.

But in NSW, associating the word "proper" with anything to do with air-conditioning regulations is a risky business.

Water-treatment companies which disinfect air-conditioning systems need Health Department approval to use biocides. Approval relies on company data being passed by an expert panel. No testing of the highly toxic chemicals they use is carried out.
In NSW, no biocides have ever received final approval

The chairman of the Australian Standards Committee on air-conditioning, says the system is "a farce" and "virtually meaningless". "Biocides are routinely given conditional approval," he says. "The sad point is that this has been going on for nearly 10 years."

An independent consultant, says: "People were virtually allowed to evaluate their own product."

In 1995, a Health Department study found a third of premises tested in western Sydney had raised levels of legionella. Most had followed maintenance procedures.

In submissions to an aborted 1997 government review of the regulations, water-treatment companies supported a review of the procedures for approving disinfection methods.

The department says after chemicals are used for 12 months, companies have to supply data demonstrating their effectiveness.
A legionella consultant to the NSW director-general of health, says: "We are not getting a lot of complaints."

Debeck says review of biocides is a matter of urgency "because [many of] the biocides are not doing the job they're supposed to".

And the type of biocide used is only part of the problem. a private consultant who tests cooling towers, cites cases of "extra heavy-handed" dosing of chemicals which has caused people to leave premises to escape toxicity.

"There are groups of people who are backyarders and there are other groups who are very competent," says Bill Pugh, of the National Water Treatment Industry Group. "Unless you get control of what people are doing and they're trained to do it properly, they could cause huge problems."

SOURCE..Sydney Morning Herald

Alex and Yvonne Milligan ... they have spent years fighting for information about Alex's illness.

Legionnaires` disease is a growing public health problem, yet the public are kept in the dark about the risks,

WENDY BACON and TRACY PILLEMER.

EXAMINE a puddle closely enough and you will find the bacteria responsible for legionnaires` disease. If you're really unlucky, however, all you need to do to come into contact with the legionella bug is to visit a shopping centre or hospital or office block on the wrong day and take a deep breath.

Alex Milligan took a shopping trip five years ago, and it almost cost him his life. Today, he is still paying with his health after breathing in air contaminated with droplets of legionella-infected water.

If Milligan had been mugged, he could have received compensation by now, even if his assailant had never been caught. But as a victim of a public health disease contracted on commercial premises he has no right to information about the source of his disease and no right to compensation.

His case is a sorry testimony to the failure of NSW's public health system to ensure the safety and the rights of people using public buildings.

Milligan was 54 and leading a busy life as a painter and decorator, and rockfishing, cycling and golfing in his spare time. A mild smoker, he was found to be in excellent health in a full medical exam in 1993.

In early 1994, he and his wife Yvonne sold the bed-and-breakfast business they ran together in the Hunter region, and planned to buy a motel. First, though, they would visit relatives in Scotland. Between February 7 and 10, 1994, the Milligans visited four shopping centres in the Newcastle area to buy gifts for their trip. They also went to the movies.

On February 23, Alex became ill with a rash, a painful headache and searing temperature. He was admitted to a local clinic where he did not respond to treatment. Several days later, he nearly choked to death as he was transferred by ambulance to the Mater Hospital in Newcastle.

During the next few days, Alex's kidneys, bowel and lungs collapsed. His family watched in horror as he struggled for his life. Close friends left the hospital expecting never to see him again. "We have no immediate family in Australia, only our two boys, then 16 and 23. We all cried together as we watched Alex fight for every breath," says Yvonne.

After a week he was so thin and grey, his eyes always closed, and still unable to talk. I just couldn't believe this man who had the physical 11 months before was dying before my eyes. If I'd known then what I know now, I think I would have been more scared."

Legionnaires` disease is contracted by inhaling legionella bacteria suspended in tiny water droplets in the air. Most Australian cases are linked to air-conditioning, although an increasing number have been linked to potting mix.

Airconditioning engineers say the disease is preventable, with the solution lying in the proper cleaning and design of cooling systems. But when those measures fail, the results for human beings breathing the air can be catastrophic. About 15 per cent of people diagnosed with the disease die. In NSW there have been about 75 deaths since 1992. Last year, there were 268 notified cases in Australia, 25 per cent more than in any previous year.

An airconditioning consultant and chairman of the Australian Standards Committee on Airconditioning, believes there may be 10 times more cases than are officially recognised.
This is confirmed by medical research.

Health authorities underplay the issue. Sometimes a press release is issued when a group of cases coincide in time or place, but there have been no announcements about successful NSW Health Department investigations of outbreaks since 1995. Victims' demands for information under the NSW Freedom of Information Act (FOI) have been denied on the grounds that to release it would prejudice the commercial interests of the companies involved.

The Health Department issued a media release announcing seven confirmed cases of legionnaire's disease in Sydney. The department assured the public that no-one had died and there was no known common link between the cases.

A department spokesperson acknowledged there had been 11 cases in February, including a cluster of victims, and that a number of possible contaminated sites had been identified. Once again, no source was identified. The public was not told about the contaminated air-conditioning systems "for legal reasons", or even that the cluster was in western Sydney.

The disease causes pneumonia-like symptoms between two and 10 days after breathing the infected air. Symptoms include severe disorientation, headache, fever, vomiting, diarrhoea. Respiratory failure is rapid and severe. Death due to cardiovascular collapse can occur within two weeks.

The 85 per cent of victims who recover are often severely debilitated. The term "successfully treated" or "fully recovered" in a Health Department news release means only that the victims did not die. The truth is those with legionnaire's disease may never fully recover.

Adele Rogers, 74, did not know that a day trip to a South Coast RSL Club in 1993 would nearly cost her her life. It was a hot day and she sat under an air vent to cool down. She ended up in intensive care for 13 days. "I was on 97 per cent pure oxygen. I died three times. I was in very good physical condition - that is the only reason I lived."

Six years down the track, she still suffers the effects. "I used to walk two miles a day, come hail or shine. I'm just existing, more or less. I can't do anything because I can't get air."

Rogers received an out-of-court settlement two years ago. "It nearly all went back to hospitals, doctors and lawyers," she says.

Soon after Alex Milligan's admission to the Mater Hospital on February 25, 1994, one doctor suspected legionnaires` disease and prescribed the antibiotic erythromycin, one of only two drugs which treat the disease. On March 7, a test showed positive for legionella for the first time. The Hunter Area Emergency Plan for legionella stressed the dangers of delayed diagnosis and notification, but the Health Department was not notified of Milligan's illness until March 31, more than one month after doctors first suspected he had the disease. His case did not appear in official figures for the Hunter region between March and June 1994.

Contacted by the Health Department, Yvonne Milligan supplied the names of the shopping centres and cinema in the area around Newcastle which she and Alex had visited. "I was led into a false sense of security. I thought they're going to fix this so it doesn't happen to someone else," she says.

But Health Department documents show it was a further two weeks before Hunter Area Health Service rang the Government Analytical Laboratories (GNA) to arrange for the sites to be tested. According to Health Department memos, Sue McKersie, the then director of the GNA, said: "Because of the lateness of receipts of the notification and diminished significance of any analytical results taken now, the laboratory, with the present workload, would be unable to accept the required number of samples."

The lab agreed to take the samples later that month - a delay during which other members of the public who visited the same shops and cinema as the Milligans risked infection.

Samples were finally taken by health inspectors from 17 separate cooling systems on April 27. Fifteen of these were tested the following day.

Since 1991, public health regulations have incorporated a code of practice for cooling towers which states anything over 10 colony forming units (cfu) per millilitre (cfu/ml) shows "maintenance practices may not be satisfactory". Between 100 and 1,000 cfu/ml is "potentially hazardous", and greater than 1,000 cfu is considered a "serious situation - shut down the system immediately and decontaminate".

The results in the Milligan case, which have been obtained independently by the Herald, reveal that six of 15 cooling towers had levels of legionella above 100. Garden City shopping centre in Kotara had two cooling towers with 650 cfu/ml and 1,720 cfu/ml respectively. A tower in Stockland Mall, Jesmond, had 1,000 cfu/ml. The cinema had 120 cfu/ml. Only one of four malls visited by the Milligans, Charlestown Square, in Charlestown, had less than the recommended limit of 10 in all its air-conditioning systems.

Despite clear instructions in the department's emergency plan that duplicate samples must be taken during any investigation, records show two samples were "lost in transit" from Garden City, owned by the AMP Shopping Centre Trust, and Stockland Mall.

A Hunter Area Health Service spokesperson says one sample was an extra, and therefore not forwarded to the laboratory, and the other was broken en route. A record of the test results, however, shows that both lost samples came from separate, identified cooling towers and were not duplicates.

When asked about the April 27 tests, the Hunter Area Health Service denied the tests were part of an investigation, saying they were part of "general environmental inspections". "It is standard practice in NSW that environmental inspections are not carried out in response to one-off cases of legionnaire's disease."

This conflicts with the Health Department's recent statement: "All cases of legionnaire's are investigated. Investigations are commenced to try and identify a possible source for every case."

After receiving Alex Milligan's test results, medical staff at Hunter Health waited nearly another fortnight before writing to managers of contaminated sites: "The level of contamination is considered unsatisfactory and could possibly represent a danger to health. When disinfection has been completed, please arrange for further samples to be taken."

No deadline for cleaning was imposed, nor were requests made for new independent tests. Garden City supplied the Health Department with test results showing counts of consistently less than 10 cfu/ml in February, March, April and May 1994. A spokesman for AMP Asset Management, which manages the AMP Shopping Centre Trust, said: "We had no explanation for the result obtained by the Hunter Area Health Service. We were not given an opportunity to have an independent laboratory test."

Alex Milligan is angry the public was not alerted to test results at the end of April. "Even if they weren't guilty in my case, the readings were high - it was there to be contracted by anyone."

An air-conditioning engineer for Stockland Mall has expressed surprise that the Herald was able to obtain the results in the Milligan case because his and other companies involved had refused to have them released through FOI. Paul Hunter, the general manager of Stockland Shopping Centres, declined to comment.

Strong evidence that individual cases are often part of outbreaks is provided by a study done the year after a 1993 outbreak in a Parramatta hotel car park. Medical researchers, most of whom were attached to the Western Sector Public Health Unit, found more than 40 of 152 retirees who had attended a seminar at the hotel had raised levels of legionella in their blood, or had suffered symptoms similar to those of legionnaires` victims during the relevant period.
The Health Department had been notified of only two of these cases.

Two other cases notified in this Parramatta outbreak were passersby. The study was limited to those who attended the seminar, although researchers acknowledged contaminated air can affect people several kilometres away.

The results were published in a British epidemiological journal in 1996, but received no publicity in Australia.

The Health Department did not inform Alex Milligan of the results of the tests on the places he had visited. Alex was still very sick, so it was up to Yvonne to pursue the case on her husband's behalf. "My anxiety turned to anger. I tried to fix it by getting information."

A Health Department officer unofficially gave Yvonne three results over the phone but said it could cost him his job if she told anyone. He told her the results were in a safe. "I just thought it was dreadful I couldn't get the information I required."

She was told that she could apply for the test results under FOI. While extremely grateful to hospital staff who saved Alex's life, she felt locked out of the health system. "The Public Health are there to protect the public but you can't even get information from them."

Victims and lawyers alike say difficulty getting information from the Health Department snags their cases. Solicitor Kim Rickard remembers the resistance and lack of co-operation he encountered from the Health Department in 1992 when he represented a victim of the 1989 Merrylands Bowling Club outbreak. "You're flying blind if you haven't got all the information," he says.

Anthony Debeck, a former Health Department health officer who runs an independent legionella assessment operation, has received test results for victims through FOI but is concerned information is not given upfront. "I am fully aware of cases where the environmental officer has grounds to indicate that [an] area was the potential source of infection. However, the people who were diagnosed with legionnaires` disease were never informed of the outcome of their investigation. The end result being that people were unaware that they could have at least got a legal opinion and sought some form of compensation."

The Milligans were in the unusual situation of being told results "off the record". In other cases, victims are simply stonewalled. Says Yvonne: "The information should be made available so you have the choice of whether you want to sue or let it go. The public health won't come to the party and unless you can afford to go to a lawyer nothing will happen."

As victims are without public rights or compensation, the only remedies available are costly and complicated negligence suits. These are difficult to pursue because it is often hard to identify who caused the damage. Several companies may control a shopping mall. These companies often, in turn, subcontract cleaning and testing of air-conditioning.

Jane, 65, has been suffering the effects of legionnaires` disease for more than 10 years. Her lawyer has advised her not to use her own name or identify the outbreak in which she was infected. She was given a 50 per cent chance of survival. For a few weeks, she seemed to be recovering, but then her health collapsed. Jane developed heart problems, crippling arthritis and drug-induced diabetes. "My life has been ruined by legionnaire's. I was so healthy and I can't get over it."

She has never received any compensation. Her son says: "I can't understand why the individual victim has to be the one that proves negligence from the other party. Why isn't it the other side that has to prove it's not their fault?"

In 1997, Alex Milligan sued eight different companies which owned or controlled the premises he had visited. One of these cross-sued its own cleaning company. Last year, the Milligans, after outlaying thousands of dollars, decided they could not afford to continue. The case ended with both sides paying their own costs and judgments entered in favour of the defendants. It seems Alex's problem was too many potential sources. "I felt Public Health totally deserted us. I just felt I was fighting this on my own," says Yvonne.

The Milligans long ago abandoned their plans for a motel. Alex still suffers medical problems and they take each day as it comes.

"I didn't want hundreds of thousands from these people," says Alex. "All I wanted was to be reimbursed for my loss of earnings. I'm 61 in December. We haven't the prospects for retirement as we did five years ago."

These days, the Milligans avoid going into shopping malls. "If you've been sick or had an operation, it's the last place I would go," says Yvonne.

Source. Sydney Morning Herald

13th July 1999

Epidemiol Infect 1996 Apr; 116(2):185-92

Legionellosis linked with a hotel car park--how many were infected?

Bell JC, Jorm LR, Williamson M, Shaw NH, Kazandjian DL, Chiew R, Capon AG

Western Sector Public Health Unit, North Parramatta NSW, Australia.

An outbreak of legionellosis associated with a hotel in Sydney, Australia, and the subsequent epidemiological and environmental investigations are described. Four cases of Legionnaires' disease were notified to the Public Health Unit. A cross-sectional study of 184 people who attended a seminar at the hotel was carried out. Serological and questionnaire data were obtained for 152 (83%) of these. Twenty-eight (18%) respondents reported symptoms compatible with legionellosis. Thirty-three subjects (22%) had indirect fluorescent antibody (IFA) titres to Legionella pneumophila serogroup 1 (Lp-1) of 128 or higher. The only site which those with symptoms of legionellosis and IFA titre > or = 128 were more likely to have visited than controls was the hotel car park (adjusted odds ratio [OR] 14.7, 95% confidence interval [CI]: 1.8-123.1). Those with symptoms compatible with legionellosis, but whose IFA titres were < 128 were also more likely to have visited the hotel car park (adjusted OR 4.4, 95% CI: 1.5-12.9). Seroprevalence of Lp-1 antibodies was higher in those who attended the seminar than in a population sample of similar age. Findings suggested that the 4 cases represented a small fraction of all those infected, and highlighted difficulties in defining illness caused by Lp-1 and in interpreting serology.

Tuesday, July 13, 1999

LEGIONNAIRES` DISEASE

The fight for facts

By WENDY BACON and TRACY PILLEMER

YVONNE Milligan believes people have a right to know the levels of legionella bacteria in the public places they visit, and the information should be posted prominently "so people can choose whether to go in".

The NSW Health Department takes the opposite view. Its policy is that the information should not be made public and it goes to a lot of trouble to enforce that, only releasing it under the NSW Freedom of Information (FOI) Act, or if issued with a subpoena "with the specific permission of the premises' owner".

In NSW, there is a 45-day limit on dealing with FOI requests, yet it took the Health Department three months to answer Milligan's request for information related to her husband's case, including the building test results.

Clause 7 of the FOI Act allows for the protection of information sensitive to business and commercial interests. In Alex Milligan's case, the shopping centres involved objected to the release of the results. So the Hunter Public Health Unit refused to give the Milligans the results.

"We're relying on them for our safety, but Public Health are more concerned about the commercial side, the loss of business in the malls," says Yvonne. "You think, to whom do I turn? Maybe most people, if they don't get the information, go away. I don't curl up and go away if there's been an injustice done."

She applied for a review of the decision, which was conducted by the then chief executive of the Hunter Area Health Service. He consulted the medical officer who had made the decision to refuse the Milligans access to the building test results.

According to department documents, the reasons the medical officer gave for his initial decision were that test results taken two months after Alex Milligan was admitted to hospital "will not really help answer the question"; that commercial objections were "the major sticking point"; that the Public Health Unit was satisfied with shopping centre protocols for cleaning and maintaining cooling towers.

Source..Sydney Morning Herald
13th July 1999

Environmental investigation of a legionellosis outbreak in western Sydney: the role of molecular profiling.

Heath TC, Roberts C, Jalaludin B, Goldthrope I, Capon AG

Western Sector Public Health Unit, New South Wales.
timh2@nch.edu.au

This investigation used DNA profiling in an attempt to identify the environmental source of a community outbreak of 11 cases of Legionnaires' disease. Nine of these cases were culture positive and a single strain (DNA profile) of Legionella pneumophila serogroup 1 was isolated from eight cases.
Spot water samples were collected from 51 cooling towers implicated by case exposure histories; this same strain was isolated from four towers at three separate locations up to 6 km apart. None of these locations had been frequently implicated by case histories. Because we did not perform an analytic epidemiological investigation, we were unable to identify a single environmental source for the outbreak. It is also possible that this outbreak was multifocal.
The use of molecular profiling should not overshadow the importance of epidemiological methods in these environmental investigations. More data is needed regarding the prevalence, distribution, and clinical significance (virulence) of environmental L. pneumophila strains.
This would aid interpretation of molecular profiling used in investigations of community legionellosis outbreaks.

Sat, 27 Jun 1998 England
This is an Email that I received.seems the same problem is world wide..............

At last, 31 pages of info about the disease. Nine months ago when I tried to find anything out I drew a blank - but now - after yet another "outbreak" it hits the news. My fiance, David, aged 33 contracted the disease last October and nearly lost his life, spending 7 weeks in hospital, three of those on a life support machine with lung, liver and kidney failure. 9 months on, and he is still off work, with associated bowel problems and unusual side affects, This is a man , who, albeit was a smoker, had never had a day's illness in his life. I cannot describe the living hell we have been through - and basically - nobody gives a damn where he got it from - since he was treated as an "isolated case". David was very very lucky. Can anybody tell me the differential between an isolated case being one, and an outbreak being classed as 2 ??? Is there some big dark secret regarding the disease as to why I have been told to "shut up" for the past 9 months by various parties ? The way I see it is that David caught the disease either from his first ever holiday abroad to the Algarve in October, or possibly from an air cooling tower which he worked adjacent to for 9 months, and during those months he began to be ill with various symptoms before the onset of the disease in October 97. Of course, solicitors cannot help, they say we are not entitled to compensation - do you really think we are bothered about that - we are grateful for David's life and the fantastic work of his medical team, but we would like to know where he got it from for sheer peace of mind and so we can sleep at night - and also to make the public more aware of this hidden killer. I rest my case.

Legionnaires' disease outbreak, Fairfield 1992: public health aspects.

Levy M, Westley-Wise V, Blumer C, Frommer M, Rubin G, Lyle D, Brown J, Stewart G

Epidemiology and Health Services Evaluation Branch, New South Wales Health Department.

An investigation of an outbreak of Legionnaires' disease in 1992 in Fairfield, a municipality of Sydney, was carried out to determine the source of the outbreak. Cases of Legionnaires' disease with onset of symptoms between 11 and 20 April 1992 were included. Definite cases were individuals with a history consistent with Legionnaires' disease, confirmed by direct fluorescent antibody testing plus serology or culture. There were two control groups: patients admitted to the same hospital as the cases, matched for age and sex, and patients admitted to hospital with a presumptive diagnosis of legionnaires' disease, in whom the diagnosis was subsequently excluded. There were 26 definite cases with onset of symptoms between 11 and 20 April 1992. Six (23 per cent) died. Twenty-two cases (85 per cent) reported visiting the Fairfield business district during the ten days prior to the onset of symptoms. They were 20 times more likely to have visited Fairfield than were matched controls. Matching of Legionella pneumophila serogroup 1 from environmental and clinical samples was achieved by cytogenetic fingerprinting. Fourteen cases were linked to a single environmental sample. The epidemiological findings were consistent with a point source of Legionella in the Fairfield business district. It is most likely that the exposure occurred on 10 April 1992.

Med J Aust 1994 Mar 7;160(5):274-7

Legionnaires' disease outbreak in south western Sydney, 1992. Clinical aspects.

Kociuba KR, Buist M, Munro R, Lee A, Cleland B

Microbiology Department, Liverpool Hospital, NSW.

OBJECTIVES: To document the clinical, laboratory and radiological features of patients with Legionella pneumophila serogroup 1 pneumonia during an outbreak, and probe for any relationship between clinical or laboratory features and outcome. DESIGN AND SETTING: Prospective identification of patients with Legionnaires' disease in an outbreak from 15-26 April 1992 in the South Western Sydney Area Health Service, centred on the Fairfield area. PATIENTS: Twenty-six patients (22 men, four women) were confirmed to have the disease, based on the presence of clinical features of pneumonia, with L. pneumophila serogroup 1 isolated on culture, or evidence of seroconversion. RESULTS: Seventeen patients (65.4%) were culture-positive for L. pneumophila serogroup 1 and nine were diagnosed on serological criteria. A direct fluorescent antibody (DFA) test of sputum performed well as a rapid diagnostic method. Twenty-three patients (89%) presented with hyponatraemia, 14 (54%) with renal impairment and nine of 19 (47%) with elevated serum creatinine phosphokinase levels. Overall mortality was 23% (71% for patients requiring mechanical ventilation). Eleven of 119 patients (10.2%) who did not have Legionnaires' disease showed serological evidence of previous exposure.
CONCLUSIONS: The duration of symptoms and severity of biochemical abnormalities at presentation were not related to outcome. The sputum DFA test is useful for rapid diagnosis during outbreaks. 

Department of Microbiology and Infectious Diseases, South Western Area Pathology Service, Liverpool Hospital, Sydney.

In April 1992 an outbreak of Legionnaires' disease occurred in south western Sydney. Twenty four patients were diagnosed as having Legionnaires' disease either on the basis of a positive culture of Legionella pneumophila serogroup I from a respiratory specimen (14 patients) or a four-fold or greater rise in antibody titre or isolated convalescent titre > 1024 with IgM antibodies present (10 patients). This is the largest outbreak in New South Wales since 44 cases of Legionnaires' disease were reported in Wollongong in 1987. Culture and direct immunofluorescent staining (DFA) were performed for early laboratory diagnosis. The DFA test and a set of defined clinical criteria were then used to classify patients as probable cases of Legionnaires' disease for subsequent Public Health investigations. The DFA test had a predictive value for a positive culture of 45.8% and for a negative culture of 97.1%. Its positive predictive value for a definite diagnosis of Legionnaires' disease (either positive culture or seroconversion), however, was 78.3% with a negative predictive valve of 95.1%. During a 27 day period DFA and culture for Legionella species were performed on 198 specimens from 127 patients. Cultures became positive after a mean of 5 days incubation (range 1-11 days). The use of both selective and non-selective media is recommended for optimal recovery of L. pneumophila since some isolates were obtained on only one culture plate. After an initial evaluation of heat decontamination of specimens this process was abandoned, since in 8/63 specimens so treated, L. pneumophila was recovered prior to but not following heat decontamination and was not grown only in heated specimens.

J Clin Microbiol 1997 Apr;35(4):954-6

Rapid diagnosis of Legionella pneumophila serogroup 1 infection with the Binax enzyme immunoassay urinary antigen test.

Kazandjian D, Chiew R, Gilbert GL

Department of Clinical Microbiology, Westmead Hospital, Sydney, New South Wales, Australia.

The Binax legionella urinary antigen (LUA) enzyme immunoassay (Binax, Portland, Maine) was evaluated in 159 patients with suspected or proven legionellosis and 209 controls. A positive LUA test was found in 37% of patients with suspected legionellosis overall and in 83% of those with proven Legionella pneumophila serogroup 1 infection. The sensitivity of the LUA test was significantly greater than that of the direct fluorescent-antigen test (83 versus 42%; P < 0.0001) but not significantly different from that of culture (85%) or serology (91%); specificity was at least 99.5%.

Aust N Z J Public Health 1998 Jun;22(4):428-31

Environmental investigation of a legionellosis outbreak in western Sydney: the role of molecular profiling.

Heath TC, Roberts C, Jalaludin B, Goldthrope I, Capon AG

Western Sector Public Health Unit, New South Wales. timh2@nch.edu.au

This investigation used DNA profiling in an attempt to identify the environmental source of a community outbreak of 11 cases of Legionnaires' disease. Nine of these cases were culture positive and a single strain (DNA profile) of Legionella pneumophila serogroup 1 was isolated from eight cases. Spot water samples were collected from 51 cooling towers implicated by case exposure histories; this same strain was isolated from four towers at three separate locations up to 6 km apart. None of these locations had been frequently implicated by case histories. Because we did not perform an analytic epidemiological investigation, we were unable to identify a single environmental source for the outbreak. It is also possible that this outbreak was multifocal. The use of molecular profiling should not overshadow the importance of epidemiological methods in these environmental investigations. More data is needed regarding the prevalence, distribution, and clinical significance (virulence) of environmental L. pneumophila strains. This would aid interpretation of molecular profiling used in investigations of community legionellosis outbreaks.

Disease sparks national alarm

By KRISTINE GOUGH

29th. April 2000

A NATIONWIDE health alert was issued yesterday over the outbreak of Legionnaires` disease at Melbourne's new aquarium.

Three more people were confirmed to have contracted the disease, taking the total number of victims to seven. Last night three were in intensive care, two were critical and two were recovering.

Doctors across Australia were advised of the outbreak by Victorian health department officials who fear more victims will soon emerge.

They appealed to the estimated 10,000 people who were exposed to the bacteria to seek medical help if they developed respiratory problems.

John Howard, his wife Janette and other senior Liberal politicians were also at risk after visiting the aquarium on April 14.

No Liberal politicians have reported any symptoms.

A 58-year-old man and two women, aged 61 and 79, were in intensive care last night after tests confirmed that they were infected. All had visited the aquarium between April 15 and 18.

Of the four others in hospital, an 88-year-old man and 65-year-old woman remain critical.

John Carnie, head of Communicable Diseases at the Department of Human Services, said the large number of people who had visited the aquarium during the school-holiday period meant more cases were likely.

"It is a significant number and it's clearly something that we are most concerned about," said Dr Carnie.

The source of the outbreak was traced to the aquarium's cooling towers on Thursday after victims and their families were questioned about their movements over the past two weeks. The disease, which often begins with flu-like symptoms, has an incubation period of 10 days.

All Victorian doctors have been notified and an Australia-wide alert has been issued through the communicable diseases network.

Dr Carnie said a decontamination team was sent to the aquarium almost immediately and the bacteria were eliminated. There was no need for the aquarium to be closed as the disinfectant process was effective immediately.

Although he is still awaiting lab results confirming the bacteria's presence in the tower, Dr Carnie said it was believed spray drift from the tower on the aquarium roof was responsible for the outbreak.

The health department has identified the period of danger as April 13 to 18, meaning potential victims could only now be exhibiting symptoms.

Aquarium general manager Bob Adams said visitor numbers were only slightly down yesterday.

Barbara Hinkins, a Year One teacher at Mont Albert Primary School, said she was happy to take her class to the aquarium yesterday, after the school's principal received assurances from the health department about the site's safety.

Opinion...........Personal recommendations would have been keep the hell out till it had been comfimed it was the cooling towers at the Aquarium Ms Hinkins

A spokesman for the Victorian branch of the Construction, Forestry, Mining and Energy Union said remaining work on the aquarium was banned until members received medical checks

My comments in an email

Legionnaires disease finally hits the headlines in Australia Because the Liberal Party members were involved in this outbreak, It hit the Bl**** headlines in papers around Australia, even my states paper (WA)

LEADING LIBERALS IN AIR DISEASE SCARE..........WOW

Niel Patrucco president of the party`s Stirling division was diagnosed with Legionnaires disease yesterday after he was admitted to Joondalup Health Campus on Sunday, He had earlier been diagnosed with Pneumonia.

Source West Australian Newspaper..Headlines....

Normally its gets two lines in center of the paper

I wont say what I am thinking..you all work it out

Seven caught up in health scare

THE AGE ONLINE
Friday 28 April 2000

The potentially deadly legionnaires' outbreak at the Melbourne Aquarium claimed another three elderly victims today, bringing the total number struck down to seven.

Four people were hospitalised yesterday shortly before health authorities warned thousands of school holiday visitors to the new $33 million aquarium to be alert for symptoms of the disease.

The Department of Human Services said this afternoon a 58-year-old man is in St Vincents Hospital's intensive care unit and two women aged 61 and 79 are critically ill in the Western Hospital with the disease.

Of the four who first contracted the disease, two are recovering but two others remain critically ill.

Earlier today it was reported that the Prime Minister, his wife Janette and other senior Liberals who attended a function at the Melbourne Aquarium two weeks ago were caught up in the legionnaires' scare.

Health authorities confirmed this afternoon that the Prime Minister's office had been in touch seeking details of the outbreak.

A spokesman for Victorian Liberal Party leader Denis Napthine, who also attended the cocktail function along with more than 100 senior Liberals two weeks ago, said the Opposition Leader was in good health.

The head of communicable diseases at the Department of Human Services, Dr John Carnie, said this afternoon that all the victims had visited the aquarium between April 13 and 18. The onset of their symptoms came between April 17 and 24.

Public information hotlines set up by the department had received numerous calls. "We would still encourage people who have been in the vicinity of the aquarium over the past two weeks and have got a respiratory illness to please go and see their doctor and asked to be tested for legionnaires' disease," Dr Carnie said.

Dr Carnie said it was quite possible there would be more cases reported over the weekend.

"Because of the fact that large numbers have visited the aquarium over the relevant period and a number of those people are in risk categories, obviously, that's older age group people. So it would not be surprising if we were to get further cases," he said.

A school group and senior citizens are among those reported to have cancelled visits to the aquarium today.

Melbourne Aquarium's general manager, Bob Adams, said today the tourist attraction had done everything possible to make sure there was no further danger.

"We gave the system what's called a slug dose of the chemical which kills all evils. Having done that the department were quite happy to say the building's safe," he said.

"Certainly, when they (the department) give their results (of testing) at the end of this 10-day period, then we'll sit down with them and review the current system and see if there's anything else we need to do," Mr Adams said.

Thousands of people may have been exposed to drifting spray containing legionnaires' bacteria from external air- conditioning system while standing in long queues outside the venue.

The aquarium attracted up to 5000 visitors a day during the school holidays.

Symptoms of legionella include headaches, fever, chills, muscle aches and pains. The onset of symptoms can take up to 10 days and develop into respiratory problems and pneumonia, which can kill if left untreated.

Fifty-seven cases of legionnaires have been reported in Victoria so far this year compared with 64 cases last year.

Anyone needing more information can contact the health department hotline on 1800 365 677.

Aquarium visit puts Libs at risk

28th. April 2000

FEDERAL cabinet ministers and senior Liberal Party figures may have been exposed to the potentially fatal legionnaires' disease while visiting Melbourne's aquarium.

Two elderly Victorians were fighting last night for their lives in hospital with legionnaires' disease that has been linked to their visit to the aquarium between April 13 and 15.

It is understood some cabinet ministers and senior Liberals visited the aquarium on April 14. They were in Melbourne attending the Liberal Party National Convention.

Another two aquarium visitors, a man aged 71 and a woman aged 69, have also been hospitalised with the disease but are considered to be in a "moderate" condition.

Health officials yesterday could not rule out the possibility of more people developing the disease, which this year has killed three Victorians.

Spray drift from Melbourne Aquarium's air-conditioning cooling towers is believed to be the source of the legionella bacteria. The towers were disinfected yesterday.

The outbreak has shocked management of the aquarium, which only opened in mid-January and has attracted 300,000 visitors.

The aquarium's 150 staff are considered to be at low risk because the spray from the cooling towers was dispersed outside the building.

General manager Bob Adams said staff had been encouraged to notify management if they developed any symptoms including fever, chills, muscle aches and pains and headaches.

William Hart, Human Services assistant director of disease control, said health officials had linked the aquarium to the disease because all four victims had visited the facility about the same time.

However, he said he was still awaiting lab results to confirm the aquarium was the source of the bacteria.

Professor Hart stressed people aged over 65 were most at risk of developing the disease and it was extremely unlikely any child visiting the aquarium would develop problems.

"This is the first day of an ongoing investigation and it may be possible that in the ensuing days some further cases are notified to us," he said.

Professor Hart said the outbreak was a timely warning about the need for frequent cleaning of cooling towers, considered an ideal breeding environment for the naturally occurring legionella bacteria.

(ONE MUST QUESTION THIS STATEMENT BY PROFESSOR HART, MELBOURNE HAVE BEEN FACED WITH A GROWING PROBLEMS OF LEGIONELLA SINCE 1998, EVERY COOLING TOWER IN VICTORIA SHOULD BE SPOTLESSLY CLEAN BY NOW)

WHO THE HELLS MINDING THE STORE

MY OPINIONS MY RIGHT TO HAVE THEM

The two critically ill visitors, an 88-year-old man and 65-year-old woman were in intensive care last night.

The aquarium was embroiled in controversy shortly before opening when the RSPCA stepped in to investigate the high number of fish deaths.

The problem was linked to the aquarium accepting fish from commercial catches, a practice which has since ceased.

Fatal disease alert strikes aquarium

MARY-ANNE TOY HEALTH EDITOR
Friday 28 April 2000

Thousands of visitors to the Melbourne Aquarium have been warned by health authorities to be alert for symptoms of legionnaires' disease after an outbreak of the deadly illness was traced to the tourist centre. Four people are in hospital with the illness after visiting the $33 million aquarium this month.

Two of them are critically ill.

But although workers were disinfecting the air-conditioning cooling towers at the centre yesterday, visitors said they had not been warned of the outbreak.

Health authorities tracked the source of the outbreak to the four-month old building on the banks of the Yarra.

The four victims, two men and two women, all over 65, fell ill after visiting the aquarium on April 13 and 15.

It is likely the victims were infected while queuing outside the building as the disease is most commonly spread by spray drifts from infected cooling towers on the roofs of buildings.

The aquarium's general manager, Bob Adams, said he was shocked to learn about the contamination and hoped it would not deter visitors. He said the building had been disinfected and was safe.

"It was something that was outside our control and we are doing everything possible since we were alerted to ensure that staff and the public are safe at all times," Mr Adams said.

Victoria's chief health officer, Dr Graham Rouch, said the aquarium was "probably one of the safest places to be in the city" now that the towers had been disinfected.

You must be joking Dr Rouch..Melbournes`s damm dangerous, has been for two years, Someone need to clean up their act

But he warned that visitors during the recent school holidays should see their doctor immediately if they developed flu-like symptoms such as headache, fever, chills, muscle aches and pains.

The aquarium has had more than 300,000 visitors since it opened on January 17. An average of about 5000 people a day visited during the school holidays.

The head of infectious diseases at the Department of Human Services, Professor William Hart, said early diagnosis was crucial but parents should not worry as legionnaires' disease did not affect healthy children.

Those most at risk are people aged over 50, heavy smokers or drinkers, diabetics or people with chronic lung disease and those with impaired immune systems.

The onset of symptoms can take up to 10 days. The symptoms develop into respiratory problems and pneumonia, which if left untreated can kill. But if signs are acted on early enough, most victims recover.

Professor Hart said there was no evidence that the installation and maintenance of the cooling towers had been anything other than exemplary and he could not yet explain how a new building came to be contaminated so quickly.

The Victorian Infectious Diseases Reference Laboratory notified the department on Wednesday about the outbreak.

After interviewing victims and relatives, the common link found between the infected patients was that they had visited the aquarium.

Definitive proof of the link will depend on the results of more detailed testing of samples taken from the towers which will be some weeks away.

The department notified the aquarium's management at noon yesterday and the cleaning began at 1pm.

The two critically ill patients are an 88-year-old man and a 65-year-old woman. All four victims are in separate Melbourne hospitals.

Professor Hart also revealed yesterday that Victoria "technically" had an epidemic of legionnaires' disease as there had been 57 notified cases this year, compared with 64 cases for all of 1999.

The department was reluctant to release full details of the cases this year, but on February 7, two men from Thomastown and two men from Fitzroy were infected. On February 10, seven people linked to the Fitzroy-Carlton area were infected and last month five workers from the Traffic Accident Commission and Workcover Authority working at 222 Exhibition Street were infected.

Anyone concerned about whether they have been infected should see their doctor or call the Department of Human Services on 1300 365 677.

Monday March 27, 2000

WARNING ON LEGIONNAIRES` DISEASE

Health authorities are urging city dwellers, office workers and visitors to be alert to the signs and symptoms of Legionnaire's Disease following two cases with links to an Exhibition Street office building.

Victoria's Chief Health Officer, Dr Graham Rouch, said a further three cases of Legionnaires` Disease which may also be linked to this area are still being investigated.

Three of the five who fell ill - two men and a woman - are being treated in hospital. The other two men had been treated and discharged.

Dr Rouch said two of those hospitalised worked at 222 Exhibition Street - one for the Transport Accident Commission and the other at the Victorian Workcover Authority.

These staff and other tenants in the building have been given information about the signs and symptoms of Legionnaires` Disease.

"One of these cases was diagnosed as a result of workplace surveillance where employees with a history of recent respiratory illness were advised to consult their doctors and inform them of the possibility of Legionnaires` disease.

Dr Rouch said the early stages of Legionnaires` Disease had flu-like symptoms, and urged people concerned about such symptoms to see their doctor.

The most common method of transmission of the legionella infection is via the spray drift from air conditioning cooling towers.

Human Services Department officials took samples from cooling towers at 222 Exhibition Street and are still waiting for confirmation of the test results.

They have also required that the towers be dosed with biocide and disinfected ahead of their regular maintenance schedule as a precaution. There is no need for staff to stay away from work because these towers and others in the vicinity have been treated.

"The recent hot weather has put a considerable extra load on cooling systems which may have provided a better environment for legionella to multiply," he said.

Multi-lingual brochures detailing the signs and symptoms of Legionnaire's Disease are available from Melbourne City Council as well as the Department of Human Services.

Evaporative air cooling units such as those used in homes and many business premises are not a likely source of legionella infection, Dr Rouch said.

Personal note
(An outbreak of Legionnaires` disease in Lama , Colorado in 1989 was caused by Evaporative Coolers that had been badly maintained which resulted in 16 cases and 3 deaths )