OUTBREAKS
2003



The Way To Go


France     3 January 2004 The epidemic of légionellose which prevails in Pas-de-Calais     since the end November caused a seventh death Friday. Total cases now stands     at 55

ISRAEL

LEGIONNAIRES' DISEASE

January 14, 2003

JERUSALEM -- Israel's Health Ministry was cited as saying a hotel in the southern resort city of Eilat was closed Tuesday after at least two guests were diagnosed with Legionnaires' disease.
The story says that two guests who stayed in the hotel in December have been diagnosed with Legionnaires' disease, and that a third hotel guest was recently hospitalized suffering from pneumonia and is under examination to check if the illness was caused by Legionnaires' disease.


Herod's Hotel


Legionnaires' disease hotel shut down
14th January 2003

 A hotel in the Israeli Red Sea resort of Eilat has been closed after at least two guests were diagnosed with Legionnaires' disease.
Two guests who stayed in the hotel in December have been diagnosed with is in hospital with pneumonia and is under examination to check if the illness was caused by Legionnaires' disease.
The Herod Hotel will remain closed for two days while its water system is tested, said a health ministry spokesman
.


Disease fears close Eilat hotel

13 January 2003

Herod's Sheraton Resort in Eilat was closed late Monday night for 48 hours by the Health Ministry after epidemiologists found evidence linking two cases Legion- naires' disease with the hotel's hot water system. The two patients, hospitalized in the center of the country and attached to respirators, had stayed at the hotel recently.

Experts from the district health office in Beersheba visited the hotel and collected water samples from a Jacuzzi and showers. They found evidence of the Legionella pneumophila bacterium that can cause complications in the respiratory system


Legionnaires' at hotel

Jerusalem - A luxury hotel in the southern resort city of Eilat was closed on Tuesday after at least two guests were diagnosed with Legionnaires' disease, Israel's Health Ministry announced.

Two guests who stayed in the hotel in December have been diagnosed with Legionnaires' disease, a health ministry official said, speaking on condition of anonymity.

A third hotel guest was recently hospitalised suffering from pneumonia and is under examination to check if the illness was caused by Legionnaires' disease, health ministry officials said.

The Herod's Palace Hotel, part of the Sheraton chain, will remain closed for two days while its water system is tested, said health ministry spokesman


HOTEL KEMAL BAY ALANYA, ANTALYA, TURKEY

Has had 3 cases associated with this cluster, onset of most recent case was 03/01/2003.

Information from

EWGLINET Surveillance System


Andalusia 24 January.. Seville.

 LEGIONELLA OUTBREAK

 The Service Andalusian of Health has initiated an investigation to the Hospital of Ecija which did not to adopt the sufficient measures after detecting a outbreak of legionella.

As a result of that outbreak  a patient passed away and other twelve had to be transferred to another health center.

The circumstance that occurs in October 2002 the Hospital of Ecija was designated better small hospital of Spain.

*****

The advisor of Health of the Meeting, Francisco Vallejo assured today that the hospital of Écija was warned "on several occasions" of the necessity to correct the deficiencies that were detected in the system of heating of the water "by the infection risk that presented/displayed".

Vallejo explained in press conference that the carried out inspection in this center, in which a bud of legionella has been detected, the past October by the technicians of the provincial Delegation of Health alerted that the water pump "was not able to warm up it the sufficient thing", since in some points of the hospital the temperature did not reach the 50 degrees Celsius.

The Service Andalusian of Salud (SAS) sent "of urgent form" to the direction of the hospital of San Sebastián de Écija, of municipal property, "the importance of fixing the hot water installation" by the danger that could entail for the patients entered in the center.

Nevertheless, the advisor emphasized that "to the day of today" still he is to the delay of which the hospital assumes the repair of the system, although at the moment it has been evacuated to a total from twelve patients to the hospital of Our Lady of the Favor in Osuna   "to avoid the appearance of new cases" of legionella.


On Jan. 28, Japan Cruise Line(JCL) announced that two passengers of Pacific Venus, the ship JCL operates, were infected with legionnaires disease and got in a hospital in critical condition. JCL said the water of the ship's spa, Japanese style bath like big version of jacuzzi, was contaminated by legionnaires. After inspection, it was found out that was more than 1500 times higher than the standard.

 

JCL canceled the future cruises from Feb.1 and now they are refitting the bath in the spa.  They were planning to go to World cruise from 26th of next month, yet right now it is not sure they can. 

 

*****

OSAKA JAPAN

3rd October 2003

Elderly couple sues over bacteria infection on cruise

 An elderly couple have filed a lawsuit with the Osaka District Court demanding some 100 million yen in damages from a tour organizer after claiming that the husband became infected with bacteria that causes Legionnaires' disease during a cruise.
A spokesman for the tour organizer, the Osaka-based Nippon Cruise Kyakusen, has declined to make a clear-cut comment on the lawsuit. "We haven't read the suit, so we would like to decline to comment. However, we will sincerely respond to the suit."

Taizo Tsuji, 71, of Ibaraki, Osaka Prefecture, and his 63-year-old wife took a cruise in the sea off Taiwan on a luxurious passenger ship, the Pacific Venus, from Dec. 28, last year, to Jan. 6, this year, according to the suit. During the cruise, Tsuji took a bath in the vessel's big common tub.

After coming home, Tsuji suffered from serious pneumonia and fell unconscious and was subsequently diagnosed at a hospital as having been infected with bacteria that causes Legionnaire's disease.

He is still suffering from the after-effects that require him to permanently use an oxygen inhaler. The couple took the legal action against Nippon Cruise Kyakusen claiming that Tsuji had been infected with the bacteria during the cruise. 


21st February 2003

HOTEL VOYAGE SELGE-BEACH, MANAVGAT, ANTALYA, TURKEY 

Has had 2 cases associated with this cluster, onset of most recent case was 21/02/2003. 



7th March 2003

Legionnaires' Disease outbreak at hotel
Public health officials are investigating an outbreak of legionnaires' disease in Somerset, England

Doctors have treated three people with the disease, which has been traced back to the leisure centre at a local hotel.
Experts say the risk of infection at the Cricket St Thomas Hotel in Chard has been isolated.
But they are warning anyone who has used the hotel's facilities in the last month to watch for symptoms.


The hotel's leisure centre is thought to be the source of the outbreak

One of the people diagnosed has made a full recovery, but two others are still in hospital.
The leisure centre's showers and spa tub have been closed for extra cleaning, but its pool, which is chlorinated, is open.

It is the second time in months the hotel - the setting for BBC television series To The Manor Born - has been at the centre of a health scare.

Dozens of guests were affected by the Norwalk virus, which causes vomiting and stomach upsets, before Christmas.

Legionnaires' disease is transmitted by airborne mist particles from contaminated water sources, such as whirlpool baths and air conditioning units.

Symptoms of the illness, which is not transmitted from person to person, include a chest infection, fever, chills and a cough.

Its incubation period can be as long as 21 days.

Anyone who suspects they may have the disease is advised to contact their GP for tests.


Update

Leisure Centre in Legionnaires’ Disease Alert

Public health officials are advising anyone who has recently used a Somerset leisure centre to be alert for the symptoms of Legionnaires’ disease after three visitors fell ill.

The county’s Health Protection Unit identified three linked cases of the potentially fatal disease in people who had used the Cricket St Thomas Leisure Centre, near Chard, in 2003.

Two of the victims remain in hospital but the third has now made a full recovery and has been discharged.

Health officials are advising anyone who visited the centre this year and who has the symptoms of a chest infection, fever, chills and a cough to contact their family doctor as soon as possible.

A spokesman for the unit said: “It is imperative that anyone with symptoms see their GP so that urine and/or blood tests are taken and appropriate antibiotics administered.”

The centre remains open and health officials are satisfied that there is no ongoing risk to the health of any current visitors.

A spokeswoman for the centre said the investigation was focusing on shower heads and spa tubs and these facilities were out of action while checks and additional cleansing take place.

She added: “We have been in constant contact with Somerset Health Protection Unit and we are following their guidelines.

“It is too early to say how this happened but tests are under way and we have shut down the suspected areas to the public.”

As part of the investigation into the incident, action has been taken to contact all leisure centre members, guests and staff.

Environmental health officers from South Somerset District Council have carried out extensive water sampling within the complex and the Public Health Laboratory Service in Bristol is conducting microbiological testing of water samples.

Outbreaks are usually associated with defective central heating, air conditioning and other ventilating systems.

The Somerset Health Protection Unit was notified of the first case of the disease on February 25, a second case was identified on February 27 and the third case yesterday.
UPDATED Friday 14 March 2003
Woman dies of Legionnaires' disease
A woman has died after contracting Legionnaires' disease linked to a Somerset hotel.

The 66-year-old from Hertfordshire, who died in February, is the first confirmed fatality as a result of the recent outbreak traced to the leisure centre of the Cricket St Thomas hotel near Chard.

The hotel - including leisure centre and wildlife park - will be closed from Friday as a precaution to allow a servicing of the water system.

Seven people have been diagnosed with the disease.

Five people required admission to hospital, including two women who are still recovering in Lancashire and Kent.

A 71-year-old man and a woman, 54, both from Somerset, a 55-year-woman from Essex and a woman, 53, from Oxfordshire have also been affected.

A spokesperson for the hotel said: "We are saddened by the news that there are additional cases of the disease, one of whom has died, and extend our deepest sympathies to the bereaved."

The showers and Spa Bath at the leisure centre were closed on 27 February and since then there have been no new cases.

Public Health officials have contacted nearly 4,000 people who have used the facilities, but are still appealing for people who show the flu- like symptoms to contact them or their local GP.

A spokesperson for the Somerset Health Protection Unit said: "Health officials are continuing to investigate the possible source of a recent outbreak of Legionnaires' disease.

"The hotel management are giving their full co-operation with the investigation and are fully implementing the recommendations of health officials.


15 March 2003
Two more Legionnaires' cases

Two more cases of Legionnaires' disease linked with a hotel's leisure centre have been confirmed.

A 30-year-old man and a woman, both from Southampton, have not required admission to hospital and are recovering at home.

Ten cases have now been confirmed by the Somerset Health Protection Unit.

Health officials say the most recent cases are not new infections, but have been identified from questionnaires sent to almost 4,000 recent guests at the hotel who could have used the leisure centre's spa bath or showers.

Two women, aged 66 and 64, are recovering in hospitals in Lancashire and Kent.

Health officials are satisfied that all appropriate precautions have been taken and any potential risk to the health of anyone coming to the leisure centre, hotel, or wildlife park is minimal. 
Somerset Health Protection Unit

Somerset Legionnaires’ Disease Outbreak

31 March 2003

Public health officials investigating an outbreak of Legionnaires’ disease associated with the Cricket St Thomas Hotel and Leisure Centre, near Chard, have identified a total of fourteen confirmed cases to date. (31st March 2003).

Of these fourteen people, one women, aged 66 remains in hospital in Lancashire.
A 66-year-old woman from Hertfordshire is known to have died from the disease in February 2003.

The confirmed cases are not new infections. All were acquired in February and have been identified as a result of public health officials checking health questionnaires from over 5,000 guests who were known to have stayed or visited Cricket St Thomas Hotel and Leisure Centre since January 2003.

Although not required to do so by health officials, the management at Cricket St Thomas have decided to temporarily close the hotel, leisure centre and wildlife park from Friday 14th March, to avoid disruption to guests whilst carrying out remedial work to their water systems.

Dr Elaine Farmery, Public Health Consultant with the Somerset Health Protection Unit says: “We are satisfied that appropriate precautions have been taken and the potential risk to the health of anyone coming to the leisure centre, hotel, or wildlife park is no greater than anywhere else in the country. Low levels of Legionella occur naturally in the environment.

“Circumstantial evidence, based on information from those affected, supports our belief that the spa bath was the most probable source of this outbreak. However, the management of Cricket St Thomas have taken widespread measures to exclude the possibility of a second source of the organism elsewhere at Cricket St Thomas.”

Source.. Somerset Health and Social Care


10 April 2003

A woman from Lancashire has died after contracting Legionnaires' disease in an outbreak at a hotel.

The 66-year-old woman is the second to die following the outbreak in Somerset - the first woman died in February.

Health officials have linked the outbreak to the leisure centre of the Cricket St Thomas hotel, near Chard.

To date 19 people have been diagnosed with the disease - the Somerset Health Protection Unit (SHPU) said many more people had been affected.

The latest victim died on Tuesday.

Source Media


6th March 2003

Legionnaires' scare at lifeboat HQ

A woman has been taken to hospital after contracting the potentially fatal Legionnaires' disease.

The woman works at the national headquarters of the Royal National Lifeboat Institution in Poole, Dorset.

Emergency checks of air conditioning and water systems are now being carried out at the office, where 480 staff work.

The woman was taken to hospital after suffering breathing difficulties, although it is not yet known how she caught the illness.

Source BBC London


13 March 2003

Catalonia. - Detected five cases of legionella in Badalona (Barcelona)

BADALONA BARCELONA 

Five people of Badalona (Barcelona) have been affected by legionellosis, according to  the City council of Badalona  and the Conselleria of Health of the Generalitat in joint official notice. 
Two of the affected ones already have been registered and the other three continue entered in hospitals of the city.


The first case is a woman, of 69 years, that initiated symptoms the 23 of February and it was entered the 3 of March in the Municipal Hospital of Badalona, where it evolves favourably. In the same centre he remains hospitalised a man of 81 years who initiated symptoms 24 of February and were entered the 5 of March. 

The third case is a man of 57 years, who initiated symptoms the 1st of March, it was admitted the Hospital Universitari Germans Trias i Pujol the 3 of March, and was registered the 10 of March. 
The quarter case is a man of 67 years, who initiated symptoms the 28 of February,
it was entered in the same centre the 2nd  of March, and was registered 8th of the same month.

The fifth case is a man of 58 years who initiated symptoms the 5th of March, entered day 9th of the same month in the Hospital Germans Trias i Pujol and continues hospitalised in a conventional plant of the centre.

The Conselleria of Health and the City council of Badalona, way coordinated, they have initiated the investigation environmental epidemiologist and in order to be able to determine the possible source of infection and if one is cases related to a same center.

The Consistorio maintains assets a census of cooling towers from the month of January of 2001, and at this moment it has registered 24facilities.


Update

A woman of Badalona affected by legionella dies, although already she suffered a very serious pathology

BARCELONA. 

A woman, of 52 years and neighbour of Badalona, affected of legionellosis the past passed away 28 of March in the Hospital of Vall d´Hebron of Barcelona, according to sources informed yesterday into the department of Health of the Generalitat and the City council of Badalona. This it is the first mortal case of the last outbreak of legionellosis that the past declared 23 of February in this municipality of the region of the Barcelonian Nord and that has affected a total of nine people, one of them resident one in the neighbouring locality of Montgat.

The victim the past initiated the legionellosis symptoms day 10 of March and after two weeks d´Hebron entered by the annoyances caused by this affection in the Hospital of Vall, where it passed away three days later. However, the woman suffered very serious a previous pathology that forced to him to receive treatments of x-ray, chemotherapy and corticoids.

The technicians of conselleria of Health, in collaboration with those of the Consistorio badalonés, investigate now if this case this related to the other neighbours affected by legionella. 

The circumstance that occurs the address of the victim is to more than 2 kilometers of the possible center of infection of the rest of cases detected in Badalona, according to explained yesterday the chief of a main directorate of Public Health, Luis Salleras. Without having the passed away woman, this outbreak has affected, at the moment, to three women of 78, 93 and 69 years, and to five men of 81, 75, 67, 58 and 78 years of age. All these patients, who began to notice the symptoms of the disease after the 24 of February, have already received the medical discharge. The department of Health and the City council of Badalona have analysed until now 19 samples of 15 cooling towers and the result of the analyses will be known in the next days.

On the other hand, one of both affected by legionellosis in the Prat de Llobregat follows entered in the Hospital of Vall d´Hebron, according to informed Salleras. This patient, who was hospitalised day 19 the past of March, is "stable" within "the gravity". Conselleria of Health both investigates from the last week cases of legionela, one of the affected ones already given of discharge, detected in this municipality of the Baix Llobregat.

NOTE, This is my translation of an Italian newspaper article

27 March 2003 

LOMBARDY, Italy

 All’istituto Bernacchi di Gavirate (Goes) Died two old ones in the rest house: it suspects legionella

VARESE  

Two dead men sospette in an institute for old and the traced bacterium of the legionella in the water of the same institute: perhaps the two facts are not correlate to you but assessments are in course to the house of rest "Bernacchi" of Gavirate, in the Varesotto, where the ricoverati ones are approximately 60. The presence of the micro-organism that provokes pulmonary infections has been confirmed from the direction of the Asl of Varese. Also the magistracy is to the job; at the moment they would be the two deaths that could be led back to the symptoms from the legionella: they have been ordered the autopsies. First to insospettirsi they have been some days before the same responsible of the house of rest "Bernacchi", a public institute.  

The deaths between you assist yourself to it have been 18 in less than three months when difficultly that figure comes caught up in a year. "One of the first controls that we have carried out - reports to Pierluigi Zeals, director of the Asl - it has regarded the water, where in effects we have uncovered the bacterium. We are not still in a position to establishing if it has determined the dead women of the ricoverati ones ". The legionella it assaults lungs and it provokes serious respiratory insufficiencies, symptoms finds to you on two of the old ones died. Other understood it is the prevention measures. "we have ordered water a general reclamation dell’impianto - it explains Zeals -. In the meantime we have advised not to use the warm water: the legionella not inferior temperature to the 37 degrees lives in fact in humid atmospheres and to one ". How it has been able to contaminate the institute? "It can are given that in the tubature of the warm water they have been formed of the incrustations; lì the bacterium can have taken root. But hypothesis draft only ". Calm, instead, it comes defined instead the situation between the ins-patient. Only one minimal part of they is subordinate to one antibiotic therapy. "we have informed the families - the health director Mark reassures River - and I exclude the existence of an alarm legionella". For the mayor Giovanni Alberio finally not sussistono dangers for the rest of the inhabitants, approximately 9 mila: "the Asl has not ordered some participation for the public aqueduct".  


Australia's first known cases of Legionnaires` disease in a 
domestic hot water system

Legionnaire's in senior's units

April 15, 2003

LEGIONELLA bacteria has been found in the hot water systems of nine of the 10 seniors' public housing units in Brisbane where a man who died from legionnaires' disease lived.

Queensland Housing Minister Robert Schwarten said today the 10 other elderly residents of the unit block in the bayside suburb of Wynnum had been evacuated and checked by doctors.

"None of the other residents have shown any trace of legionella and that includes a frail elderly lady who suffers from cancer," Mr Schwarten said.

 

 

He said a task force had been set up between his department and Queensland Health to investigate the outbreak and to carry out a risk assessment of all other seniors' units in Queensland.

A 60-year-old former resident of the Wynnum units, named only as "Graham", died in hospital of legionnaires' disease about three weeks ago.

Legionella bacteria were found in the kitchen and bathroom of his unit, leading to the hot water system, as well as in a standpipe outside.

"We have Q-build workers at the units now and they will be flushing out the system with chlorine until it is free of the bacteria," Mr Schwarten said.

"Once that's done, those that want to return can go back and for those who don't wish to return we will help them relocate."

Mr Schwarten said doctors had informed him that the temperatures of hot water systems used by the elderly were often turned down to avoid scalding accidents, and this sometimes created ideal breeding conditions for the legionella bacteria.
**

TEN elderly residents have been evacuated from a Housing Commission apartment block in Brisbane after a resident contacted legionnaires' disease and died.

Housing Minister Robert Schwarten yesterday said the units in Agnes St, Wynnum, were evacuated on Friday after legionella bacteria was found there.

It was believed to be the first time legionella bacteria had been found in the hot water system of a residential dwelling in Queensland, Mr Schwarten said.

The resident, known only as Graham, 60, died in hospital about three weeks ago. It was believed he had suffered ill health for some time before contracting legionnaires' disease. His family has not been notified of the exact cause of his death.
"The place has been quarantined off, this is a unique case, we've never had to do this before," he said.

Each unit's hot water system and water supplies would be treated before residents could return.

Mr Schwarten said no other residents showed any signs of the disease but they were being monitored.


Scare in Madrid when a parcel opens itself which was directed to the laboratory of legionella  
25 April. 2003
Madrid. Spain

 Specialistic police in chemical outfits but also in any situation that supposes a biological risk have had to act today in Madrid.

Company of transports transferred samples that had to be analysed in the laboratory.
One of the containers spilled and caused the situation of alert to the power to contain bacteria like the one of
legionella

Specialistic police in nuclear, chemical and bacteriological fight extracted the bottles that contained the liquid in the box in which it was transported and they isolated them in hermetic bags. The bottles contain water of the deposits of a boat anchored in the port of Bilbao. It is the water that is used in the boat to drink, to clean up or to cook and was sent a sample to the National Center of Microbiology, in Madrid, to analyse it in search of possible bacteria. "the boats have water tanks that, when remaining on the high seas during long time, are practically suspended water and must be made those controls to control possible infections 

The workers did not know the content of the package. 
Fifteen employees were isolated as a preventive measure until knowing  the danger. 
The analyses have confirmed that the water did not have bacteria. Although it had had, the risk was minimum since legionella is not transmitted by direct bonding but by inhalation. 

 

Susto en Madrid al abrirse un bote dirigido al laboratorio  

25 Abril.  2003
 Madrid
.

Policías especialistas en lucha nuclear, química y bacteriológica extraían los frascos que contenían el líquido de la caja en la que era transportado y los aislaban en bolsas herméticas. Los frascos contienen agua de los depósitos de un barco anclado en el puerto de Bilbao. Es el agua que se utiliza en el barco para beber, para asearse o para cocinar y se enviaba una muestra al Centro Nacional de Microbiología, en Madrid, para analizarla en busca de posibles bacterias.
"Los barcos tienen unos depósitos de agua que, al permanecer en alta mar durante mucho tiempo, es prácticamente agua estancada y deben hacerse esos controles para controlar posibles infecciones


Four cases of legionella in Alcoy

25 April.2003
Valencia. Spain

 The condition of the three patients who continue to be hospitalised by Legionella in Alcoy is good.
The fourth patient, to whom also the disease has been detected
in him already has been registered. 
According to the counsellor of health, that has met this morning with the Mayor of the locality, the outbreak is controlled, although new cases do not discard, due to the increase of the temperatures. Legionella returns again to threaten Alcoy.

To so single one week of the celebrations, four patients have given positive in the analyses of this bacterium. "Three of them are hospitalised, although their condition is good. 
The four already has been registered " According to counsellor, that has met this morning with the mayor of Alcoy, temporary space of the cases can be spoken of a new outbreak due to the coincidence. 
The origin of this new center could in the last be due to the increase of temperatures days. "All the systems of control have started up, the zone has been delimited and samples have been taken" adds counsellor. In spite of all these measures, the appearance of new cases does not discard
 

ALICANTE

Health confirms a new outbreak of legionella in Alcoy with four affected

ALCOY (ALICANTE)

Conseller of Health, Castilian Serafín, has informed in Alcoy of the existence of a new "outbreak" of legionella in the locality, that has caused the hospitalisation of four people, three into which follow entered with favorable prognosis.

Castilian it has made these declarations in the seat of the City council of Alcoy, after studying the health situation with the mayor, Miguel Peralta. He has indicated that a man of the third age is about two women and and another man of 34 years, one of which already has received the medical discharge in the Virgin Hospital of the Irises and one is in his address.

Conseller has showed that the maintenance of the preventive medical protocol has allowed that the health authorities could detect this center "with prontitud", and has added that indeed this circumstance causes that still the surveys and the analyses are being elaborated directed epidemiologists to find the origin of the present outbreak. In addition, it has trusted that this fast detection of the cases allows that new patients do not repeat themselves and has reiterated that the Conselleria has a "constant preoccupation" to avoid this type of episodes.

Confirmed a fifth person affected by legionella in Alcoy Spain

26 April 2003

Alcoy. -- the council of Health of the Generalitat of Valencia has confirmed a new case of pneumonía by legionella in Alcoy, that becomes the fifth affected the new center of this disease that has caused the hospitalisation of four people.

The patient is a man of 47 years who is hospitalised and who is in good state, according to sources of the Generalitat.

The advisor of Health, Castilian Serafín, informed yesterday into the existence of a new "center" of legionella in Alcoy, that has caused the hospitalisation of four people, three of which follow entered with favourable prognosis.

Ywo women and a man of the third age and another man of 34 years, one from which already has received the medical discharge in the Virgin Hospital of the Irises and it is in his address.

The regions of Alcoy and Cocentaina have undergone a total of eight epidémicas situations caused by legionella from end of 1999, by which they have been affected near 200 people.
 


HOTEL LINDA, SIDE, ANTALYA, TURKEY 

Has had 3 cases associated with this cluster, onset of most recent case was 27 April 2003 



Source EWGLINET Surveillance System 


9 April 2003

  Disease plea: `don't panic'

INVESTIGATIONS are continuing to find the source of a legionnaires' disease outbreak in Dandenong South which last month hospitalised two people.

A Department of Human Services spokesman said a Dandenong South meat factory Castricum Brothers conducted a routine check of a cooling tower on February 21, with results testing positive for legionella bacteria on February 28.

A woman who worked about 1km from the factory was diagnosed with legionnaires' disease on March 3.

The following day a male factory worker was also diagnosed with the disease.
Castricum Brothers declined to comment.

The Department of Human Services spokesman said they were still investigating a possible link between the infections and the factory and had not said the factory was the source.

The public had no reason to panic.

"We are not treating it as a public health issue," he said.

"We don't believe there is any threat to the public.

"I would like to stress we are treating this as a one-off incident."

He said Castricum Brothers in Dandenong South had washed down the cooling tower and had done "everything right".


 

WHEN IN MELBOURNE.......
Dress for the
occasion


Legionnaires' disease cases investigated

30 April, 2003

Two cases of Legionnaires' disease were being investigated with a possible link to a function centre on Melbourne's north-eastern outskirts, health authorities said.

 A 72-year-old man and a 82-year-old woman  contracted the illness after they visited the RACV Club at Healesville last month.

Both have recovered after receiving hospital treatment.

Tests conducted on the club's cooling tower system tested positive for the legionella bacteria.

Department of Human Services Chief Health Officer Dr Robert Hall said there was no reason for people to avoid the club since it had its cooling tower disinfected on April 23.

No other cases of Legionnaires' diseases have been associated with the venue, he said.

"As a precaution, any visitors to the club prior to April 23 who became sick within 10 days of their visit with flu-like symptoms should seek medical attention," Dr Hall said.

So far this year there has been 36 cases of Legionnaires' disease notified to the department compared to 37 cases in 2002 and 49 cases in 2001


20 May 2003

THE CANARY ISLANDS.

Four people were affected by a outbreak of legionella detected in the municipality centre of Adeje, although two of them were registered, whereas the other two were entered in the University Hospital the Candlemas. 

One of these affected was entered in the Unit of Intensive Cares of the hospitable center, although according to sanitary sources its state improves progressively. 

The service of Epidemiología of the Canary Service of the Health of the Council of Health received yesterday the notification of four cases of affected by the outbreak of legionella that was detected the week last in the municipality centre of Adeje.

Causal nexus

Sources of the Council of Health indicated yesterday that the four cases have a causal and temporary nexus to be related to the premises in which thinks that it is the infection center, and that has been closed of form to prevent until the origin of the outbreak of legionella is determined.

Technicians of the Service of Epidemiología consider that he is "a small and limited" outbreak, that was detected Thursday the past, when in this department the notification of a case was received that was united to other two appeared in previous weeks.

The inspected premises

After verifying a possible causal nexus between the affected ones, the technicians of Public Health made an environmental inspection of the premises in which deficiencies were detected, reason why it was come to the suspension to prevent of his activities until the origin of the outbreak is determined.

Sources of the Council of Health indicated that it has been come to the drained one from all the facilities and to a disinfection of shock, and within fifteen days another new inspection will be made to verify that the outbreak of legionella has been eradicated definitively.

In addition, the laboratory of Public Health of the canary Government will analyse the samples obtained with the purpose of determining the bacteria cause of the outbreak, thus to cut the transmission.

Source Spanish Media



30 May 2003

Tenerife.

 The seventh case of Legionella in Tenerife is confirmed.

This time is a foreign citizen who usually spends seasons in our island and that used spa of Adeje where the outbreak was located. This person was admitted the Hospital of the Candlemas from month principles, and although in the first tests that practiced did not detect the bacterium to him, now if the diagnosis has been confirmed. Of sietre affected cases, three of them permancen hospitalised, one of them in serious state.

.

Se confirma un séptimo caso de Legionella en Tenerife

  30 Mayo 2003.    Redacción. Tenerife.

 

 

Se confirma el séptimo caso de Legionella en Tenerife. Esta vez se trata de un ciudadano extranjero que suele pasar temporadas en nuestra isla y que utilizó el spa de Adeje donde se localizó el brote.

Esta persona estaba ingresada en el Hospital de La Candelaria desde principios de mes, y aunque en las primeras pruebas que se le practicaron no se detectó la bacteria, ahora si se ha confirmado el diagnóstico. De los sietre casos afectados, tres de ellos permancen hospitalizados, uno de ellos en estado grave.


Health confirms three new cases of legionella, two in Castellón and one in Ibi

Technicians of Health sealed a cooling tower yesterday contaminated with the bacterium of legionella in a company of the urban centre of Ibi 

30 May 2003

CASTELLÓN   IBI.

The Direction of the Provincial Hospital of Castellón confirmed yesterday the existence of a outbreak of legionella in the center, after  detecting two new cases of pneumonía produced by this bacterium. 

Both new diagnosed cases are the companion of a patient that was 5 days ago entered in the Provincial Hospital of Castellón and a patient that was in ambulatory treatment of the Service of Rehabilitation. Both cases have been derived to the General Hospital of Castellón where they remain in observation state. The affected ones are a neighbour of Castellón and a neighbour of Benicasim.

The direction of public Health already has applied the performance protocol and during the day of Thursday it gathered samples of possible the focuses of infection, but the test results will not be known until within 9 days. In this sense, and before the appearance of these two new cases, the direction considers that "indications sufficient exist to think apparently about the existence of a outbreak", since the past Thursday a patient entered the oncología area passed away by an insufficiency cardiorespiratoria, agravated by a picture of pneumonía by legionella together with very low defences by an advanced state of cancer.

The committee of labour health of the Provincial Hospital emitted yesterday a note, in which it confirmed new cases, and indicated that both or the disinfection of the system of water distribution has begun, with one more a part of the programmed measures of shock that or took applying from the knowledge of the first case. The Provincial Hospital also has begun the hyperchloronation of the water and the evacuating of the rehabilitation swimming pool to come so to its new stuffed disinfection and as it was predicted in the protocol.

New case in Ibi

A fourth case of legionella was detected yesterday in Ibi, after the health authorities noticed affected Wednesdays the past that a "dripping" could take place of in the following days, since the disease produced by the outbreak still is in incubation. At the same time, technicians of the Conselleria of Health located the presence of the bacterium in a cooling tower of a company located in the urban case of Ibi, that he could be the cause of the outbreak.

The affected one is a man of 45 years, who has not needed hospitable entrance and follows the treatment in his address with a good prognosis. The other three patients - a man of 31 years and two women, one of 56 and another one of 63- were admitted the Virgin hospital of the Irises of Alcoy and its evolution is also favourable.


They locate the  area at the Provincial Hospital
of Castellon where the center of the outbreak of legionella is

5 June 2003

The center of the outbreak of legionella detected in the Provincial Hospital of Castellón and that already has affected five people, one of which it has passed away, is in the plant of oncología of the health center, according to confirmed yesterday the advisor of Health, Castilian Serafín.

After a press conference in the occasion of the celebration of the National Day of the Donor, Castilian it showed to the journalists whom the four people who remain hospitalised after contracting one pneumonía by legionella in the Provincial Hospital "evolve favourably" and no is entered the Unit of Cuidados Intensives (UCI).

The affected ones are four women. Three of them, of 59, 61 and 70 years, are admitted the General Hospital of Valencia, whereas fourth, of 43 years, it remains in the Hospital of the Magdalena de Castellón. Fifth affected by this outbreak he is a man, neighbour of Castellón, that the past passed away 29 of May in the Unit of Oncología of the Hospital, where was entered to undergo "adenocarcinoma pulmonary scattered with cerebral metástasis and respiratory infection by legionella".

Sources of the Conselleria of Health informed into which three of the affected women were accompanying of patients who were entered the unit of oncología of the Provincial Hospital, whereas fourth he contracted the disease in the area of rehabilitation of this sanitary center, located next to oncología. Castilian Serafín explained that after knowing the cases pneumonía by legionella "immediately the opportune measures for the cleaning and disinfection were taken from all the necessary one to avoid that nosocomial outbreak".

Health confirms two new cases of legionella in Castellon and one in Alicante

7 June 2003

CASTELLÓN / ALICANTE. 

The Conselleria of Health has confirmed the existence of two new cases of legionella,  produced by  infection with the outbreak detected in the Provincial Hospital of Castellon.

A Married couple one who is aged 78 and the other 79 years of age. 

The woman was entered the surgery area, where she was operated during the dates in  which the outbreak took place, and the husband remained with her like companion. 

With these days are already the eight cases detected in the last, seven of them by infection in the General Hospital with result of two deaths and six patients, who are taken care of in the General Hospital of Castellon and evolve favourably. 

The director of Public Health, Bred Javier, recognized the facts yesterday in the morning, after the meeting of the Council of Health, summoned with extraordinary character, indeed after the appearance of the numerous cases of legionella that they have taken place in Castellón.

According to him he indicated that the water has been the factor of transmission of this bacterium, whose center settled down in the zone of Oncología of the hospitable center. 

Antiquity of building seems to be culprit of his appearance in other areas of center, through pipes blinded, where the water stagnates that cannot be chlorinated, and overflows to the rest of the low network when the pressure.

The person in charge of Public Health has also recognized that the period of incubation of the disease will not conclude until Sunday or Monday, reason why could be possible the appearance of new cases in the next days of people who are been in contact with the bacterium.

The person in charge of Working Commissions, with presence in the Council of Health, has indicated that the subject complica because the Administration has recognized that sometimes have taken place increases of the PH of the water, which they prevent his disinfection.

On the other hand, as much the UGT representative as the Union of Consumers denounced the failure of the prevention measures that must be adopted.

Consulted sources also indicate the existence of malaise between the relatives of the patients, who affirm that very little has been facilitated them or no information on which it happened.

On the other hand, Health also confirmed the existence of another case of legionellosis in the zone of Alcoy, this time of the municipality of Plans. Conselleria did not clarify if it is an isolated case or if it bears relation to the centres from Alcoy or Ibi.

New Zealand
18 May 2003

Sick building disease strikes police officers


Three police officers have been struck down with legionnaires' disease, contracted at the Counties-Manukau headquarters building which is now under investigation by the Labour Department.

About 180 staff continue to work at Harlech House in Otahuhu despite police headquarters accepting the building's water tower air conditioning system was to blame for the trio contracting the potentially fatal disease.

Staff are unhappy that the building dangers were identified in 2000 - but just three months ago a positive test was again recorded at the station.

It is understood two of the officers received secret payouts to prevent employment court action. One of those officers has since quit.

Police Association vice-president Richard Middleton confirmed the three cases, saying the officers had suffered pneumonia-like illnesses.

They contracted legionnaires' disease - caused by inhaling legionella bacteria from a water source - from the air in the building. 

Middleton said the association had been fighting to get police headquarters to accept responsibility since problems first emerged in 2000, when two officers fell ill.

"It wasn't until last year that there was an acknowledgment by the department that the disease was contracted through the building," he said.

"There's a massive loss of confidence by staff there in the ability for the department to resolve the matter once and for all."

A third officer had been diagnosed with the disease in the last six months, Middleton said.

It is understood tests have revealed the presence of legionella bacterium in at least one part of Harlech House - a bathroom shower-head.

One officer has quit, one was undergoing rehabilitation and the third had been transferred to another building, Middleton said.

"Their immediate needs have been looked after, although it took some time for that to happen.

"This matter has been extremely frustrating but we have now moved on from there."

An Occupational Safety and Health spokeswoman confirmed the department was investigating building safety, with a report due in about six weeks.

Counties-Manukau district commander Ted Cox, who works at Harlech House, said the health and safety issues were being addressed by a working party comprised of professors, a doctor and building safety representatives.

The recommendations of a hygiene safety report had been implemented and the building was tested every month. The working group, which OSH was also involved with, would review the health of current staff, Cox said.

Police bought Harlech House from the Inland Revenue Department in 1997 for more than $8 million.


Seems no one is minding the store

Update 9 June 2003

Police fury over diseased office

The Police Association says South Auckland police are furious at being exposed to the risk of Legionnaires disease.

Nearly 200 staff are being relocated from the Counties Manukau District Headquarters after an expert declared the building unsafe.

Six staff have got Legionnaires since it was discovered in the building's air conditioning four years ago.

The association's national vice president, Richard Middleton, says the association had asked police managers to eliminate the risk right from the start.

He says it is unacceptable that the management tried to minimise the risk instead.

One police officer battling the debilitating lung disease says it is a tragedy the problem wasn't fixed earlier.

Senior Sergeant Dave Anstiss, who tested positive three years ago, says police managers left it far too late to evacuate.

Anstiss says five of his colleagues got sick after a device designed to fix the problem was fitted in the building's water cooling tower.

He believes more cases have yet to come to light because every police officer in the district has spent time in the building's training division.

Source Media


Legionnaires Problem At Police HQ

8 June 2003

Two new cases of legionnaires disease have been confirmed at Counties-Manukau police headquarters.

The disease was discovered at Harlech House, where the police are located, three years ago.

Six people have now contracted legionnaires, two in the past few days.

Their condition is not considered serious.

Superintendent Ted Cox says despite precautions taken when it was discovered three years ago, the two new cases mean the building must be evacuated.

He says police are working closely with other agencies to ensure the safety of police staff.

Superintendent Cox says police headquarters will be relocated until the building is safe to return to.

He says police have been working with medical experts from Auckland University, who have advised them to move for their staff's safety.

Superintendent Cox says police headquarters will move on Monday morning.


  14 June 2003 Three more police staff down with Legionnaires disease Police have confirmed that a further three officers who worked at the Counties-Manukau district headquarters have legionnaires disease.. Jun 09, 2003 Police fury over diseased office, The Police Association says South Auckland police are furious at being exposed to the risk of Legionnaires disease Six staff have got Legionnaires since it was discovered in the building's air conditioning four years ago...Update 8 June 2003 Two new cases of legionnaires disease have been confirmed at Counties-Manukau police headquarters. The disease was discovered at Harlech House, where the police are located, three years ago. New Zealand...Sick building disease strikes police officers, Three police officers have been struck down with legionnaires' disease, contracted at the Counties-Manukau headquarters building which is now under investigation by the Labour Department. About 180 staff continue to work at Harlech House in Otahuhu despite police headquarters accepting the building's water tower air conditioning system was to blame for the trio contracting the potentially fatal disease..May 13  2003 UK, Legionnaires' found in hospital pipe A hospital treating a policeman with Legionnaires' disease has discovered the bug in its water system, it has been confirmed.The Queen Elizabeth Hospital in Birmingham said there was no link between the officer, from Worcester, and the discovery of the legionella bacteria in a shower pipe on one of its wards.

New Zealand

Three more police staff down with Legionnaires' disease

14 June 2003

Police have confirmed that a further three officers who worked at the Counties-Manukau district headquarters have legionnaires disease.

The cases identified this week bring to nine the number of staff who worked at Harlech House in Otahuhu, Auckland, and now have the potentially fatal bacterial condition.

The building was closed a week ago, with about 200 staff moved to other buildings for an estimated two months.

One staff member was today undergoing tests to determine whether hospital admission was necessary, said police welfare officer Rhys Cantwell.

The confirmed cases were made up of a mix of police officers and non-sworn staff.

Mr Cantwell would not provide any other details, but it was understood at least two were female officers.

About 100 staff have contacted Mr Cantwell and will be tested at the Auckland University medical school in the coming weeks.

He said the 33 people who had suffered illness such as long-term coughing or infections were priorities.

A further 26 people who had suffered occasional influenza would then be tested.

"Then we have about 60 (staff) with no symptoms whatsoever who want to be tested," Mr Cantwell said.

Other staff were consulting their own doctors for testing rather than going through the police-organised university team.

The Police Association has criticised management handling of the outbreak, saying senior officers denied there was a problem and positive test results were withheld from staff.

Two police officers with the disease received confidential compensation payouts last year because of the way their concerns had been dismissed.

Update

More cases of legionnaires at police HQ


THURSDAY  4th  SEPTEMBER 2003


The number of police staff confirmed with legionnaires disease after working at the Counties Manukau headquarters has risen to 14.

A further six staff were waiting to hear if they had contracted the bacterial condition, after working at Harlech House in Otahuhu.

The building was closed in early June and work began this week on renovations, including replacing the water tower with a dry air-conditioning system and upgrading toilets and showers.

The Police Association has employed an independent investigator, lawyer Richard Earwaker, to review the work and ensure it met international standards.

Association vice-president Richard Middleton said the police had agreed to the review, aimed to give staff confidence the revamped building is a safe working environment.

Mr Earwaker would compare international standards to work on Harlech House, said Mr Middleton.

He would also make recommendations on any further work to ensure the building is safe before staff return, he said.

Mr Middleton this week asked management when a medical report on 400 staff tested for legionnaires would be made available.

The cases confirmed so far dated from 2000, when legionella was first found in the building, to February of this year.

The association has asked lawyers to investigate compensation for staff affected by the disease.

Two police officers with the disease received confidential compensation payouts last year because of the way their concerns were dismissed.

Counties Manukau District Commander Ted Cox said renovation work was on track to be completed around mid-November and staff will move back into the building soon after. 


A new outbreak of legionella in the Valencian Community one victim dies

9 June 2003.

 Madrid.

One persaon died and ten affected are the provisional balance of several outbreaks of legionella detected in the Valencian Community in the last days. Most serious of them she is located in the Provincial Hospital of Castellón, where a patient in the plant of Oncología passed away.

She was in the showers of his room where the bacterium was located. This same hospital has registered six cases more of legionella, between patients and companions. In addition they have taken place contagios isolated in Alcoy, Ibi and Onil, localities of the same alicantina region. 
The health authorities do not discard the appearance of new cases in the next days, since the period of incubation follows
.


9 June 2003

Alarm in the Valencian Health after detecting two new outbreaks of legionella

CASTELLÓN/ALICANTE.

One person is dead and other 24 affected are the provisional balance of the reappearance of the legionellosis in the Valencian Community lately. 

From the 28 of May a person has died and ten diagnosed cases have revealed the existence of two new outbreaks.

First it was a outbreak in Alcoy (the eighth from 1999) and other places of his region. Soon another one in Castellón was registered, with a center in the plant of Oncología of the Provincial Hospital. The Valencian health  authorities insist on which the situation is under control.

The bacterium of legionella seems to have shown no mercy with the Valencian Community, specially with the zone of the Alcoy industrialist, inside the province of Alicante, where almost 300 cases of I infect since have been registered the disease appeared for the first time in 1999. But in this occasion, where there is to lament a death is in Castellón, and indeed in a place that had to be well safe from this disease: the area of Oncología of the Provincial Hospital.

A deceased

The 29 of May passed away a patient entered that unit due to I infect of legionella. Later other six cases have been registered, with which no has special gravity. Three of them companions correspond to of patients of plant of Oncología of thr health center , and quarter is woman which apparently it was infected in the area of Rehabilitation, that is in a contiguous space, reason why was not difficult to find out the possible location of the center. 

The bacterium has been located in the hot water of the showers of room 202 of the center, where the first patient passed away who contracted the disease and that suffered a cancer of lung, as well as in the hot water and it fries of clothes. 

The Council of Health of the Generalitat assures that the measures in the hospitable center are had extreme, like the hyperchlorination of the water, the increase of their temperature in faucets and showers, the cleaning and disinfection of the rehabilitation swimming pool and the taking of samples of almost a hundred of hypothetical centres.

Nevertheless, the advisor of Health, Castilian Serafín, does not discard the appearance of new contagios during the next days, and to that the period of incubation of the disease continues open. The alert also follows in Alcoy, although the tenth case in hardly three weeks confirmed the 19 of May there and since then new one has not been registered any affected by legionellosis. For that reason, the health authorities consider, with the caution that the circumstance they demand, that can occur by surpassed the risk of propagation of this outbreak. Its control has demanded an increasing unfolding for the closing of tens of accomplishment and cooling towers of analysis.

While in Alcoy the crisis situation seemed to send, the bacterium of legionella began to act in the near population of Ibi, also with abundant industries that need great facilities of refrigeration. The 21 of May detected a case in this city and another one in Onil, in the same region. What the Generalitat considered a fact isolated, to the few days it was confirmed as at first the first outbreak of legionella in the history of Ibi, whose mayor came assuring that its population did not reunite the bad geographic conditions of Alcoy.

The disease has affected or five people in Ibi and continues extending by the zone when detecting itself day of 5 June a case in Wall of Alcoy, urban nucleus that or happened through this experience in June of 2000 and November of 2002, and another one day 6 in Plans.


The possibility of a greater advance has alerted to the locality of Cocentaina specially, where legionella was fattened in previous years. In fact, a neighbour of this municipality is ill of pneumonía by legionella, although he was infected in Alcoy.


France

17 June 2003

 Légionellose: Closed  the Thermal baths of Casteljaloux

  BORDEAUX

The prefect of the Batch-and-Garonne decided by decree the provisional closing of the Thermal baths of Casteljaloux after the discovery of the bacterium "legionella pneumophila" at the exit of the drilling which feeds the establishment out of water.

"the care was suspended and the cures from now on are stopped until is noted a return to a strict microbiological quality of water", the prefecture in an official statement specifies.

This measurement was taken on proposal of the departmental Management of the medical and social action (DDASS)"under the terms of the principle of precaution".

The legionella is a bacterium which is propagated in an optimal way in a water with approximately 40° and causes acute pulmonary infections, the légionellose or "disease of the légionary". The duration of incubation is two to ten days and 10 to 15% of the cases are mortals.  


Also known as Tercis-les-Bains


Four cases of légionellose, of which a mortal, detected in Savoy
Ju
ne 27  2003

GRENOBLE  

The hydropathic establishments of Support-the-Baths and Saline-the-Thermal baths ( Savoy ) were closed by measurements of precaution, after the description of four cases of légionellose, of which a mortal.

The departmental direction of the medical and social businesses (DDASS) of Savoy had been alerted on 20 last June of a case of légionellose at a woman having carried out a cure with Support-the-Baths a few days before.

Thereafter, three other cases were highlighted. One of the four victims died on June 23.

Environmental research is in hand on the water supply networks of the two hydropathic establishments where the victims carried out a cure but also in the places where they resided in Savoy .

The thermal baths of Support-the-Baths and Saline-the-Thermal baths were closed by measurement of precaution until the investigation made it possible to identify the origin of the contaminations.

The légionellose is a respiratory infection caused by a bacterium, the légionella. The latter is transmitted by contaminated water inhalation diffused by aerosol in the environment.

NOTE

Tuesday June 17, 2003

 The Batch-and-Garonne: 

Thermal baths closed following discovered the légionelle one 

BORDEAUX 

The activity of the care of the Thermal baths of Casteljaloux (the Batch-and-Garonne) was suspended by the prefecture of the Batch-and-Garonne after the discovery, during lawful controls of thermal spring, the presence of bacteria légionella pneumophila at the exit of the drilling which feeds the establishment, announced the prefecture. No case of disease was detected and it is about a measure "taken under the terms of the principle of precaution". 

The close center thermoludic, supplied with another collecting, remains open. 

The Thermal baths of Casteljaloux were inaugurated on July 15, 2002, after an investment of 8 million euros. 


(1) TURIST HOTEL, ANKARA, TURKEY 

has had 2 cases associated with this cluster, onset of most recent case was 25/05/2003. 

(2)
GRAND ONS HOTEL, ISTANBUL, TURKEY 

has had 2 cases associated with this cluster, onset of most recent case was 25/05/2003. 

(3)
EDEN GARDEN HOTEL, ASSOS,  CANAKKALE, TURKEY 

has had 2 cases associated with this cluster, onset of most recent case was 25/05/2003. 

(4) HIERAPOLIS HOTEL, PAMUKKALE,  DENIZLI, TURKEY 

has had 4 cases associated with this cluster, onset of most recent case was 25/05/2003. 

(5) KIRIS ALINDA HOTEL, KEMER, ANTALYA, TURKEY 

has had 2 cases associated with this cluster, onset of most recent case was 13/06/2003. 

(6) THE YELLOW ROSE HOTEL, GUMBET, BODRUM, MUGLA, TURKEY 

has had 2 cases associated with this cluster, onset of most recent case was 23/06/2003

(7) GRAND ONS HOTEL, ISTANBUL, TURKEY 

has had 3 cases associated with this cluster, onset of most recent case was 04/08/2002. 

(8) HOTEL GRAND SAVUR, ISTANBUL, TURKEY 

has had 3 cases associated with this cluster, onset of most recent case was 04/09/2003

(9) HOTEL GRAND ONS, ISTANBUL, TURKEY 

has had 3 cases associated with this cluster, onset of most recent case was 04/08/2003. 

SOURCE....EWGLINET Surveillance System


Legionnaires' disease suspected in death

 July 9, 2003

VIRGINIA BEACH, Va. 

Health officials are investigating a death they suspect is linked to a possible outbreak of Legionnaires' disease in the Hampton Roads area.

The director of the Virginia Beach Health Department, said Wednesday an autopsy is planned. The Virginia Beach man died Sunday. Officials did not release his identity.

Health officials are also looking at the origins of 14 Legionnaires' cases.

We are still investigating to see if there's any common sources or links a spokesman said

Thirty-seven Virginians have been diagnosed with the disease this year, three times the number of reported cases for the same period last year, said Betty Rouse, an epidemiologist for the state health department.

**********
Legionnaires' disease kills Beach man

Health officials say an outbreak of Legionaires' disease in Hampton Roads has sickened 14 people, killing a Virginia Beach man.

Virginia Beach health department officials have not released the man's name, but say he died Sunday.

The health department director says they have not determined the cause of death, but says he did have Legionnaires'.

According to the state Department of Health, 37 people in Virginia have been diagnosed this year with the disease, which is a type of bacterial pneumonia. That's three times the number of reported cases for the same period last year.

Health officials have not found any links among the recent Virginia cases.

Six cases have been reported in Virginia Beach, along with three in Norfolk, two on the Eastern Shore, one in Chesapeake and two on the Peninsula.

**********

VIRGINIA BEACH, Va. 

Legionnaires' disease makes deadly return


 July 10, 2003

Two Peninsula residents have developed Legionnaires' disease from an outbreak that has affected 14 people in the Hampton Roads area, health officials confirmed Wednesday.

In both cases, the patients are male, at least 40 years old and live within the Peninsula health district, authorities said.
The district includes Newport News, Poquoson, James City County, York County and Williamsburg. Hampton is controlled separately.

In addition to the Peninsula cases, six others were reported in Virginia Beach, three in Norfolk, two on the Eastern Shore and one in Chesapeake, said Michelle Stoll, spokeswoman for the Virginia Department of Health in Richmond.

A Virginia Beach man died Sunday after contracting the disease, although health officials have not yet determined if the disease was the cause of death. Thirty-seven people in Virginia have been diagnosed with the disease so far this year, two more than for all of last year.

The last deaths in Virginia from the disease were in 1996, when two people died out of 23 confirmed cases. The outbreak was spread by a hot tub display at a home improvement store in southwest Virginia.

Dr. Elaine Perry, Peninsula health district director, said the disease cannot be passed from person to person, and health officials have not established a link among the recent cases.

Outbreaks of legionellosis occur after a person breathes mist from water sources like air-conditioning cooling towers, whirlpool spas, humidifiers and hot tubs contaminated with the Legionella bacteria. There is no evidence of people becoming infected from household window air-conditioning units.

The Legionella organism can be found in many types of water systems and can reproduce in high numbers in warm, stagnant water, typically 90 to 105 degrees.

Stoll said the recent outbreak should not be a cause for concern, but recommended that people in a high-risk category for the disease or anyone experiencing symptoms of lower respiratory infection consult their physician.

"Early detection is the key," she said.

The disease affects people of all ages, but middle-age and older people, especially smokers or those with chronic lung disease, are particularly susceptible. Those with a suppressed immune system from illnesses such as cancer, kidney failure, diabetes or AIDS run an increased risk of contracting the disease. Also at higher risk are those who take medication to suppress the immune system.


Legionnaires' disease is fatal for two in Delaware

Twelve cases reported

11 July 2003

Twelve cases of Legionnaires' disease, a potentially fatal bacterial disease with pneumonia-like symptoms, have been reported in Delaware since May 29, state health officials said Thursday.

Two people died from the disease.

Dr. Maureen Dempsey, director of the Delaware Division of Public Health, said the cases do not appear to be related and there is no public health risk. But health officials will continue to investigate whether there is any connection because of the number of cases reported in a short time period, she said.

"There are no common denominators between any of the infections that leads us to believe there is an outbreak," Dempsey said. "There is no cluster of cases, no common source or related factors."

Seven of the 12 cases were reported in New Castle County, and two were in Sussex. Three cases involved non-residents who received care in Delaware.

The range for Legionnaires' cases in the state is 16 to 22 in any given year, Dempsey said. There was an average 13.8 cases per year in Delaware between 1995 and 2002, she said.

Legionnaires' disease usually occurs as isolated cases, not in large outbreaks, according to the federal Centers for Disease Control and Prevention.

Mandi Morrow, whose father, Thomas Miller, 56, died June 11 from the disease, said the public should have been made aware of the number of cases in Delaware.

"If there's West Nile, they will tell you if you go outside, you might get bitten by a mosquito," said Morrow, 25, of Newark. "My dad didn't go to the doctor because he thought he had the flu. He could have lived if he went to the doctor [earlier]. I think this is public knowledge if it could save somebody's life."

No information was available about the second death in Delaware.

Greg Patterson, spokesman for Gov. Ruth Ann Minner, said Minner was told Thursday about the caseload.

"The number of cases in one month is certainly something that gets your attention," he said.

The southern Atlantic region has shown an increase in Legionnaires' cases so far this year, with 161 reported cases, up from 89 in 2002, Dempsey said. The region includes Delaware, Washington, D.C., Virginia, West Virginia, North Carolina, South Carolina, Georgia and Florida.

She could not explain the increase in cases and said the cases were isolated.

There were 549 reported cases in the United States for the week ending June 28, 2003. That number is up from 416 at the same time last year, state health officials said.

About 8,000 to 18,000 people get Legionnaires' disease in the United States each year, and 5 percent to 15 percent die from it, Dempsey said.

Morrow said her father quit smoking 10 years ago and had no other health problems. She added that her father went from being in good health to displaying flu-like symptoms to experiencing massive organ failure in less than a week.

"It was all very fast," she said. "I have no idea how he got it. He was in the wrong place at the wrong time."


Delaware  USA 16 July 2003

State confirms Legionnaires' cases in Sussex
Dagsboro man recovering from June battle with illness

State health officials are monitoring 12 reported cases of Legionnaires' disease that occurred between May 29 and July 5 in Delaware, one of which was fatal.

Two recent patients, both of whom survived, were residents of Sussex County, the Delaware Department of Public Health (DPH) confirmed on July 14.

The state's lone death from Legionnaires' was from New Castle County, the DPH reported.

According to the DPH, current cases in Delaware are not believed to be directly related but are part of a larger increase of Legionnaires' in the south-Atlantic states this year.

One of the two Sussex County patients treated for the ailment was Dagsboro resident Harvey Justice.

In mid-June, Justice said he began feeling ill from flu-like symptoms, and only at the insistence of his wife did he visit his family doctor.

"I felt sick on Monday, and felt no better on Friday, and didn't have the strength to argue," he said.

Recognizing that Justice did not show signs of having the flu despite his symptoms, his doctor immediately sent Justice to Beebe Medical Center in Lewes. For three days, Justice ran a high fever that doctors treated with a cooling blanket.

Justice was shortly thereafter released with two prescriptions of powerful antibiotics and instructions to "take it easy" for a few weeks.

"I'm lucky I got into the hospital," said Justice. "Otherwise I might have been a goner."

Legionnaires' has a 30 percent fatality rate, but can be treated with common antibiotics, and is not spread from one person to another, DPH officials said.

"I think it's important for people to know that it's not contagious, and that they should get themselves checked out if they show symptoms," cautioned Justice.

Delaware, Maryland, Washing-ton, D.C., Virginia, West Virginia, North Carolina, South Carolina, Georgia and Florida have between them reported 161 cases of Legionnaires' this year, compared with 89 cases in 2002, said DPH officials.

Brendan Flannery, an epidemic fellow and Legionnaires' disease specialist with the CDC, said this year's increase in cases has public health officials baffled.

"We really don't have an explanation for the increase this year, and there are very few links between the cases that can point to a common source," he explained.

The cases in Delaware, and indeed the entire East Coast, are geographically disparate, Flannery said, and therefore do not point to an outbreak from a common point source. In a situation where multiple patients spent time in the same place, officials can point to that as the likely source of contamination.

The DPH confirmed that the cases currently being investigated in Delaware are of a diverse cross-section: age, gender, occupation. In fact no common thread has been found, said DPH officials.

"The states are currently taking the lead in gathering information that we will examine to try to find an answer," Flannery said. "But right now, we can't identify what is causing this. There are too many possibilities."

For the time being, the source of his illness is not what concerns Justice -- he just wants to feel normal again.

"I'm still not perfectly straightened out, and that may take some time they tell me," he said. Thankfully, his ordeal is largely over. "I felt absolutely sicker than a dog. I wouldn't wish this on anybody"


Delaware USA

2nd death reported from Legionnaires' disease

Sussex County man, 77, died Wednesday

31 July 2003

One Delaware man has died and another has become ill from Legionnaires' disease within the past week, the state Division of Public Health reported Wednesday.

The 77-year-old Sussex County man who died early Wednesday morning had the 15th case of the disease reported in the state and was the second Delaware resident to die from it since May 29. He was diagnosed July 26. On June 11, Thomas Miller, 56, of Newark, died from Legionnaires'.

The other case announced Wednesday was that of an 82-year-old New Castle County man diagnosed with the disease on Tuesday. The 12 other people infected have recovered.

The two cases announced Wednesday are the first diagnosed in the state since July 14.

"This is an unusual situation," said state epidemiologist Leroy Hathcock, "and it's being seen all along the East Coast."

The south Atlantic region of the country, which includes Delaware, Maryland, Washington, D.C., Virginia, West Virginia, North Carolina, South Carolina, Georgia and Florida has reported 237 cases of Legionnaires' disease this year, compared with 97 last year, said public health spokeswoman Donna Sharp.

There is no discernible pattern to the outbreaks, Hathcock said. Eight cases were from New Castle County, three were from Sussex County and four involved out-of-state residents, all of whom were hospitalized in Delaware.

The recent spate of cases also is unusual because they have happened within two months, Hathcock said. Since 1995, the state has averaged 14 cases a year, but they are often spread throughout the year. Since 1992, there has been only one serious outbreak, when 20 cases were reported. Not one was fatal, however.

Although Hathcock mentioned the preponderance of rain the East Coast received this year as a possible cause, he could not say why there was such an outbreak without further investigation. He said the state is working with the other south Atlantic region states and the federal Centers for Disease Control and Prevention.

Investigators have interviewed all the people involved in the 15 cases reported, he said, and have found no common denominator. "That's why we're working with other states and the CDC," Hathcock said. "This doesn't look like a typical outbreak."


Birmingham England

10 July 2003

Tests at hospital after two legionnaires' disease deaths

Hospital officials are waiting for the results of tests for Legionnaires' disease today following the death of two patients thought to have contracted the bug.

The patients, who were being treated at the neuroscience department of the Queen Elizabeth Hospital in Birmingham, both developed chest conditions and subsequently tested positive for the water-borne disease.

The University Hospitals Birmingham NHS Trust has carried out an inspection of water systems at the hospital and is awaiting the outcome of the tests.

It has also written to GPs in the area asking them to be alert for any patients developing chest infections after being treated at the hospital at the same time as those who died.

The first patient died on June 17 and the second two days ago.



Oviedo Spain

Nine people are infected of Legionella in Oviedo

11 July 2003

All the affected ones reside in the District of the Aragañosa and the well-known zone like the Ería, reason why it investigates itself in that circumscription to locate the center

A total of nine people, all of them residents in the District of the Aragañosa and the well-known zone like the Ería, have been affected by an assumption appears of Legionella whose origin investigates the Principality of Asturias, that does not discard that new cases in the next hours are registered, according to informed the chief of a main directorate into Public Health, Ramon Quirós. Eight of the affected ones followed entered yesterday in the Central Hospital of Asturias , although its evolution was favorable, informed sources into the hospitable center.

The first patient the past entered day 1 of July in the Hospital, although the outbreak was not detected later until days. The affected ones have between 36 and 84 years and single have in common the residence place. The regional person in charge explained that the Council of Health the past had knowledge of the cases Tuesday. A day later was come to close the six registered cooling towers in the zone of the Asturian capital where it suspects that it can be located the outbreak.

Inspections have not  detected the bacterium , although  pending are the results of the taken samples. Also, aerial images have been taken from the zone to discard that illegal systems of refrigeration can exist that could be the origin of the center. Also samples in the public sources were taken from the seat of America and in the Park of the West and declaration is being taken to the affected people to have more details of places where they can be the focus of infection.

UPDATE 

Asturias . - Sariego defends the attitude of the regional government front to the outbreak of legionella

OVIEDO , 28 July 2003


The Advisor of Health of the Principality of Asturias, Rafael Sariego, he appeared today in the General Meeting of the Principality to inform about the outbreak of legionella that has  affected to 15 people this month in the capital of the Principality. Sariego explained that the Principality acted at any moment with transparency and it accused the PP to try to make profitable the problem politically. The appearance was solicitd by 5 deputies of the Popular Party.

Sariego indicated that the outbreak declared the 10 of July, after period demanded for this type of diseases. The PP maintained from the principle that the Principality knew the existence the outbreak from day 1, two days before the session and investiture of the president regional, Vicente Alvarez Areces.

On the other hand, Sariego affirmed in addition that from the same moment in that knowledge of the outbreak was had, the Council has acted with total speed and transparency. As it shows of it, it assured that they have made 83 diagnósticas tests.


Legionnaires' disease kills two

29 July 2003 

BERLIN , GERMANY

Two women have died in an outbreak of Legionnaires' disease in a German hospital, and health officials said Tuesday the bug seemed to have taken hold in the hospital hot-water pipes.

Heinz-Dieter Walter, health spokesman for the eastern city of Frankfurt/Oder on the Polish border, said three other patients were being treated for the illness at the hospital, the Klinikum Frankfurt.

The outbreak was reported at the start of the month to Berlin health authorities but the hospital's battle to expel the Legionella bacteria that cause it was not made public. Walter said cold-water pipes in the clinic were not affected.

Because of suspicions that hot-water pipes were infected, patients in several wards are currently forbidden to take showers.

Germany's national disease-control agency, the Robert Koch Institute in Berlin, estimates between 6,000 and 10,000 cases of pneumonia in Germany every year are due to Legionella, though only 413 cases were confirmed in the country last year.

Friday, 1 August 2003 

Legionaerskrankheit chief suspends After the death of two women with Legionaerskrankheit in the clinical center Frankfurt. 

The technical chief of the house was suspended. The woman employee of many years was relieved provisionally by her obligations, communicated the clinical center on Friday and confirmed thereby a report of the "Maerki Oderzeitung". 

The two female patients had died in July at Legionellen. 

The public prosecutor's office determines to altogether six deaths as well as against two coworkers of the hospital. The germs had arisen last in the chilled water system of the new building. The hospital belongs to quoted Rhoen clinical center to the AG (bath Neustadt/Saale). 

The position was occupied from the house again, said company spokeswoman Brigitte Sallwey of dpa. For suspending the technical chief it meant in the report: "according to opinion of the operator the falserun development of the technical structure in new bed bed without visible initiative accompanied you for reducing or removal of the problem."


Tuesday, July 29, 2003

Ruidoso Downs visitors should be aware


The New Mexico Department of Health has contacted TDH to make us aware of the following investigation. TDH IDEAS Division is aware of this, so should you learn of a possible case of legionnaires disease in your area, please inform IDEAS as usual.

Dennis Perrotta, State Epidemiologist.

The New Mexico Department of Health, Office of Epidemiology, Public Health Division, is investigating a possible cluster of Legionnaire’s Disease cases that may have a common exposure at the Days Inn Motel in Ruidoso Downs, N.M. 
Two patients from two states (CA and OK) have tested positive by urine antigen assay for Legionella serogroup 1 since July 7, 2003. The motel visits appear to be the only common link between these cases at this point in time. 

Tests to determine a source of exposure are underway.

We are advising health care providers to consider Legionellosis among patients with undiagnosed, febrile, respiratory illness who had recent travel (in the last 30 days) to this motel in Ruidoso Downs, NM.
Additionally, we request that health care providers report any suspect diagnosis of legionellosis immediately to the Office of Epidemiology at (505) 827-0006. An epidemiologist is on-call 24 hours per day, seven days per week.


Spain

1st August 2003

 A outbreak of legionella in Arteixo (To Corunna) affects three people, two of who already they were registered

A outbreak of legionella has affected to three people of the municipality coruñés of Arteixo, two of which already they have been registered in the Hospital Juan Canalejo of A Corunna and third it is on the verge of receiving it in the same clinical center, given its favorable evolution.

The assistant director of Programs of the Main directorate of Public Saúde, Angel Go'mez Amorín, today explained  that are two men, of 26 and 58 years of age, and one woman of 43 years, whose "only nexus of union" is that they live in the locality of Pastoriza, that belongs to the municipal term of Arteixo.

He emphasized east civil employee of the Consellería of Health that, since the last date of appearance of symptoms in this group were the past day 22, if between today and tomorrow the appearance of the characteristic sintomatología in any other citizen is not detected, considers that the outbreak "is closed", to the being the maximum period of incubation of ten days.

TO LOCATE THE SOURCE

After receiving pasts 23 and 25 of July the Alerting service Epidemiología the corresponding notifications of the Hospital Juan Canalejo, technicians of Public Saúde initiated the tending investigations to locate the source of the outbreak, without to have obtained results at the moment.

On the matter, González precise Amorín that in the proximities of the addresses of the affected ones it does not exist registered no installation of risk, that are those that uses circuits of hot water in mechanical of refrigeration, air conditioning or aerosol.

Therefore, the first performance of the inspectors was to rake, by earth and air from helicopter, the zone, in order to verify if some installation non registered existed.

When not detecting no, the technicians have started up an inspection in detail in the industrial estates of Arteixo, Sabón and To Grela, that is in course.


Norway

5th August 2003

Legionnaires' disease flares up again

Three Norwegians, two in Trondheim and one in Oslo, were being treated for Legionnaires' Disease on Tuesday. Health department officials claimed there's no fear, however, of an outbreak like one that hit Stavanger in 2001.

A 67-year-old man was put on a respirator at St Olav's Hospital in Trondheim on Tuesday, while a 68-year-old woman also was being treated at St Olav's. The two cases were unrelated and it remained unclear how they were infected.

Guttorm Eilertsen, in charge of contagious disease control in Trondheim, called the cases "coincidental" and said the patients' homes would be isolated and cleaned in an effort to get rid of any source of infection.

The third case of Legionnaires' Disease emerged in Oslo, where a 52-year-old man also was put on a respirator at Lovisenberg Hospital. It's believed he was infected while staying at a rheumatism clinic in Izmir, Turkey.

His condition was listed as serious, but stable.

Norway's national health institute isn't issuing any warnings. "This disease pops up every year," said Egil Bjoerloew of the institute. He said there were 22 cases of Legionnaires' Disease in 2002 and 43 in 2001, when an epidemic of sorts hit Stavanger with 28 cases reported over a relatively short time frame.

En 67 år gammel mann ligger i koma på St. Olavs Hospital i Trondheim, etter å ha blitt smittet av den dødelige bakterien legionella. Ytterligere to er smittet.

En 68 år gammel kvinne i Trondheim er også smittet, skriver 

Ifølge overlege Ulf Mostad ved St. Olavs Hospital er det foreløpig ikke snakk om noen epidemi:

- Vi er bekymret, men har så langt ikke funnet fellesnevnere mellom de to tilfellene bortsett fra at begge er fra Trondheim, sier Mostad til avisa.

Smittekilden er foreløpig ikke funnet.

Også en 52-åring i Oslo er smittet. Tilstanden hans er alvorlig, men stabil. 52-åringen i Oslo har antakelig fått smitten på reise i Tyrkia.

 


NORWAY

Hot tub likely legionella source

Wednesday, 6 August 2003

More cases of legionella make headlines in Norway . Ten women were likely infected with the legionella bacteria after a bachelorette party in Nesodden, Akershus ended up in a bubbling hot tub a week and a half ago, newspaper Dagbladet reports.

 "In the days after the party every one was knocked out. I had a high fever, chest pains and difficulty breathing," the bride-to-be told Dagbladet.

The women learned after visits to doctors that the site of their festive bath had been shut down in June after three elderly women fell ill there.

Chief district physician Knut Erlend Hagen believes the ten celebrants have contracted Pontiac Fever, a milder version of legionella. This ailment tends to last a few days but can become dangerous if it develops into pneumonia.

Legionella cases tend to flare up in the summer months, and there have been three cases reported in the Trondheim and Oslo area.


Friday 8th August 2003

Milwaukee USA

Four Cases of Legionnaires' Disease Confirmed in Milwaukee


Newpaper  reports state that four people have been confirmed to have the disease.

All four were infected in mid or late July. Officials learned about the cases Wednesday when lab results were returned.

The patients were all middle-aged or elderly, and all were hospitalized. 

Milwaukee health officials are investigating whether the four cases are related.

Officials say all four are recovering.

Legionnaires' disease is caused by a bacterium that grows in warm, stagnant water. An estimated 8,000 to  18,000people in the U.S. get the disease each year. About 5 percent to 30 percent of people who get the disease die.


FRANCE

LÉGIONELLOSE

One death and 17 patients in Hérault

8th August, 2003

Occurred, in the department of Hérault, of seventeen cases of légionellose, and one death  during the last ten days  is worrying the local medical authorities.

Yesterday,  its first victim died, a 81 year old man. The whole of the infected people are currently hospitalised within CHU of Montpellier . Among them, six were placed in intensive care unit and are "in an alarming state".

The source of the first recorded contamination on July 28, then of the sixteen others counted between the 4 and August 8 in the agglomeration montpelliéraine and with Palavas-the-Floods is for the unknown hour. So that the departmental Management of the medical and social businesses (Ddass) of Hérault put itself as of yesterday on the track possible new cases, in particular by inviting the people having fever, pains muscular, headaches and a dry cough to consult their general practitioner.


"this stage, we privilege the assumption of a single source of exposure common to the whole of these people", explains Philippe Malfaix, director of the interregional Cell of southern epidemiology (Wax) which, as of yesterday, sent two investigators in Montpellier. Wednesday, a first interrogation of the conscious patients had made it possible to exclude the track from contaminations which have occurred in a hospital or a center of thalassotherapy, directing the doctors towards a possible calling into question of turns aéroréfrigérantes. 


Update France

Legionnaires' outbreak claims 2

8th August 2003

Montpellier - A second elderly man in two days has died of legionnaires' disease in the southern French city of Montpellier, a local police spokesperson said.

The 70-year-old victim passed away early on Friday, 24 hours after an 81-year-old man succumbed to the influenza-like lung infection.

Twenty cases have been diagnosed during the week in Montpellier hospitals of legionnaires' disease, which is caused by water-borne bacteria often found in old water pipes or air conditioning systems.

The heatwave currently gripping France is thought responsible for the outbreak of the disease, as the bacteria grow best in water temperatures of 37°.



Update France
9th August 2003

Montpellier health authorities say there are aware of 22 further cases of the disease in the city, eight of whom are in intensive care.

A further two cases -- one diagnosed in Paris, the other in Italy -- are also believed to have been contracted in Montpellier.


12 August 2003

Montpellier

Légionellose. 

A third victim in Montpellier is a woman aged 47 years  hospitalized since the end of July in Montpellier (Hérault) for a légionellose died yesterday morning, changing to three in C E department the number of deaths due to this pulmonary infection. 

On the whole 26 cases, whose three mortals, were listed, including 23 in L ' Hérault. Three other cases concern people having remained in the department: one in the Valley-D ' Oise, one in Italy and one in the Netherlands. 

Six people are still currently in intensive care unit. Seven other patients could leave the hospitals and are in good health.  inquires epidemiologic carried out by the prefecture made it possible to direct controls and disinfections towards the center of Montpellier where concentrate the majority of the turns air coolers. Sampling, analyses and disinfections preventive were carried out. 


Grouped cases of légionellose identified in Montpellier
July - August 2003

 August 14, 2003 17h30

 Thirty cases of légionellose were declared in Ddass of Hérault between July 31 and August 14, 28 by the system of the obligatory declaration and 2 cases notified by the European network of monitoring of the légionellose related to voyage (EWGLI).
All these patients presented signs of pneumonia, were hospitalized and the biologically confirmed diagnosis of légionellose. For 26 of these 30 cases, the beginning of the symptoms appeared between July 24 and August 3 (figure 1).
63% of the cases are of male sex. The age of the cases lies between 36 and 92 years (average 61 years; 30% of the cases are old less than 50 years). To date, three patients died and eleven are cured. Seventeen of the 26 patients reside in Montpellier, 7 except Montpellier but in the same department, four in other French departments and two abroad (Italy, Netherlands). The cases not living in Montpellier had attended the centre town for the incubation period.

The last announced case, having begun the disease on August 10, works in Montpellier. However, it carried out a displacement of 1st at August 4 in other departments. Investigations are in hand near the various establishments which it attended.

The epidemiologic investigation near the cases, carried out by Ddass of Hérault with the support of the interregional Cell of epidemiology (Wax) Southern, of the national Center of reference and InVS directed towards one or of the common sources of type turn aéroréfrigérante located at the centre town of Montpellier.

The environmental investigation carried out by Ddass, Drire and the communal Service of hygiene and health made it possible to identify the presence of légionelles in several turns aéroréfrigérantes of the centre town of Montpellier. These turns were stopped and of measurements of disinfection were taken.

The stocks the légionelles ones isolated among patients and from the environmental taking away are being analysed in order to specify the sources of the epidemic.


August 19, 2003 12h00 

Thirty one case of légionellose were declared in Ddass of Hérault between July 31 and August 18, 29 by the system of the obligatory declaration and 2 cases notified by the European network of monitoring of the légionellose related to voyage (EWGLI).

All these patients presented signs of pneumonia, were hospitalized and the biologically confirmed diagnosis of légionellose. A stock of légionelle was insulated among 8 patients. For 26 of these 30 cases, the beginning of the symptoms appeared between July 24 and August 3 (figure 1).

61 % of the cases are of male sex. The age of the cases lies between 36 and 92 years (average 61 years; 29% of the cases are old less than 50 years). To date, three patients died and fifteen are cured. Among the other patients, nine are always in intensive care unit.

Eighteen of the 26 patients reside in Montpellier , 7 except Montpellier but in the same department, four in other French departments and two abroad ( Italy , Netherlands ). The cases not living in Montpellier had attended the centre town for the incubation period.

Source Institut de Veille Sanitaire

Legionnaires' disease France


224th   August  2003 

Two Germans contract Legionnaires' disease during cruise

Berlin, Germany

 Two Germans have contracted Legionnaires' disease while on a 14-day cruise near Greenland but their condition is reported to be not life  threatening, the health minister of the state of Lower Saxony said on Sunday.

In a statement, health minister Ursula von der Leyen said passengers were on the "Ocean Monarch" ship. It arrived in the northern port of  Cushaven on August 22 with 358 passengers, including 218 Germans.

About half of the passengers who got off the boat have been contacted by health authorities, including 38 from Switzerland. Seven other people  have symptoms of the disease, the health minister added.


26th August 2003 
German cruise passenger dies from Legionnaires' disease

BERLIN

A German has died from Legionnaires' disease contracted during a 14-day cruise near Greenland and four others are infected,  German health authorities said on Tuesday.

The man died in a clinic in the eastern German city of Magdeburg where he was being treated after the ship "Ocean Monarch" returned to Germany, the Health Ministry of the state of Saxony-Anhalt said.

Health officials in neighbouring Lower Saxony said four other passengers had also contracted the disease.

The state's Health Ministry had previously stated that only two passengers were infected.

"The cause of the infections is not yet known," a spokesman for the cruise ship operator, Hansa Kreuzfahrten GmbH, said.

The "Ocean Monarch" docked in the northern German port of Cuxhaven last Friday and all the ship's 358 passengers, including 218 Germans, had been told to visit a doctor if they noticed symptoms.

******

Legionnaires’ disease associated with a cruise liner – Germany: update

Carol Joseph (carol.joseph@hpa.org.uk), European Surveillance Scheme for travel associated legionnaires' disease project coordinator  (http://www.ewgli.org/), Health Protection Agency Communicable Disease Surveillance Centre, London, England, and Konrad Beyrer, State Health Authority of Lower Saxony, Germany.

The number of cases of legionnaires’ disease in passengers who traveled on the Ocean Monarch cruise ship from 6-23 August is still three (1). One case has been confirmed by culture of the organism and the others by urinary antigen detection.

The ship remained berthed at Harwich (England) for one week where it underwent extensive environmental investigations and implementation of  control measures. Hot and cold water samples were taken for analysis and have yielded isolates of Legionella pneumophila serogroups 1 and 2-14. These isolates as well as those of the German case will be sent to the reference laboratory at the University of Dresden for further investigation. The ship left for Dover (England) on 30 August after all the control measures had been reviewed by marine and port health staff, and staff from England and Wales’ Health Protection Agency. Further water sampling was carried out in Dover before the ship sailed on its next cruise the following day.

In Germany, passengers associated with the cruise outbreak are being followed up to assist with identification of the source of infection and to assess the full extent of associated illness. Further information about the cluster can be obtained from the State Health Authority of Lower Saxony, Germany at the following address by contacting Adolf Windorfer via email (Adolf.Windorfer@nlga.niedersachsen.de), telephone (+49 (0) 511 4505 500), or fax (+49 (0) 511 4505 502).

Reference:
  1. Joseph C. Legionnaires' disease associated with a cruise liner – Germany. Eurosurveillance Weekly 2003; 7 (35): 28/08/2003. (http://www.eurosurveillance.org/ew/2003/030828.asp)

CAMPING DES CINQ VALLEES, BRIANCON, 05 ALPES HAUTES, FRANCE 

has had 2 cases associated with this cluster, onset of most recent case was 25/08/2002. No Form B (six week report) has been received to provide information on sampling and control measures at this site, following the hotel reopening after Winter closure.


EWGLINET Surveillance scheme

Nursing home investigating respiratory illness of residents

4 September 2003

READING, Pa. - A nursing home was placed on lockdown while state health investigators look into at least one    apparent case of Legionnaires' disease.

Seven residents of Beverly Manor who were hospitalized for upper respiratory illnesses were being tested for the bacteria that cause Legionnaires' disease. Tests on three of the hospitalized residents came back negative and tests for the other four are not yet complete, Health Department spokeswoman Jessica C. Seiders said Wednesday.

However, urine samples from two other residents have tested positive for legionella bacteria - and one of those residents also had a chest X-ray showing pneumonia, suggesting the likely presence of Legionnaires' disease. Both of those patients were being treated at the nursing home, Seiders said.

Seiders said it could take about two weeks for additional tests to return from the laboratory.

"We cannot say this is an outbreak," Seiders said. "We need to do more testing and more culture   sampling."

Beverly Manor, which has 125 residents and 110 staff members, voluntarily went into a lockdown mode last Thursday, meaning it cannot accept new visitors or residents.

Health officials also were investigating whether the weekend deaths of three Beverly Manor residents were linked to any respiratory illnesses, but there was no evidence of any connection so far, Health Department spokesman Richard McGarvey said.


Legionnaires' disease cases reach 22 in Delaware

September 3rd 2003

The total number of Legionnaires' disease cases in Delaware has reached 22 so far this year, state health officials said Aug. 26.

The Delaware Department of Public Health (DPH) has been tracking a rise in the number of Legionnaires' disease cases since the beginning of this year. On average, between 1995 and 2002, the state saw only 14 cases.

Of the 22 so far, four of those infected have been Sussex County residents.

Thirteen were from New Castle County, one from Kent County and another four were out-of-state residents who were hospitalized in the state. Three remain hospitalized.

Two patients (one of whom was from Sussex County) died from the disease, while the rest were released following treatment.        

According to the DPH, the patients' ages ranged from 35 to 81 years old. They worked at a variety of occupations and so far   displayed no signs of being infected from any common sources.

All but three of the patients were known to have risk factors associated with being infected with Legionnaires' disease: smoking, chronic lung disease, compromised immune systems, kidney problems or diabetes.

The increase in Delaware's Legionnaires' disease cases, however, reflects a rise in occurrence of the disease throughout the region, health officials note.

As of Aug. 17, the states of Virginia, Maryland, Delaware, North Carolina, South Carolina, Georgia and Florida and Washington, D.C., have seen a total of 304 cases. Those same areas saw a total of 117 reported by this time last year.

State health officials said they are still cooperating with investigators from the federal Centers for Disease Control and Prevention (CDC) on the cases.

Officials with the CDC are still investigating whether the increase is real or simply an affect of better reporting mechanisms and more attention being paid to diagnosing suspected patients.


France 

8th September 2003

Poitiers on the track of the légionellose 19 cases were diagnosed since August 28. 

' is one of the strongest epidemics of these last years: a nineteenth case of légionellose was still diagnosed in Poitiers (Vienna), in weekend. According to the official statement of the prefecture diffused Saturday, it concerns an old man of an about sixty years, which does not live the perimeter defined in the city for the large majority of the preceding cases. 

"This man does not reside in the zone that we supervise but that does not want to say that he did not go there", one, yesterday afternoon indicated, with the prefecture. Not contagious. The first cases of légionellose were announced in Poitiers on August 28. On the 19 touched people (10 men and 9 women), of an age spreading out between forty and the about sixty, nine were hospitalized Saturday, six having been able to leave the CHU of Poitiers Friday. 

The légionellose, which is not contagious, resembles a pneumonia: tire, fever, cough and possibly respiratory insufficiency. Taken in time, it is looked after with antibiotics. Or badly not diagnosed, it can have serious consequences for the old people or those weakened by another affection. The Legionella bacterium, at the origin of the disease, opens out in the urban circuits of distribution of hot water and the systems of air-conditioning. In Poitiers, 17 of the 19 people reached by the légionellose live or work in a zone 4 km in diameter delimited in the east of the city. 

This geographical concentration led the medical authorities to be interested in priority in the turns aéroréfrigérantes administrative or commercial buildings of the district, where could have placed the bacterium. "the analyses of the operated taking away should be known at the beginning of week", declared yesterday the services prefectoral. Air-conditioning. 

The systems of air-conditioning of the municipal skating rink, of the social hypermarket Giant-Casino and EDF-GDF, Agricultural credit, Security Offices were stopped and disinfected these last days. These buildings remained nevertheless opened with the public, except for the skating rink. The town hall of Poitiers made analyze all the buildings with its load in the suspect sector, in particular its social housing. 

An official statement was addressed to the doctors of city to attract their vigilance on respiratory pathologies and the grippaux syndromes which they would be brought to meet in the days to come.

Update 11 September 2003

Grouped cases of légionellose identified in Poitiers

August 2003

September 11, 2003

 

Twenty one case of légionellose were declared in Ddass of Vienna since August 27 by the Hospital complex and the doctors of Poitiers .
All these patients presented signs of pneumonia and were hospitalized. The diagnosis of légionellose was confirmed biologically for 19 patients; for two patients, the diagnosis is in the course of biological confirmation. The beginning of the symptoms of the patients appeared between August 18th and 3rd September (figure 1).
57% of the cases are of male sex. The age of the cases lies between 41 and 84 years (average 60 years). To date, no death occurred and ten patients are always hospitalized.
All the cases resided or worked in
Poitiers in the districts of Beaulieu and Touffenet in a radius of 4 km.

 Source....Institut de Veille Sanitaire

See my page on FRANCE


THREE CASES OF LÉGIONELLOSE IN the HÉRAULT
 05/09/2003

 

MONTPELLIER

September 4th  2003

Three cases of légionellose were diagnosed at the hospital of Béziers, it was announced on Thursday, by the prefecture of Hérault in an official statement.

The three cases concern old people, two women of 75 and 93 years and a 77 year old man. Two live Béziers and Agde. Two are hospitalized in a satisfactory state.

Since the beginning of the summer, three people died of this infection in the department and 25 people were hospitalized. No new case was announced in Montpellier since the 15 August


State looks into pneumonia at care center

An assisted living facility in Wilsonville has had 22 residents diagnosed with pneumonia

26 September 2003

WILSONVILLE -- Clackamas County and state health officials are investigating a cluster of pneumonia cases in two health care facilities in Wilsonville.

Since July, 22 of the 300 residents of the assisted-living and independent-living care facilities at Spring Ridge at Charbonneau have been diagnosed with pneumonia, said Dr. Alan Melnick, Clackamas County health officer.

The number of cases has grown steadily, from one in July to five in August to 21 in September. Of 28 residents admitted to area hospitals, 22 were diagnosed with pneumonia. The most recent case was reported Thursday.

One resident has died, and others remain in area hospitals or have been treated and released. Three patients tested positive for   Legionnaires' disease; one has recovered and two remain hospitalized. Six others have tested negative for Legionnaires'.

Legionnaires' disease results from breathing in contaminated water in the form of a spray or mist. Symptoms include fever, chills and a cough, which may be dry or may produce sputum. Some patients also have muscle aches, headache, tiredness, loss of appetite, and, occasionally, diarrhea.

Health officials, checking to determine whether the pneumonia cluster has been caused by a bacteria or a virus, said they haven't found a common cause for the disease.

Tests of chlorine levels and water temperatures in the facilities found nothing amiss, Melnick said.

Although the number of pneumonia cases appears to be large, the illness is common among elderly people with weakened immune systems, state epidemiologist Dr. Mel Kohn said. Because the cases occurred over a three-month period and a common cause hasn't been identified, he and others aren't characterizing the number of cases as an outbreak.

Nevertheless, officials plan to keep monitoring the cases.

"It's a bit more of a concentration than we'd expect in a retirement home," Melnick said. "It's unusual, and we are concerned."

Health officials are asking all doctors who treat Spring Ridge residents to report any pneumonia cases to Clackamas County's public health division. They also are sending letters to residents reminding them to practice good hygiene, such as washing their hands and covering their mouths when sneezing, and to report fever, chills, weakness and other pneumonia-like symptoms to their doctors. The letters also advise  residents to keep up-to-date on their flu shots.

The average age of those who fell ill is 82, Melnick said, and more than half of them were women.

Officials with Spring Ridge at Charbonneau have done their own tests. On Thursday, they flushed the facilities' water system with chlorine as a preventive measure and gave residents bottled water to drink while the work was being completed.

Health officials told Spring Ridge it was unnecessary to impose a quarantine or to stop admitting residents.

Spring Ridge officials also took the extra precaution of adding chlorine to the facilities' pool and hot tub, which should be open to residents today.

State officials said they'll continue conducting tests until they determine if the cases have a common cause.

There's no reason for Spring Ridge residents to panic, Kohn said. "We're not brushing it off, but we're not ringing all the alarm bells, either.

Source The Oregonian


LE HAVRE, France

September 26 2003

 A 83 years old woman died Thursday in Le Havre of the continuations of a légionellose, however that three other cases were detected in the city, without the origin of the contamination, one being still determined learned Friday, near the departmental Management of the medical and social businesses (Ddass). 

Four people reached of légionellose were hospitalized in Le Havre during the first fortnight of September. If one died because of its brittleness, the three others left currently the hospital and are "out of danger", precise in Reuters Santé, the director of Ddass, Christine Palasset. 

No bond between these people, inhabitant of the different districts, made it possible to identify a source of contamination formally. As soon as the known cases, the municipal service of hygiene were alerted. 

This one made carry out checks installations of the turns suspectées air coolers and disinfections by measurement of precaution. "All the taking away carried out are negative", explains the director, no trace the légionnelles ones was not found in these turns, leading the investigators to seek other possible sources. Taking away thus will be carried out in the residence of the victims

**

légionellose Four cases of légionellose detected in Le Havre

 LE HAVRE, 26 September 2003 

Four people reached of légionellose were hospitalized in Le Havre during the first fortnight of September, one learned Friday near departmental Management from the medical and social businesses (Ddass) of Seine-Maritime. 

These old people from 41 to 83 years reside or work in places different from the city and no bond could be established between them, specifies Ddass which considers however that they are "grouped" cases. 

By measurement of precaution, it asked for a score of owners turns air coolers and systems of air-conditioning listed in the city and the agglomeration to check their installations. 

The results of controls should be known at at the end of September. The bacterium "Legionella", at the origin of the légionellose, a pulmonary infection which can be mortal, opens out in the distribution systems of hot water and the systems of air-conditioning.  

Quatre cas de légionellose détectés au Havre
LE HAVRE, 26 September 2003

Quatre personnes atteintes de légionellose ont été hospitalisées au Havre au cours de la première quinzaine de septembre, a-t-on appris vendredi auprès de la Direction départementale des affaires sanitaires et sociales (Ddass) de la Seine-maritime.

Ces personnes âgées de 41 à 83 ans résident ou travaillent dans des endroits différents de la ville et aucun lien n'a pu être établi entre elles, précise la Ddass qui considère toutefois qu'il s'agit de cas "groupés".

Par mesure de précaution, elle a demandé à une vingtaine de propriétaires de tours aéro-réfrigérantes et de    systèmes de climatisation recensés dans la ville et l'agglomération de vérifier leurs installations. Les résultats des contrôles devraient être connus à la fin septembre.

La bactérie "Legionella", à l'origine de la légionellose, une infection pulmonaire qui peut être mortelle, s'épanouit dans les circuits de distribution d'eau chaude et les systèmes de climatisation. 


Spain

BARCELONA

14th October of 2003

 The Catalan Generalitat investigates the possible relation between the five cases of legionellosis of Reus ( Tarragona )

The Generalitat investigates the possible relation between the five detected cases of legionella in Reus (Tarragona), according  the delegate of Health in Tarragona,  Until the moment, "it is not possible to be confirmed that one is a outbreak, although it cannot either be guaranteed that these cases are isolated". 

She explained that four of the affected ones reside in the area of the center of Reus , whereas another one of the patients lives in a district located in the same municipality. 

The affected ones have become infected in a short space of time

Technicians of the Conselleria of Health and the Council of Public Health of the City council of Reus investigate yesterday from the 18 cooling towers that there is registered in the city. Until the moment, already samples from water of several facilities located in the centre of Reus have been taken and of a ornamental source.

The delegate of Health in Tarragona did not discard the possibility that new cases of legionellosis arise. Two of the five affected remain in the Sant Hospital Joan de Reus, whereas the rest already has received the medical discharge.

The first one affected, a man of 35 years, initiated symptoms 9 of September the past, entered in the sanitary center day 12 of the same month and at the moment he is outside the hospital. The second case, a woman of 36 years, initiated the first symptoms of legionellosis day 1 of October and was hospitalized 9 of this month the past.

The third case is a man of 27 years who began to present/display the first signs of legionellosis 2 of October the past, later entered in the hospitable centre two days and later it received the medical discharge.

The affected others are two men of 53 and 70 years, respectively. First it initiated symptoms 2nd October and was hospitalized the following day and at the moment one is outside the health centre. The second was the 4th October and admitted to the hospital on the 10th October  


Hereford England

7 November 2003

Hunt Continues for Source of Killer Disease

Public health officials were tonight trying to find the source of an outbreak of legionnaires’ disease which has claimed the lives of two pensioners and infected three other people.

Herefordshire Primary Care Trust said the elderly man and woman and two middle-aged women contracted the disease over the past five weeks.

A second man, also middle-aged, was confirmed as having the water-borne disease today and is receiving hospital treatment, along with the two female patients.

Dr Gary Reynolds, consultant in communicable disease control, said all five victims lived in and around Hereford, where officials are focusing their search for the outbreak’s source.

They will be examining public air conditioning systems and water cooling towers, which could be harbouring the legionella bug.

According to the trust, Herefordshire’s average share of Legionnaires’ should be around one case every two years, given that there are around 200 reported cases in England and Wales every year.

Dr Reynolds said: “The numbers are clearly well up on what we would normally expect and this is part of the reason we decided to go public with this.

“However, we do not wish to cause alarm or anxiety. Many people who experience the flu-like symptoms are probably experiencing nothing more than that.”

Doctors around the county have been alerted to the outbreak and a temporary hotline on 01785 231011 has been set up by NHS Direct to deal with questions from the public.
 
Update 8th November 2003
Search for Legionnaires' source

Health officials have confirmed two more cases of Legionnaires' disease in a fatal outbreak in Hereford which has killed two people and left two more in a critical condition in hospital.

A man and woman aged in their 70s have died and four middle-aged people are being treated in Hereford County Hospital for the disease.

Two of the hospital patients are in a critical condition in the intensive care unit, the Health Promotion Agency said on Saturday.

All victims were linked to Hereford city centre, where investigations were focused on Saturday.

Public health officials are investigating the cause of the outbreak.

Environmental health officers visited shops and businesses to take water samples from air conditioning systems to check for the bacteria which causes the disease.

Professor Rod Griffiths, director of public health for the West Midlands region, said anyone who was exhibiting symptoms of the disease should contact their GP.


Source Media
 
 
12 November 2003
Ten Legionnaires' cases confirmed

Health officials have confirmed two more people have contracted Legionnaires' disease in the outbreak in Hereford, bringing the total number of cases to ten.

A man in his 50s and a woman in her 40s are described as "stable".

Two people in their 70s, from Hereford, have died during the outbreak.

Unusually, health officials have said that they may never know the source of the disease, although environmental health officers are continuing to test buildings around Hereford.

Dr Mike Deakin, the county's director of public health, said further cases of the illness linked to the outbreak were not unexpected.

Legionnaires' inquiry at Bulmers

Investigations into the outbreak of Legionnaires' disease in Hereford are concentrating on the city's best-known employer, the cider maker Bulmers.

Tests carried out on a cooling tower at the firm's Plough Lane site have come back suggesting the presence of the Legionella bug.

The results, which have still to be confirmed, came on the day the number of people found to have contracted the illness in the city rose to 12, including two elderly people who died.

Bulmers said there was no direct evidence linking the outbreak to the company and said there was no risk to the public from drinking its products.

Investigations continue

The tests were carried out at the cider firm by environmental health officers at Herefordshire Council, who have identified all premises with systems that could potentially disperse the bacteria.

Update 15 November 2003

Three more have Legionnaires'  Disease

Three more victims of a Legionnaires’ disease outbreak were recovering in hospital today as the number of those struck down by the disease rose to 15.

The people diagnosed are two men, in their 60s and 70s, and a woman in her 90s, Herefordshire Primary Care Trust said.

The infection in Hereford has claimed the life of one man in his 70s and struck down another seven men and four women who are all either middle-aged or elderly.

The trust said the latest developments were consistent with the incubation period of the infection, which can be between two days and three weeks.

“It also reassures us that the heightened state of awareness among local GPs and hospital staff is doubtless helping to ensure that cases are diagnosed quickly,” the trust added in a statement.


Public health officials have been trying to trace the source of the water-borne bug in the city since they revealed the outbreak on November 7.

Investigations are focusing on Hereford-based cider manufacturer Bulmers after the legionella bug was found in a sample taken by health officials from one of its evaporation towers on the same day.

Bulmers has closed down the tower while it is sterilised, but production is continuing as normal.

Firm spokesman George Thomas said none of the victims, who are either middle-aged or elderly, were employees.

Most of the victims are recovering at Hereford General Hospital.

One man has been discharged and another victim from Wales, who is thought to have been infected during two visits to Hereford, is recovering at an undisclosed hospital near his home.
 
Further Information at
 
 

http://www.hpa.org.uk/cdr/PDFfiles/2003/cdr4603.pdf

Update 16 November 2003

Seven new cases of Legionnaires' disease confirmed

Seven new cases of Legionnaires' disease have been confirmed in Herefordshire bringing the total of cases to 22.

The number of new cases was the biggest in one day since Herefordshire Primary Care Trust revealed more than a week ago that the disease - which has killed one man - had struck.

No details about the patients or their conditions were being released because relatives were still being informed, the trust said.

Mike Deakin, the county's director of public health, said the latest cases were "not unexpected". He said: The procedures that have been put in place since the start of the outbreak mean that GPs are on increased lookout for Legionnaires' symptoms."

"We are also continuing our intensive case finding exercise and this is helping to identify some people who have a milder form of the disease which in normal circumstances may have passed with no ill effects. We would emphasise again that Legionnaires' disease cannot be transmitted person to person, and that it is safe to visit Hereford."

Dr Brian McCloskey, of the Health Protection Agency, said the new patients were being diagnosed within the normal incubation period of Legionnaires', which is between two days and several weeks.

Mr McCloskey said: "This means that these new cases may have contracted the disease from a local source but we are confident this has now been eradicated as part of extensive cleaning and disinfecting."

Although the source of the outbreak has not been confirmed, health officials have focused their search on Hereford-based cider manufacturer H P Bulmer after the legionella bug was found in a sample taken by health officials from one of its evaporation towers on November 7 - the same day the outbreak was publicly announced.

The firm has closed down the tower while it is sterilised, but production is continuing as normal.

None of the original 15 victims, including the man in his 70s who died, were or are employees.

Update 20th November 2003

New legionella case confirmed

A new case of Legionnaires' disease has been confirmed in Hereford, bringing the total to 24.

A man aged in his 50s is said to be in a stable condition.

Three patients, who contracted the disease, were discharged from hospital on Wednesday bringing the total number of people allowed to return home to eight.

On Monday tests confirmed that legionella bacteria was present at the Bulmers cider plant in Hereford, less than a week ago.

The bacteria was identified in a cooling tower at the company's Plough Lane factory.

Traders' concerns

The Health Protection Agency, said that despite the discovery it could not be certain the HP Bulmer site was responsible for the outbreak.

Herefordshire Council has tried to reassure vistors to the city about safety after traders voiced concerns that shoppers were staying away.

Andy Tector, the authority's head of Environmental Health and Trading Standards, said: "We can understand people's concerns - Legionella is a serious disease.

Update 2 December 2003

Woman Dies after Legionnaires' Outbreak

A second person has died after an outbreak of Legionnaires’ disease centred on a cider plant cooling tower, health officials said tonight.

Herefordshire Primary Care Trust said a woman in her 50s, who had other medical problems, had died after spending a month in hospital.

The disease, which has previously killed a man in his 70s, has affected 26 other people in the Hereford area.

A spokesman for the Herefordshire Primary Care Trust said: “Sadly the second person originally diagnosed with Legionnaires’ disease died yesterday evening.”

Two new patients were diagnosed as having Legionnaires’ yesterday, although both had “a history” consistent with them acquiring the disease before the closure of a cooling tower at a Bulmers site in Hereford, which has been identified as the source of disease.
 
Update 2 December 2003
 
A second person has died from Legionnaires' Disease in Hereford, a month after contracting the disease which has infected 28 people.

The woman, who was in her 50s, was the second person originally diagnosed with Legionnaires' during the outbreak.

Health chiefs said the woman, who had other medical problems, died in hospital on Monday evening.

Two new cases of the disease in Hereford were confirmed on Monday.

But health and environmental teams said they were sure the source of the disease had now been traced and the outbreak was over.

 


Alcoy. Spain

8th November 2003

A failure in the system of chlorinatión of an industry causes a new outbreak of legionella in Alcoy

The chief of a main directorate of Public Health, Manuel Escolano, today confirmed the existence of a outbreak of pneumonía by legionella, that at the moment affects four people, produced by a failure in the system of chlorination of an industry. 

In an encounter with mass media, Escolano explained that throughout the morning the atypical affection by pneumonía in a fifth patient has discarded, to the delay of definitive confirmation of the analyses. 

The four affected by this new outbreak evolve favourably and they are entered in the Virgin Local Hospital of the Irises. First of these patients it entered in hospitable centre the past 3 of November and was confirmed Thursday by Health, along with another case of Ibi. Escolano clarified that the contamination with presence of the bacterium has been declared after the corresponding analysis epidemiologist, and did not discard that more cases take place so during the week "that will communicate precise, and as has come doing until now". It explained that the centre of the outbreak "is located in an industry that repels on the city of Alcoy", although did not specify its exact situation. 

"This industry - Escolano- said fulfilled the protocol and their people in charge have always given collaboration samples", but before the evidences of the presence of the alive bacterium, "something must have failed in the mechanization of the chlorinatión system". 

This systematized chlorine contribution takes place of periodic and automatic form in the companies with facilities susceptible to transmit the bacterium and is reviewed by the technicians of continuous way. The chief of a main directorate of Public Health affirmed that "we cannot speak of satisfaction, but knows that the way undertaken by the Conselleria of Health and the City council of Alcoy is the correct one and worked so that in a future we do not have to speak of more outbreaks". 

He also specified that "the special orographic situation of the city conditions that a simple emanation of the bacterium causes a outbreak in Alcoy, whereas in other places only there are sporadic cases". On the other hand, the mayor of the municipality, Jorge Sedano, assured that "the industrialists very are sensitized" and added that "Alcoy is one of the cities of the world with more control on the bacterium".

Update

They confirm a outbreak of legionela in Alcoy with four affected

 ALICANTE/VALENCIA.

 The Conselleria de Sanidad informed yesterday into the appearance of five new detected in between the 26 of October to the 1 of November and located cases of legionella in several areas of health of the Valencian Community, as well as of other four affected in Alcoy that, according to the Virgin Hospital of the Irises of this city, keeps space and temporary relation to each other. 

In an official notice, Health explained that these four patients, entered in the mentioned hospitable centre, are stable and evolve favourably. One is two men of 72 and 75 years and two women of 73 and 81. The Conselleria also indicated that at the moment the facilities of risk in the zone of influence of these cases are studying. 

Of the other five cases, three correspond to the province of Alicante and sehan registered in the municipalities of San Vicente of the Raspeig and Novelda, to himself like in the Area of Health number 20, corresponding to the region of the alicantina Low Fertile valley. 

These cases elevate to fourteen the number of people affected by legionela in the two last weeks, since before they confirmed one in Alcoy, another one in Petrer, two in Elda and fifth in Ibi. In syntony with the conducted declarations Thursday in Alicante by conseller Boulevard, the spokesman of popular Health in Valencian Cortes, Merciful Antonio, criticized to the PSPV to try to make profitable legionella electoral. "a responsible opposition would not use the cases of legionella of electoral form like vienesiendo habitual in the PSPV", said. For Merciful, "is stranger which existing as other independent communities with cases exist, he is solely in the Valencian Community where the opposition uses of electioneering form the appearance of new infections and at any moment tries to confuse to the opinion publishes". 

It indicated that the 248 cases appeared in 2002 in the Valencian Community "are very below the registered ones in other communities, like for example Catalonia, with 429 cases in the same year, or Murcia, where in 2001 the greater communitarian bud with 689 confirmed cases was registered. The peculiar thing is that in these autonomies it has not been heard to the opposition treating create the social alarm that the Valencian Socialists try in our Community ". 
Finally, the affected ones by the different outbreqks registered from legionella in the alicantina region of L´Alcoiá-El Comtat from year 1998 do not discard to request responsibilities to the Administration and to the companies in which the bacterium by "a presuntodelito against the environment with result of injuries" detected itself, the lawyer of the harmed ones said after studying the judicial documentation of the case

Update 20th  November 2003

Legionella. - Health informs into the entrance of two new cases of pneumonía by legionella in Alcoi ( Alicante  

The facilities sealed and disinfected for 10 days have been returning to give positive

ALCOI ( ALICANTE ), 20 November 2003

 The Conselleria of Health informed today into the entrance of two new ones affected, a man and a woman, by the last tbreak of legionella in the Virgin Hospital of the Irises of Alcoi (Alicante), according to today needed sources the Valencian Generalitat.

Both new affected of pneumonía by legionella they are a man of 72 years and one woman 67 years of age. reason why the total number of patients entered since the last outbreak of legionella in Alcoi began, tenth from 1999, rises to a total of 16 people, of who to day of today they remain entered eight people.

Update 29 November 2003

The affected ones in Alcoy by the last outbreak of Legionella rise to 25

  ALCOY

The Conselleria of Health informed yesterday into the detection of two new cases of pneumonia by legionella in the alicantino municipality of Alcoy that agree in the space and temporary distribution with registered in the last the days in this locality and that, therefore, registers in the outbreak detected in the city at the beginning of November.

This way, already they are 25 people those that have been affected by this last outbreak from Legionella, ninth of described in the locality in the last the five years.

In the case of both last affected, one is a man and of a woman of 57 years, that are entered in the Virgin Hospital of the Irises and the situation of both is stable.

Also, the hospitable centre discharged yesterday the medical from the hospital to a person, according to added sources of the Conselleria of Health. T
hursday other two people also received the medical discharge. Of the affected ones by this outbreak, other two did not surpass the disease.

 C. Valenciana.-Rambla it says that if the origin of the last outbreak of legionella is confirmed the incubation would be finishing

 VALENCIA, 2 December 2003

 Valencian conseller of Health, Vicente Boulevard, assured today that if the origin of the last outbreak of pneumonía is confirmed by legionella registered in Alcoi (Alicante), the period of incubation of the disease would be in "the last days", to the time that assured that 17 registered facilities of risk exist and pointed the possibility that in the next days it appears some case more.

Boulevard, that made these declarations to the journalists in the corridors of Cortes, based on 28  people affected by the outbreak and declared that in the day of today "we do not have any pending person to be made the opportune analysis". 

It stressed that if is confirmed "our forecast in relation to which origin of the outbreak was the center we are speaking already of the last days of a period of incubation". However, it recognized that although the period of incubation "can occur by finalized", are people who suffer the disease but "days in going to the health centre take" because the symptoms usually begin with a fever that do not associate with legionella, reason why did not discard the appearance of new cases.

 "It is possible that still we could have some case, if more it is confirmed indeed that the centre of the outbreak is the one that we have raised and the one that we have defended, in relation to that already is closed like installation of risk" from the past day 14 of November, indicated. On the conclusion of the period of incubation, it stressed that its calculation "is not an exact science", although needed that normally "we are speaking of 15 days of period of incubation".


Two Cases of Illness of the Legionary in Coimbra Portugal

Tuesday, 18 of November of 2003

The Hospital of the Covões, in Coimbra , has two men interned in the services of intensive cares that had contracted the illness of the legionary. "the two sick people are in serious state, citizens the ventilation mechanics, keeping clinical stability and with reserved prognostic", she gives to account an official notice emitted yesterday for concelho of administration of that hospital unit.

The PUBLIC still had knowledge of the existence of one third case, confirmed for António Vieira, clinical director of the Hospital of the Covões. "He had of fact one third situation, that evolved favorably", it recognized the responsible one, affirming to be about a recent case, that "ran well" and therefore the sick person already had high.

One of the patients now interned in the intensive cares of the Covões, Carlos Abrantes, of 46 years, works in the Regional Center of Social Security of Coimbra and in the end of October it was some days in Spain, where it spendt the night in hotel. The other sick person, António Blacksmith, of 47 years, works in an agency of the Land Credit Portuguese, next to the installations of the Social Security. Its sister works in the Social Security and António Blacksmith was there to visit it in the previous week to the internment.

Despite the presence in the building of the Social Security joining the two occurrences, he will be premature to associate them: "the trend to bind the two cases seems me completely been improper for already", evaluates António Veríssimo, specialist in microbiology of the University of Coimbra , heard for the PUBLIC. The official notice of the Hospital of the Covões also points in same the sensible one: "Of the point of view epidemiologist if it cannot affirm that it has relation between the two cases, even so both live and work in Coimbra , in conditional air environment."

The order of António Veríssimo, was off friday the conditional air system of the building of the Social Security, what it compelled to the closing of digs, where if finds the parking and that it needs constant ventilation. The closing of digs remained until the a hour of lunch of yesterday, height where it finished the inspecção efectuada for Veríssimo, that was folloied by the commission agent of health of Coimbra, Sara Birth, and for a representative of the regional center of public health, Isabel Lança.

"He is premature to discard any hypothesis or to take off any type of conclusions in this height", analysed António Veríssimo after the visit. "me it does not seem that the workers [ of the Social Security ] run any species of danger", safeguards. Also the professor of the department of Zoology of the University of Coimbra collected water samples in some points of the building of the Social Security, whose resulted they will have to be known this week.

Studious of he has long date of the responsible bacterium for the illness of the legionary, "legionella", António Veríssimo explains that "he is rare, in Portugal , to have two cases at the same time", excepting however that the cases of Coimbra "can be a pure coincidence".

The situation has provoked distrust in the employees of the regional center of Social Security, but the director of this institution, Oliveira Alves, does not see reason for alarm: "our conditional air system is completely stanches; it are of the system does not have water. We were tranquilizados relatively to our situation and therefore the work elapses normally ", assured. Oliveira Alves remembers that it is necessary to perceive if the illness is or not on to the recent stay of the employee in Spain . An opinion also partilhada by the regional commission agent of health of the center, Jose Tereso.

To that he was possible to select, in the agency of the Portuguese Land Credit where it works the interned sick person tests had become in order to detect the presence of "legionella", and the result will have been negative. Still a cleanness to the behaviors was efectuada where it passes water.  

Update
19 November 2003

Third Case of Illness of the Legionary in Coimbra

One third case of the illness of the legionary was detected in the Hospital of the Covões, in Coimbra , where if two patients reached for the infection find with "private prognostic" others, the regional commission agent of public health of the Center said yesterday, Jose Tereso.

Despite the stationary clinical state, the two men - a bank clerk of 42 years and an employee of the Social Security of Coimbra , of 46 years - remain on the machines of artificial breath, added Jose Tereso.

The commission agent had in the monday knowledge of the existence of one third person infectada with the bacterium, interned has some days in the same hospital. One is about a man of 65 years, proceeding from concelho of Alvaiázere, district of Leiria, whose situation is to evolve favorably and must have high in briefing, advances Jose Tereso, lamenting the delayed notification of the cases.  


The légionellose progresses in Pas-de-Calais

 

LEMONDE.FRANCE  09.12.03 

 

Research is undertaken systematically in the communes touched to try to discover the source of the infection.

The area of Lens, in Pas-de-Calais, has been victim for a few days of the appearance of several cases of légionellose, a pulmonary infection engraves which one is unaware of the source and who already killed two people and touched ten others.

On the whole, twelve people living in a raduis of less than ten kilometers around Lens were infected since the end November by the légionella, a bacterium of the hydrous medium, supported by a temperature varying from 25 to 50 degrees.  

Two people succumbed to this affection, whose authorities are unaware of still the origin: a 79 year old man domiciled in Harnes, close to Lens, is deceased on November 30, and another man, 53 years old, domiciled in Lens, died in the night of Wednesday to Thursday.

The last victim listed by the departmental direction of the medical and social businesses (Ddass) is a 73 year old woman of Fouquières-lès-Lens, which was allowed Saturday evening with the service of pneumology of the hospital complex of Lens. The nine others are either neat at the hospital, or at them, the légionellose being able "to be very well treated by antibiotics" and not being able to be transmitted between human, Ddass specified.

This affection, baptized "disease of the légionary" since it killed, in 1976, about thirty ex-serviceman American assembled in congress in a hotel of Philadelphia, is transmitted by the micro-organisms suspended in the air, generally starting from the systems distribution of domestic hot water (showers) and of air-conditioning (turns air coolers). The time of incubation of this disease is two to ten days.

MEASUREMENTS TO LIMIT THE RISKS OF CONTAMINATION

Research is undertaken systematically in the communes concerned, in the residence of the patients by Ddass, but also by the regional direction of industry, research and the environment (Drire) in all the establishments receiving of the public or concerning regulation ICPE (installations classified for the environmental protection).

"We have until now inspected and taken readings in approximately about fifteen sites. In the petrochemical factory Noroxo with Harnes, a pre-result made it possible to detect the presence of legionella, without however enabling us to identify this factory like the source of the epidemic ", explained Guillaume Panié, chief of the service environment in Drire.

In this factory, which employs 250 people, subcontractors included/understood, and of which none was affected, the production was stopped at the end of November and the cleaned circuits coolant. "We carry out everywhere where the risk exists a ' shock chimique', i.e. a cleaning containing chlorine which kills the bacteria, after having carried out sampling for analyses", specified Mr. Panié.

For the prefecture of Pas-de-Calais, these preventive measures should make it possible to limit the risks of contamination and to perhaps even stop the epidemic "without one knowing finally which was its starting hearth". The prefect of Pas-de-Calais, Cyrille Schott, receives Tuesday the whole of the elected officials of the touched communes.



Update France

Légionellose: 17 cases in the area of Lens

Five new cases of légionellose were announced in Pas-de-Calais, where two people already died of the continuations of the contamination.

Seventeen cases of légionellose from now on are listed in the area of Lens (Pas-de-Calais), announced the prefecture Monday in an official statement. Five new cases were announced in the course of the day. They are four men and of a woman, four septuagénaires and a 52 year old man, all domiciled in the suburbs is of Lens.

This epidemic, whose medical authorities always sought the origin Monday, already made two died: a 79 year old man domiciled in Harnes, is deceased on November 30, and another, 53 years old, domiciled to Lens, which "returned from holidays abroad", succumbed in the night of Wednesday to Thursday. Four patients in reanimation in the hospital complex of Lens, eight are hospitalized in the services of pneumology of establishments from the area, and three in their residence.

Controls continue

"the DRIRE (regional Direction of industry, research and the environment, note) continues to control all the establishments concerned with regulation ICPE (installations classified for the environmental protection) located in the communes of residence of the people reached and in the neighbouring communes", the prefecture indicated


Grouped cases of légionellose in the district of Lens

Department of Pas-de-Calais (November - December 2003)

The situation at December 12, 2003

  Twenty cases of légionellose were announced to Ddass of Pas-de-Calais since November 28, 2003 .
All the patients were hospitalized. 75 % of them are of male sex. Their age lies between 44 and 86 years (average 71 years). The date of beginning of the clinical signs is between November 10 and
December 5, 2003 . Two people died, 14 patients are still hospitalized and 4 left.
The diagnosis of légionellose is confirmed for all the cases by the presence of soluble antigen urinary. Bronchial taking away for search for Legionella were carried out among seven patients and are being analysed in the National Center of Reference (CNR) of Legionella.

The epidemiologic investigation is carried out by the Cell Inter Regional of Northern Epidemiology, and the DDASS, with the support of InVS. All the patients were questioned to document their practices of life and their displacements in the 10 days preceding which has occurred by the disease, the maximum duration of incubation of the légionellose being 10 days. According to information collected, the majority of the patients had attended a zone in the east of the town of Lens : Harnes and its avoisinnantes communes. This information suggests the assumption of a local common source of contamination, of type turn aéroréfrigérante (TAR).

The investigation environementale is led by the DRIRE and the DDASS. Measures were taken right now by the DRIRE and the prefecture near the installations at the risk (disinfection of the systems of cooling). A factory was suspectée in Harnes, following taking away having revealed high rates of Legionella, and was closed on December 3 to allow the disinfection of the system of cooling of its TAR. The other installations were the subject of inspection, and the whole of sampling were transmitted to CNR for analysis. In addition, the DDASS, in collaboration with the town halls concerned, counts the installations not recorded with the DRIRE and being able to be suspect.

If the suspectée factory, closed the 3/12, is at the origin of the contamination, other cases can still occur until December 13, taking into account the duration of incubation.

The insulation of clinical stocks and their comparison with environmental stocks will make it possible to determine if one of the identified sources at the risk is at the origin of the contamination.


Update 20 December 2003

Grouped cases of légionellose in the district of Lens

Department of Pas-de-Calais (November-December 2003)

The situation at December 19, 2003

 

Thirty cases of légionellose were announced to Ddass of Pas-de-Calais since November 28, 2003 .
All the patients were hospitalized. 80% of them are of male sex. The average age is 69 years. The date of beginning of the clinical signs is between November 10 and
December 15, 2003 . Three people died.
The diagnosis of légionellose is confirmed for all the cases by the presence of soluble antigen urinary. A stock was insulated for 3 patients and was transmitted to the
National Center of Reference (CNR) of Legionella.

The epidemiologic investigation is carried out by the Cell Inter Regional of Northern Epidemiology, and the DDASS, with the support of InVS. Vingt-sept patients on 30 were questioned to date to document their practices of life and their displacements in the 10 days preceding which has occurred by the disease, the maximum duration of incubation of the légionellose being generally 10 days. According to information collected, the majority of the patients resided or had attended a zone in the east of the town of Lens : Harnes and its avoisinnantes communes. This information suggests the assumption of a local common source of contamination, of type turn aéroréfrigérante (TAR).

The environmental investigation is led by the DRIRE and the DDASS and measurements of control were taken right now near the identified installations at the risk (disinfection of the systems of cooling). A factory was suspectée in Harnes, following taking away having revealed high rates of Legionella, and was closed on December 3 to allow the disinfection of the system of cooling of its TAR. The taking away realized in the installations at the risk were transmitted to CNR for analysis. In addition, the DDASS, in collaboration with the town halls concerned, listed the installations not recorded with the DRIRE and being able to be suspect, and set up measurements of control.

The insulation of clinical stocks and their comparison with environmental stocks will make it possible to determine if one of the identified sources at the risk is at the origin of the contamination.

27 December 2003

Four new cases of légionellose were announced Saturday by the prefecture of Pas-de-Calais, increasing the number of patients reached of this serious pulmonary infection to 42, including four death, since the end November in the department.
The four new people touched by the légionellose are two domiciled men with Hénin-Beaumont old of 88 and 72 years, man a 83 year old with Montigny-in-Gohelle, and a 81 year old woman in Fouquières-lès-Lens.
These patients expressed the first symptoms of the affection (of which the usual time of incubation varies from 2 to 10 days) between the 20 and on December 23. 

They were hospitalized in the hospital complex of Lens and the polyclinic of Hénin-Beaumont.
"Currently, on these 42 grouped cases of légionellose, one deplores the death of four patients, 16 could regain their residence and 22 remain always hospitalized", according to the last assessment of the prefecture.
The origin of the bacterium is known to date only for two cases, at which the stock of the bacterium are common with that found in the petrochemical factory Noroxo de Harnes (Pas-de-Calais), whose coolant circuits were disinfected on several occasions.

December 30, 2003
Fifth death due to the légionellose in Pas-de-Calais

 
ARRAS 

A fifth person died of the légionellose in Pas-de-Calais and six new cases were announced on Monday by the prefecture, which changes to 48 the number of patients reached of this serious pulmonary infection since the end of November in the department.
The new victim is a 69 year old woman, deceased in Hénin-Beaumont, specified the prefect Cyrille Schott during a press conference. Mr. Schott qualified this epidemic of "situation exceptional, serious, which worries us".
The authorities evoke from now on the existence of a second possible source of contamination. Until now, only the petrochemical factory Noroxo de Harnes (Pas-de-Calais) was formally identified.
According to Dr. Danièle Iles, interregional cell of epidemiology, "the agreement in time and space make that we think that a great number of cases, from 20 to 25 currently, are explained by the Noroxo source".
Two of the victims presented a stock of common bacterium with that found in the cooling tower of the Noroxo factory, stopped since December 3.
However, eight cases declared between the 20 and on December 25 "seem not easily attachable with this source" (note: Noroxo), according to Dr. Iles, "because the last cases appeared 22 days after the stop of the contaminant source" and the time of incubation of the légionellose is only one ten days.
According to the prefecture, two different waves would have touched the field lensois. The first wave, that whose Noroxo factory seems in the beginning, was localised around Harnes, the second would touch the sector of Hénin-Beaumont, where four of the new cases were identified.
A prefectoral decree was taken to oblige the companies to practise weekly analyses. Moreover, the results of the analyses in progress will be communicated in the next days.
In all, 563 establishments and companies were inspected on ten communes, and of the taking away carried out for some.

Among the 48 cases declared since the end of November, one counts 16 women and 32 men. 21 people are still hospitalized and 22 are cured.

30 December 2003

The légionellose makes to one 6th victim in Pas-de-Calais

The epidemic of légionellose made a sixth victim in Pas-de-Calais, announced Tuesday the prefecture of Pas-de-Calais, which decided to widen medical research from 18 to 22 communes of the area of Lens.

A 92 year old man is deceased Monday with Harnes, the city where the petrochemical factory Noroxo is, in the center of many interrogations.

Moreover, another case of this serious pulmonary infection was detected at a 75 year old woman, domiciled with Annay-under-Lens.

On the whole, fifty people were or are still touched by the légionellose in the sector of Lens. Six patients succumbed, 24 could regain their residence and 20 are always hospitalized.

Because of the unusual and unexplained persistence of this epidemic, the Management of the prevention of pollution and risks and the Directorate-General of health (DGS) announced Tuesday evening the appointment of national experts who will give "a technical support" for the prefect of Pas-de-Calais and his services.

They will be with work as of Wednesday December 31, specifies the official statement.

Update 31 December  2003

Fifty three cases of légionellose were announced to Ddass of Pas-de-Calais since November 28, 2003 .
Thirty five (66 %) are of male sex. The average age is 70 years. For 52 of the indicated cases, the date of beginning of the clinical signs is between November 10 and
December 27, 2003 . To date, 22 patients are hospitalized, 25 left and six people died.
The diagnosis of légionellose is confirmed for 51 cases by the presence from soluble antigen urinary and two by seroconversion. To date, among the taking away received in the
National Center of Reference Legionella (CNR), 7 stocks were insulated. Two of these stocks isolated from the first patients present the same profile genomic. The 5 other clinical stocks are being analysed genomic. Ten other taking away are currently in culture and will be analyzed as soon as stocks are insulated.

The epidemiologic investigation is carried out by the Cell Inter Regional of Northern Epidemiology and the DDASS of Pas-de-Calais, with the support of InVS. The interrogations near the cases or their close relations are carried out in order to document their practices of life and their displacements in the 10 days preceding which has occurred by the disease, the maximum duration of incubation of the légionellose being generally 10 days. According to information collected, the majority of the patients resident or attended a zone in the east of the town of Lens: Harnes and neighbouring communes. The information received from the last cases identifies a geographical area located more at the east.

The environmental investigation is led by the DRIRE and the DDASS and measurements of control were taken concerning installations at the risk (disinfection of the systems of cooling). These investigations first of all related to 18 communes where the first cases reside. They were extended since the 29/12/03 to 4 other communes located more at the east.
Taking away revealing of the high rates of Legionella made it possible to identify a company located at Harnes (Noroxo) like source of contamination. Indeed, these environmental stocks are identical to those of 2 patients. The Noroxo company was closed between the 3 and on December 20 for disinfection.
The other investiguées installations were the subject of taking away which were transmitted for analysis to CNR and of systematic disinfections were carried out.
To date, of the taking away for search for Legionella were applied to the residences of 33 patients. A positive taking away was obtained at only one patient, which indicates that this source of contamination in the residence of the patients cannot be retained like source of the epidemic.

Taking into account the evolution of the epidemic curve and data available at this stage, it is possible that another source of contamination not identified to date can be the origin of which has occurred of the cases in the second fortnight of December or that the contamination by the identified source (NOROXO) persists.

Analyses of samples are still in hand at CNR. The comparison of the human stocks and the environmental stocks, will be able to inform about the existence of one or more sources of contamination.

Because of this important and unusual episode of légionellose, the Ministry for health and the ministry for ecology and durable development, indicated a mission of experts specialized in epidemiology, in the fight against the proliferation of légionelles in the turns of cooling and the transport of the bacteria in the environment in order to give a technical support for the prefect of Pas-de-Calais and with its services.

Though it is, a reinforced monitoring continues because it is important to identify and treat precociously the new patients in order to prevent the serious risk of form and death.

Source http://www.invs.sante.fr/

 

Wednesday December 31

Mobilization of the experts on the légionellose

LENS 

 Mobilization of the experts on légionellose

Five specialists in this affection which prevails since the beginning of December in the area lens were named this week  by the authorities, took stock with the local authorities with the prefecture of Arras.

They in addition held a conference call with the people having already worked on the file with the levels local and national, one learned near the Directorate-General from Health.

This one as well as the Management of the prevention of pollution and the risks indeed mobilized these five scientists in order to give a technical support for the prefect of Pas-de-Calais, Cyrille Schott.

Among the five mobilized specialists two experts of the national Institute of medical day before appear (InVS): a specialist in epidemiology in environmental health and a epidemiologist of the infectious diseases.

The authorities also called upon a specialist in environmental health having worked on the microbiological risks related on légionnelles and the amoebas, with a specialist in dispersion in the aerosols and finally with an expert in management of the turns, water treatment and methods of sampling of water.

The letter of mission of these five experts provides that they come into contact with Mr. Schott "who (their) will indicate the tracks which appear priority to him". The five specialists will have to draw up a report/ratio at the end of their mission of which the duration is not specified.

The disease is caused by an alive bacillus in the tepid water which proliferates in particular in the sanitary facilities (showers, taps in particular), the installations of air-conditioning and the coolers (turns aéroréfrigérantes, circuits coolant industrial), the basins and fountains, the thermal springs and the producing medical equipment of aerosols. The infection occurs by inhaling contaminated water an aerosol, the treatment resting on antibiotics.

Cinquante-trois case were listed since the beginning December, six people having succumbed whereas 23 patients remained hospitalized with the day before of New Year's day.

The investigations, which related to several hundreds of installations in 18 communes, made it possible to identify a source of contamination, a tower aéroréfrigérante of the petrochemical factory Noroxo (group Exxon Mobil) with Harnes. This factory was stopped to carry out a complete cleaning of the system of refrigeration between the 3 and December 20.

Cases continue nevertheless to appear. And even if the duration of incubation of the légionellose can sometimes exceed ten days, the existence of another source of contamination is probable. The task of the experts is to discover it. For the prefect Cyrille Schott, "it is clear that today it is necessary that we concentrate our efforts on this zone of Hénin-Baumont where these cases appear". AP


A seventh death from légionellose 
3 January  2003

LILLE  

The epidemic of légionellose which prevails in Pas-de-Calais since the end November caused a seventh death Friday evening and a 55 case was detected by the private clinic of Hénin-Beaumont, announced Saturday by the prefecture.

The person deceased is a 85 year old woman. The prefecture did not give details in the immediate future on this death, and one is unaware of when the victim was contaminated.

The new case is a 91 year old man, inhabitant of Harnes at which the first symptoms of the disease had been diagnosed on December 31.

Since last 28 November, the légionellose touched 55 people in two successive waves and a source was identified. The authorities wonder about the possible existence of one second source.

The first wave of contaminations related to the area of Lens and the west of this city. A second wave of contaminations started since Christmas in the sector of Hénin-Beaumont.

In addition to the seven died people, 18 are always hospitalized including four in an intensive care unit, and the thirty others regained their residence.

The prefecture of Pas-de-Calais announced Friday the closing of the factory Noroxo d' Harnes, at the origin of the first wave of the epidemic, and which had already been stopped from the 3 to last 20 December for a complete cleaning of its coolant circuit.

Results of analysis of the national Centre of reference of the légionellose, based in Lyon, had made it possible to affirm that the bacterium which had struck seven people at the time of the first wave of the epidemic was the same one as that found in atower air cooler of the petrochemical factory Noroxo d' Harnes.

The first closing of the factory had been decided at this time. However, for three other cases of the second wave, detected more recently, the first provisional results seemed to also show that the bacterium was the same one as that identified at Noroxo.

New expertises are in hand but pursuant to the "principle of precaution", the authorities required of the persons in charge for the petrochemical factory to again stop their installations for a cleaning and a complete decontamination


 
 
 

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