legionnaires disease

The Generalitat confirms as origin of the outbreak of legionella of l'Hospitalet in the cooling tower

The cooling tower of an ice factory of l'Hospitalet of Llobregat, closed from the 5 of December, has been confirmed as the origin of the outbreak of legionella that has affected nine people, according to the Conselleria of Health and the City council of l'Hospitalet.

After the obtaining of the analytical ones that has allowed to resist the isolated stocks in the patients and legionella, the Generalitat and the Consistorio they have transacted the file to the judicial authority in case it considers "opportune" to impel legal measures.

They closed cooling tower belongs to the ice factory ' the Cristalinó, located in the district of Santa Eulàlia.

The outbreak of legionella has affected nine people, one of who the past passed away 6 of January in the Hospital of Bellvitge.

Six of the affected ones already have received the medical discharge and the other two, that continue entered in the same hospitable center, "evolve favourably".

A person of L"Hospitalet of 76 years who entered the 4 of December in the Hospital of Bellvitge affected of legionella died yesterday Monday in the mentioned center. According to the Consellería of Health informed, the death took place "by causes other people's to legionella".

Two of the nine affected by the outbreak arisen in the district of Santa Eulàlia de L"Hospitalet, of 37 and 74 years, respectively, follow entered in Bellvitge and evolve favourably, whereas the six rest already had been registered previously.

On the other hand, the Consellería investigates the origin of other three cases of legionella appeared between the terms of Sant Joan Despí, Cornellà and Esplugues, also in the Barcelonian region of the Baix Llobregat.

One of the three entered people passes away in Hospitalet because of the legionellosis

7 January 2003
The Department of Health and the City council of Hospitalet de Llobregat informed yesterday into which one of the three people entered the Hospital of Bellvitge because of the legionellosis has died that contracted in Hospitalet de Llobregat (Barcelona).

Detected two new cases of legionellosis in Alcoi (Alicante) by a possible common source of exhibition

The Virgin hospital of the Irises of Alcoy has notified the detection of two cases of pneumonía by legionella in this week, that agree in a space-temporary grouping with the declared case Friday of the last week, apparently, by a possible common source of exhibition, according to today informed sources into the Generalitat.

The main directorate of Public Health informed into which they have adopted, after the corresponding analysis, all the opportune measures and that anticipates a "quick remission" of this situation, since a possible common source of exhibition has been appraised.

On the matter, they emphasized that already it was even acted on this possible source prior to the appearance of these cases due to an analytical identification in a risk installation that agrees with this space-temporary grouping. "This performance has been fast and effective, according to the established system of monitoring", they emphasized.

Health limits the zone of the possible center of I infect of the outbreak of pneumonía in Cocentaina (Alicante)

Conselleria of Health today limited the zone of the possible center of infect of the outbreak of pneumonía by legionella in Cocentaina (Alicante) after analytical the positive one obtained in a risk installation, while it is continued working in the taking of samples in the facilities of existing risk in the locality, according to today informed in an official notice sources into the Valencian Generalitat.

Also, also today, a new case of pneumonía by legionella in Cocentaina was diagnosed. This patient is entered in the Virgin Hospital of the Irises of Alcoi (Alicante), according to the same sources. On the other hand, the other three patients who remain entered in this hospitable center evolve favorably.

Affected by legionella they request that the companies with infected cooling towers are sanctioned

The president of the Association of Affected by Legionella, Jose Miguel Pons, affirmed today that the association has decided, after the appearance of a new outbreak in Cocentaina (Alicante), to demand the administration that he sanctions to the companies in whose cooling towers the presence of the bacterium is detected, and requested that more severe "measures are taken", with a cleaning of the conductions of the towers and not only of the refrigeration apparatus.

The Consellería de Sanidad diagnosed yesterday a new case of neumonía by legionella in Cocentaina. With this new case, already they are the six patients who remain entered with neumonía by legionella in the Virgin Hospital of the Irises of Alcoy (Alicante), five which are in plant and one remains in the UCI to the delay of being transferred to plant.

Jose Miguel Pons indicated Europe Press that "calls the attention to us that towers that have been sealed and cleaned, and at a first moment give negative, later return to give again positive". Thus, it explained that "normally" what they are cleaned they are the apparatuses but "they are left germs within the pipes". For that reason, when the towers are put again into operation "become infected again".

This way, it considered that the adopted measures are not sufficient and requested that a sanction is applied to the companies in which legionella is detected, since until now the measurement that are taken she is the one to seal the tower. In his opinion, the conclusions are "clear" and is that conselleria sanctions to the companies "to see if him we can put a brake to this, that they have a punishment and that they have a little fear".

Also, it considered that the orography of the region of L"Alcoià influences in which the disease extends with greater facility because it is "a closed" zone, which "is more than cause so that there are more cases than in other sites of Spain, where are no sprouts again".

C. Valencian. - Health diagnoses a new case of legionella in Alcoi (Alicante)

5 of December of 2002

The Virgin Hospital of the Irises of Alcoi (Alicante) today diagnosed a new case of pneumonía by legionella in a patient of 61 years, person of this alicantina locality, according to informed sources into the Generalitat. Also, today a patient of Cocentaina received the discharge that remained entered in this aquejado hospitable center of pneumonía by legionella. At the moment, according to they indicated the same sources, they are hospitalized six patients, four of Alcoi and two of Concentaina, all of them with a stable situation. The number of affected by the bacterium in the last weeks ascends, with this nine case, to 16 people in both populations, nine of Cocentaina and seven of Alcoi, adding the diagnosed patient today and who is hospitalized.

Three cases of Légionellose in thermal baths in Charente-Maritime

November 14 2002BORDEAUX

Three cases of légionellose, respiratory infection of bacterial origin, were detected these last days in the hydropathic establishment of Jonzac (Charente-Maritime), one learned near the prefecture.

The prefect of Charente-Maritime took a decree pronouncing the temporary closing of the thermal baths in waiting of the epidemiologic and environmental surveys carried out in collaboration with the departmental Management of the medical and social action (DDASS) and the national Institute of medical day before.

All the people having attended the establishment in the last weeks will be informed of the situation.

The légionellose is a respiratory infection caused by a bacterium of the Légionella kind which generally appears by a feverish pneumonia. Its diagnosis rests on clinical and biological signs specific.

The disease is not transmitted person to person but it can appear mortal in cases of late diagnosis on fragile people

Discharge from the hospital other of the patients entered by legionella in Jaén, a man of 76 years, and is left four hospitalized

One of the five patients diagnosed with legionellosis that continue entered in the surgical medical hospital of the hospitable complex of Jaén, a resident man of 76 years in Martos (Jaén), was discharged from the hospital this morning after recovering completely of pneumonía that suffered. According to hospitable sources informed in an official notice, this patient is fifth who leaves the health center, reason why are entered four of the ten that in Martos and Jaén was diagnosed with this pathology.

Three of the other four patients who follow hospitalized by legionellosis, a man of 34 years, and one woman of 67 years, both of Martos and a man of 84 years of the jiennense capital, continue with the favourable evolution of pneumonía with reserved prognosis that suffer. The entered other, a man of 36 years, follows in stationary situation within the gravity in the Unit of Cuidados Intensivos (UCI) of the Surgical Doctor, where it takes more than three weeks.

The other four patients affected by legionella who were registered in the jiennense hospital were two men of 57 and 53 years of Martos, another one of 66 years of the capital, and a woman of 65 years also of the locality marteña.

One of the patients of Martos(Jaén) passes away entered by legionelosis in the Medico-Qurúrgico hospital

The woman of 86 years entered by legionellosis in theMedico-Quiru'rgico Hospital of the Hospitable Complex of Jaén passed away today after suffering an insufficiency cardiac and after remaining the past in the center from 28 of October, according to informed to Europe Press sources of the Service Andalusian of Salud (SAS).

However, the SAS indicated that legionella already had surpassed it, but could not react before the agravamiento of the cardiopathy with which it was entered and that him complicó by the effect of the bacterium of this person of Martos.

Martos to that deals with one about eight people of legionella has been detected to them and that next to both of capital Jaén, that according to the SAS does not have relation with the previous ones, they elevate to ten the affected ones by this bacterium that have been discovered 16 days in the last.

Today a new case of another person of Martos of 65 years was detected that it has had to be entered the hospital. Both men of the jiennense capital have 66 and 84 years of age and evolve of favourable form of one pneumonía with reserved prognosis, like two men of Martos, 76 and 34 years, that also remain entered in the hospital.

Another one of the patients also hospitalized by legionellosis, a man of 36 years, continues in stationary state in the Unit of Intensive Cares with pneumonía with serious prognosis, whereas there are other three patients of Martos who already have been discharge data, which they are two men of 57 and 53 years and one woman of 65 years.

Detected two cases of legionella in Jaen, although the relation with the found ones in Martos discards

They register to another one of the entered patients, a woman of 65 years, whereas the old one of 86 years makes worse its state

The Provincial Delegation of the Council of Health of Jaén has diagnosed two new cases of legionellosis in two men of 66 and 84 years, neighbours of capital Jaén, who suffer pneumonía of reserved prognosis and favourable evolution, although discarded that these two new cases, that are entered in the hospitable complex of Jaén and with which rises to nine in the jiennense province, have relation with the seven appeared in Martos.

According to the Meeting informed in a note, these two cases were detected through the tension in which is the epidemiologist alert network in all the jiennense province to detect the legioneLlosis presence.

With respect to the cases detected in Martos, a neighbouring woman of 65 years of Martos has been discharged from the hospital this morning in the Surgical Medical hospital of the jiennense hospitable complex, after recovering of pneumonía that suffered when it entered 31 of October the past.

This is the third patient with the same pathology that leaves the center, after making it two men of 57 and 53 years, pasts 31 of October and 4 of November, respectively, reason why they are hospitalized four patients of Martos affected by legionellosis.

Two of them, two men of 76 and 34 years of age evolve of favourable form of pneumonía by which they were entered day 4 the past. The woman of 86 years has undergone a relapse in the cardiopathy that to day before contracting the legionellosis, due to its outpost age, whereas the man of 36 years remains the past in the Unit of Intensive Cares from day 24 with one pneumonía of serious prognosis.

The first results of the analytical ones carried out in the laboratory of Public Health of Cordova with the water samples gathered in different points from the municipal term of Martos to determine the presence of legionella do not throw conclusive results, reason why they will continue during the next days making new cultures of this bacterium.

The survey epidemiologist made of joint form by the Provincial Delegation in Jaén of the Council of Health and the City council of Martos is centering their investigations in the zones next to the industrial estate and the park of the locality. The commission of pursuit constituted by members of both institucones to direct to all the works search and inspection of sources of risk of transmission of this disease, has become to reunite today to recover all collected until now by the technicians.

The City council of Martos maintains all the preventive measures taken since it appeared the first case of legionella in the city, like the closing of the ornamentales sources and of the deposits or rain tanks non supplied by the public potable water network, the prohibition of irrigation by aspersion or the closing of the laundries of automobiles.

The municipal technicians and those of the health district of Jae'n-North continue the inspection and controls of the cooling towers of Martos that have been cleaned in two occasions to analyse the water next to the search of evaporative condensers and aerosols of great power. The neighbours have secundado in their majority the side dictated by the mayor, Jose Antonio Saavedra, so that they cleaned to all the deposits or rain tanks.

Three men have been taken to hospital with Legionnaires’ disease after an outbreak at Clayton.

Andalusia
Confirmed the outbreak of legionella in Martos, whose Ayto. discards that the infection comes from the rain tanks

Defense of the Public Health says that it is not possible to be denied that there is outbreak of legionella when new cases exist

During today four new cases of pneumonía by legionella in Madrid have been diagnosed

Detected three new cases of legionella in La Paz, Ramon and Cajal and Leganés

From the 10 in the morning of today three new cases of pneumonía by legionella have been diagnosed in the hospitals of the region, according to informed to first time of the night the Main directorate into Public Health into the Community into Madrid. First about them one is a woman of 50 years, entered in today in the La Paz Hospital, that lives and works in Area 5, in municipalities in which they have not diagnosed any other case in recent dates.

The second of them is a man of 58 years, entered day 16 of October in the Severe Hospital Ochoa de Leganés, that works in this municipality and lives in that health Area (number 9). No of these two affected has had nothing to do with Area 4, where the first cases and of where have been detected comes the greater number of patients.

Third about the patients one is a man of 50 years, entered today in the Hospital Ramon and Cajal and whose date of beginning of symptoms was day 14, same in which last cases of the six entered in this center both that they communicated in the press conference of day 16, which relates to him directly to the patients of Area 5.

At this moment the mandatory survey is being made epidemiologist, with exhaustive spirit, since the same one can determine in relation to the others, a common nexus between the affected ones, adds the Public avalanche Main directorate.

With the three cases of today they are already the 11 patients detected in Madrid, of which one has passed away

The Main directorate of Public Health of the Community of Madrid informed to first time of the night of which three new cases of legionellosis have been notified that have been diagnosed throughout the day of today. With the three of today they are or the eleven cases of legionellosis detected in the Community of Madrid from the past 25 of September, one of which, a old one of 76 years, it passed away the 2 of October, and other two or have been registered: one, to last hour of yesterday Thursday, the Ramon and Cajal; and another one, in the morning of today Friday, of the Hospital of the Princess.

Of the total of affected, seven - including which it passed away and one of the diagnosed ones today took place in Health Area 4 (districts of San Blas, Linear City, Hortaleza and Barajas) that has like reference the Hospital Ramon and Cajal. Another one is a patient who was in the hospital of the Princess and who already has been registered. One is a carrier who has circulated around diverse zones of Madrid, reason why she has not taken shape where she could be infected.

Ninth of the cases, detected Thursday yesterday, he is a pensioner of 62 years, nonresident in the municipality of Madrid, that entered by pneumonía in La Paz, hospital of reference of the Health Area 5, in which they are including the districts of Fuencarral and Tetuán, and municipalities like Alcobendas, San Sebastián of Kings and Old Colmenar, among others. A tenth patient - a woman also is in La Paz and eleventh, in the Severe Hospital Ochoa de Leganés.

Of this form they are the eleven patients diagnosed in the Community until the moment, of which one passed away, two have been registered, and the eight rest are hospitalized in the Ramon and Cajal (five), La Paz (two) and Severe Ochoa de Leganés (one).

Valencia
Advisor of Health says that case of legionella detected in an inmate of Picassent is "at the moment" isolated

"conseller" of Health, Castilian Serafín, it showed today that the prisoner of Picassent (Valencia) to which diagnosed one to him pneumonía by legionella when he was admitted the General Hospital of Valencia is "at the moment a sporadic case".

Castilian, which she made these declarations after the company/signature of an agreement of collaboration with the minister of Health, Ana Shepherd, for the establishment in Valencia of a Superior Center of Biomedicina, affirmed that the main directorate of Public Health is investigating the causes and the circumstances of this case.

One of four British tourists recently infected with the legionella bacteria at a Menen hotel has died, it has been revealed.

Four British tourists were infected with the legionella bacteria at a hotel in Menen recently, it was revealed on Thursday.

The Menen Mayor, Gilbert Bossuyt, resolved at the request of the Health Inspectorate to temporarily close the hotel, forcing it to find temporary accommodation for 50 people.

Legionella infections recently killed several people in Britain in what BBC News said was the worst outbreak of infections in 10 years.

Three British pensioners are seriously ill in France after contracting Legionnaires' disease while on a European coach tour.

The three women were among passengers on two separate trips heading to Austria when they picked up the potentially fatal bug.

The two women, from the Christchurch area of Dorset, who have not been named, are said to be in a critical condition in a hospital in Colmar in the Alsace region of France.

The third woman, Felicity Lodge, 65, from Melksham, Wiltshire, is being treated at the same hospital after falling ill and collapsing on the last day of her holiday, which had started on September 21. Her condition is said to be serious.

Tour operator Wallace Arnold Holidays says investigations are now focusing on a hotel in Belgium where both parties are thought to have stayed early last week on route to the Austrian Alps.
A spokesman for Wallace Arnold confirmed the passengers are suffering from Legionnaire's Disease.
"All three passengers, from the Dorset and Wiltshire areas, are being treated at a hospital in the Alsace region of France where their conditions are described as very poorly.

"The matter is specifically being investigated by the French health authority, the body responsible for identifying the source, and we are awaiting their findings.

"All relevant information has also been passed to the European Working Group for Legionella Infections, in London."

Two men have died and a woman is in hospital following the latest outbreak of Legionnaires' disease in Melbourne.

Health authorities suspect all three people got the disease after visiting the same area in inner-city Brunswick.

The Department of Human Services confirmed all cooling systems of premises between Moreland Road, Dawson Street and Sydney Road are being inspected.

HOTEL MERRIMENT, FETHIYE, MUGLA, TURKEY has had 3 cases associated with this cluster, onset of most recent case was 08/11/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL HIERAPOLIS, PAMUKKALE, DENIZLI, TURKEY has had 2 cases associated with this cluster, onset of most recent case was 25/11/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

PEGASUS WORLD HOTEL, SIDE - SORGUN, ANTALYA, TURKEY has had 2 cases associated with this cluster, onset of most recent case was 30/09/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL MERIT SUNSET, KUSADASI, AYDIN, TURKEY has had two cases in 2001 and one further case in 2002 associated with it, onset of most recent case was 14/09/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

Please be advised that data was removed from the EWGLINET website at 15:00 BST on 17/12/02 because the following hotels have now implemented satisfactory control measures (Form B):

HOTEL ANITAS, ALANYA, ANTALYA, TURKEY
HOTEL GREEN FUGLA BEACH, ALANYA, ANTALYA, TURKEY
HOTEL HAMBURG, ALANYA, ANTALYA, TURKEY
CLUB VIKINGEN BEACH, ALANYA, ANTALYA, TURKEY
CLUB APHRODITE, BODRUM, MUGLA, TURKEY
HOTEL FAUSTINA, KUSADASI, AYDIN, TURKEY

SILLYON RESORT, SIDE, ANTALYA, TURKEY has had 2 cases associated with it, onset of most recent case was 26/07/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL BELLIS, ANTALYA, TURKEY has had 2 cases associated with this cluster, onset of most recent case was 15/08/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL KEMAL BAY, ALANYA, ANTALYA, TURKEY has had 2 cases associated with this cluster, onset of most recent case was 08/11/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL GREEN FUGLA BEACH, INCEKUM, ALANYA, TURKEY has had 2 cases associated with it, onset of most recent case was 24/09/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

CLUB HOTEL APHRODITE, BODRUM (Gundogan Belbesi), MUGLA, TURKEY has had 2 cases associated with it, onset of most recent case was 22/10/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL CLUB 55, MARMARIS, MUGLA, TURKEY has had 2 cases associated with it, onset of most recent case was 12/10/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL ANITAS, KONAKLI, ANTALYA, TURKEY has had 2 cases associated with it, onset of most recent case was 31/07/2002. No Form A (two week report) or Form B (six week report) has been received for risk assessment and control measures at this site.

HOTEL CLUB VIKING BEACH, ALANYA, ANTALYA, TURKEY has had 2 cases associated with it, onset of most recent case was 02/10/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL FAUSTINA, GUZELCAMLI, KUSADASI, TURKEY has had 4 cases associated with it, onset of most recent case was 15/10/2002. No Form A (two week report) has been received for risk assessment and control measures at this site.

HOTEL OMAR, TORBA BAY, NEAR BODRUM, TURKEY has had 3 cases associated with it, onset of most recent case was 04/10/2002. Satisfactory control measures have now been implemented.

Information supplied from the following
EWGLINET Surveillance
ewglinet@ewgli.org

A new case of legionella infection has been discovered in Rogaland. A 62-year-old Stavanger woman is the
third case in recent days.

Her condition at Rogaland Central Hospital was stable, but worse than the other two cases.
The woman was admitted to hospital late Saturday night with symptoms of pneumonia. She was immediately tested for legionella and treatment began on Sunday, according to divisional
director of medicine Jon Sundal.

Just before the weekend two cases were reported involving men who both traveled daily between Stavanger and Sandnes. One of these men has already been released from care and the other is expected to be well in a few days.
Dr. Sundal said that there are about 20-30 patients with pneumonia in the hospital, which is normal.

Comprehensive checks of cooling towers between Sandnes and Stavanger are now underway. The path following route 44 appears to be the only area which the two first patients had in common.
Stavanger was the site of the source of Norway's first legionnaire's outbreak last summer. A hotel cooling tower produced bacteria that infected 28. Seven died.

New legionnaires` outbreak worries Stavanger
Health authorities in Stavanger hope that two new cases involving the legionella bacterium are isolated
incidents, but are preparing for the worst. Last August 28 cases resulted in seven deaths in the area.

Doctors and hospitals in the Sandnes and Stavanger area are besieged with calls from worried citizens wondering how to avoid or detect signs of infection.

On Thursday Sep. 5 legionella infection was confirmed in a 49-year-old Sandnes man. The next day a 55-year-old Stavanger man was hospitalized in Rogaland with the same symptoms. The only common factor known so far is that they two commute to work daily between Sandnes and Stavanger. Both are responding well to treatment for pneumonia and fever.

Last August an infection source at a cooling tower in a hotel resulted in 28 cases of legionnaire's disease and seven fatalities. Hotel procedures appear to rule out the tower as a source this time, and health officials are examining possible causes along the route that connects the two cities.

The Stavanger epidemic last year was the first time a legionella source was found in Norway - all earlier cases were found to be 'imported' from abroad. Now experts are puzzled about why Stavanger seems to be vulnerable.

Director of the microbiology wing at the regional hospital in Rogaland Olav Nåstad believes that legionella is simply not often reported in Norway. He points to 80-90 cases a year in neighboring Sweden, compared to about 10 in Norway, where climatic conditions are about the same.

A rare and deadly illness has left two area construction workers fighting for life in the same hospital where they are believed to have contracted legionnaires' disease.

The men, one a labourer with Bondfield Construction, the other a steelworker with a subcontractor, are believed to have contracted legionellosis, better known as legionnaires' disease, while working on the roof of Kitchener's Grand River Hospital on King Street West.

The men, age 34 and 47, are on life support in the hospital's critical care ward.

Chief of critical care services Dr. Bill Plaxton said the first man turned up in the hospital's emergency room Tuesday with what appeared to be a severe and fast-moving case of pneumonia. Tests confirmed legionellosis.

The second man was admitted to hospital Thursday. His diagnosis was confirmed late Thursday afternoon.

As a result of the disease, both have developed adult respiratory distress syndrome, shutting down their lungs. For those that survive, the condition can require weeks or months of hospitalization, Plaxton said.

Before falling ill, both victims were working on renovations to the roof of the main hospital building, an area constructed in the 1960s.

Extensive testing is underway to confirm the source of the legionella bacteria, but for now, wet roofing material is the prime suspect. The bacteria flourish in stagnant water. People can become infected with the disease after breathing in water vapour containing the bacteria. It is not passed from person to person.

Waterloo Region's medical officer of health Dr. Liana Nolan said that based on past outbreaks, the bacteria rarely travels more than 7.5 to nine metres.

Of those directly exposed to the bacteria, only a few will develop symptoms of legionellosis, she said.

Confirmed cases of Legionellosis must be reported to public health officials. But Nolan said documented cases of the disease are rare -- only two or three are seen in the region each decade.

The disease got its official name in 1976, when it killed 30 American Legion convention delegates who had gathered in a Philadelphia hotel.

Dr. Chris Steingart, an internal medicine specialist at Grand River Hospital, said the bacteria can be difficult to identify.

Although rarely diagnosed, legionella bacteria are widely occurring and may be the second leading cause of pneumonia cases serious enough to require hospitalization.

Until the source of the bacteria is confirmed, rooftop areas where the men are known to have worked have been sealed off for at least 10 days as health officials await test results.

Construction workers who may have been exposed to the bacteria have been warned to watch for symptoms including loss of appetite, fatigue, body aches and headache.

According to the latest official announcement by Hyuga City, 294 (158 men and 136 women) became ill (29 confirmed and 265 probable cases) and six people (four men and two women over 60 years old) had died. All had visited the same hot-spring resort in Hyuga City and had been bathing in contaminated spas with Legionella pneumophila. It was revealed that the facility had not followed health ministry cleaning and disinfection procedures in spa and public bath facilities.

An outbreak of deadly Legionnaires` disease that has killed six people and infected up to 272

All of those infected with the disease, including 22 who are in hospital, had been bathing at a spa in southern Miyazaki prefecture, engaging in a pastime enjoyed by millions of Japanese every year in the belief that it will relieve stress and benefit health.

"The exact cause is still under investigation by the prefecture.
Because six people have died, the police are carrying out their own investigation, According to a spokesman for the prefecture's health department.

The outbreak has apparently claimed another victim -- a 49-year-old local public health worker who committed suicide by taking cyanide last week after days of dealing with the outbreak.

By that time, checks on the water at the newly opened Sun Park hot springs in Hyuga town had discovered Legionnaire's bacteria present in levels up to 150,000 times greater than those set by the Health Ministry.

The disease, which recently claimed four lives in Britain, is a form of pneumonia caused by bacteria living in water droplets.

Disease is the last thing that most Japanese would expect to find in their beloved hot spring, or "onsen."

Sitting naked in warm, mineral-rich waters in the middle of scenic countryside is a national institution, not to mention the cornerstone of Japan's tourist industry. Before climbing in, bathers have to thoroughly scrub and rinse themselves to ensure the onsen water stays clean.

About 137 million people stay at onsens each year, according to the Japan Hot Spring Federation, not including the millions more who just pop in for a quick dip.

In the few weeks since the Sun Park onsen had opened, Atae said about 20,000 customers had bathed in its waters and were now extremely worried about their health.

"We're fielding a lot of calls from worried people who used the onsen, most of them from the local area," he said.

"Other onsen in the area are being checked to see if they are following hygiene procedures, but there are a lot of them so it will be some time before we get the results."

Worryingly for Japan's tourist industry, a recent study suggested that the Miyazaki hot spring may not be an isolated case of poor hygiene.

Japan's National Institute of Infectious Diseases (NIID) said that danger may be lurking in thousands of hot springs where Health Ministry cleaning standards are not being properly followed.

Its researchers found 64 percent of the 237 hot springs they tested contained amoebae, which can serve as hosts for dangerous bacteria, including the variety that carries Legionnaires` disease.

SPAIN GOES BANANA`S ON LEGIONELLA

A fifth cooling tower, possible center of the outbreak of legionella

Barcelona 20 August 2002

The Generalitat considers that, " more likely ", the clandestine cooling tower of an ice factory of the district of Cerdanyola de Mataró (Barcelona) is the cause of the bud of legionella that already has affected 80 people, to the delay of the results of the analyses.

This cooling tower belongs to a factory in the Burriac street and it was not located until the past day 16, days after they appeared the first patients, since his proprietor had not declared his existence to the City council.

Conseller of Health, Eduard Rius, informed that yesterday they appeared 5 new cases of the disease, with which the affected people rise to 80, of whom two, a woman of 83 years and a man of 49, they have died.

At the moment there are 34 patients entered the Hospital of Mataró, among them a man of 42 years who is serious.

Rius said that until half-full or final of the next week the analytical ones of the samples gathered in the tower of the factory will not be ready. However, it added that all the indications " aim with much probability to that this tower would be the origin of the center ".

The department bases its hypothesis on that the last patients who have contracted the disease underwent the first symptoms before the 16 of July, date in which the installation of refrigeration of the Burriac street closed. The fact that they continued arising cases much after the first four suspicious towers became disinfected, and of which many of the patients reside in the same street where it is the ice factory, it corroborates the suspicions of the Generalitat.

BARCELONA CASES NOW 32
12 August 2002

29 cases Legionnaires` Disease in Barcelona Spain

12 August 2002

TWENTY-nine people are in hospital after an outbreak of Legionnaire's disease in the Spanish town of Mataro near Barcelona.

Health authorities say the epidemic is under control, but one patient, in her 80s, is in critical condition.

Three additional people were affected by the outbreak, but did not need to be admitted to hospital.

The air conditioner of a public building, which has not been identified, is being blamed.

Meanwhile, near the port city of Valencia, 13 other people have also been diagnosed with Legionnaire's disease in two small towns, and nine are in hospital - six at Alcoy and three at Segorbe.

SORIA Spain
10 August 2002

This small outbreak occurred in April 2002

The results of the second analysis of health water samples made in the Institutional Hospital of Soria, where they took place three cases of legionella, have given negative, according to informed today Territorial delegation of the Meeting, reason why the outbreak "can be given by controlled ".

The samples were gathered by the technicians of the Service Territorial of Health and Social welfare the past 18 of July, passed 15 days since the treatments were applied thermal and of hyperchlorination in the health water facilities of the hospitable center, so and as it establishes the effective legislation, it adds the Meeting.

In addition to the negative result to the investigation and count of legionella in these samples, has not detected any new one either case from the application of the shock treatments.

The outbreak the past detected month of April but until the one of July did not occur to know the public opinion.
Altogether it affected a three internal ones of the hospital, all of outpost age. One of them it passed away finally, because of the gravity of the disease that it suffered previously, according to the Meeting.
The made tests they determined that the transmitter had been the water network of legionella.

MATARO.

Update 11 August 2002

The number ascends to 20 of affected by the outbreak of legionella of Mataró

They continue the investigations to detect new centers in the district of Cerdanyola

To the nine people infected by the virus of legionella in Mataró during the previous week, 11 affected entered yesterday in the Hospital of Mataró has been added.

The center of the epidemic is centered n the cooling towers of several buildings of the district of Cerdanyola.
From 20 detected cases only two they have received the medical discharge, while they follow under observation nine women and seven men of ages between the 30 and 87 years that, according to the director of Urgencies, Square Carles, evolve favorably. However, the critical state of a patient of 82 years has advised its enter the Unit of Intensive Cares with serious prognosis

***

Barcelona, 9 ago

A outbreak of legionella affects nine people in Mataró

A outbreak of legionella has affected nine people in Mataró (Barcelona), according to have indicated from various sources of the Department of Health of the Generalitat

According to these sources, the outbreak, whose origin is investigated and still it is not known, has affected to 9 people in the last days, of which eight follow entered in hospitable centers, after three of them made it today same.
The Consellería of Health will late explain the this in press conference reach of this outbreak of legionella

Spain
8 August 2002

Five cases of legionella in Alcoi and its region.

The number is only provisional, since it does not discard that in the next days it increases the list of affected by this quarter appears of the epidemic that registers the alicantina city. In fact a case more in Bañeres de Mariola has been detected, but the Consellería assures that it is an isolated patient who nothing has to do with this outbreak.

The association of affected of Alcoi, after three years of contínuos outbreaks and than 150 people more infected, has announced already, whom the administration will denounce.

New outbreak of legionella, this time in Catalonia.

This same afternoon, cases in the Barcelonian locality of Mataró have been confirmed neueve. Eight of the nine affected have had to enter the hospital.

All the patients live in a perimeter of a kilometre in a district residential, near an industrial estate.

The cause: once again, a cooling tower.

The Generalitat has inspected four, three of them have given positive and one, in particular, very was contaminated. Health has disinfected all those towers, and it does not discard that new cases of the disease in the next hours take place.

7 August 2002

Five patients of pneumonía by legionella have been diagnosed in Segorbe.

Two of them are hospitalized in Sagunto and at the moment new cases because do not discard still the center of the infection has not been located. Health has opened an investigation to analyze the potable water network as well as the apparatuses of refrigeration where the bacterium usually lodges. The city council already has taken all the measures to avoid new contagious.

The neighbors of Segorbe live these days with anguish. In the last weeks, the cases of legionella have gone off. At the moment the center of the infection is not known and those that have let ingest water of the faucet, by fear are already many.

The technicians of the Consellería of Environment have taken today samples from water in sources and parks public. The objective is to find out if in some of these points is the origin of I infect. Until then, the city council has qualified a information telephone. Take note, is the 964.13.21.48. Between the prevention measures, the chlorination has been increased of the water and from this late, the provision of the public sources will be cut. It is left a warning. Joaquin was the first one affected by the bacterium of legionella. Now, already recovered, he knows that he has had much luck. Until the moment, only in Segorbe five cases have been entered already. Three affected have been registered, but one of them is very serious and it is afraid for his life. Other two people entered the Hospital of Sagunto could be infected by the bacterium of legionella.

Wednesday, 7 August 2002
Death by Legionella

Four holiday-makers in treatment

In Slovenia at least five holiday-makers from Saxonia infected themselves with the dangerous Legionaerskrankheit. A spokeswoman of the Saxonian Social Department said at the Wednesday evening that four holiday-makers were in Saxonia in medical treatment. With two of them the infection is clearly proven.

A fifth tourist had already died, as at the vortag admits became, on 30 July in a hospital in Slovenia. The 73-Jaehrige and the four Heimkehrer would have belonged to a 19-koepfigen travel's group from Saxonia, said the spokeswoman.

Three further member of the group were stationarily observed at present in hospitals in their homeland. With the 13 remaining Rueckkehrern give it at present still no sufficient suspicious factors. The spokeswoman stressed that the illness, which is released by the Legionella bacterium is not sticking on.

The bacteria had obviously spread after information of the Slovenian authorities in the water system of a hotel in Koper, to the Adriakueste, 80 kilometers southwest the capital Ljubljana to a city.

*****Update****

German dies in Slovenia

The Legionella spreads in Great Britain ever more. Meanwhile more than 100 humans with suspicion on the illness are in treatment.
The number of the confirmed infections increased to more than 90. Approximately 20 humans must be treated on intensive care units. Also in Slovenia for the illness the responsible persons bacteria struck several humans. A 73-jaehriger German tourist died at the consequences of the infection, six further Germans, which had in the same hotel used, is likewise gets sick.

In Slovenia an incorrect water pipeline applies as origin of the exciters. In Great Britain it is assumed that unsatisfactory maintenance of an air conditioning system is responsible in a citizen center of the norwest city Barrow in Furness for the outbreak of the epidemic disease. The bacteria are to have been blown over the exhaust air of the air conditioning system into a close passage, hundreds of passanten are daily in which on the way.

Alcoi Spain
8 August 2002

Health detects four contagious by a new outbreak of legionella in Alcoy
The affected ones by the bacterium in Segorbe rise to six after diagnosing another case

The Conselleria of Health has confirmed four new contagious of legionella as a result of a outbreak detected in Alcoy. The affected ones are entered, although they are outside danger. To these cases a new one is added I infect in Segorbe, with which the patients of pneumonía by this bacterium already are six.

Four people - three of Alcoy and one of Cocentaina- have contracted pneumonía by legionella in the last week in a new outbreak of this disease, the quarter, that affects the alicantino municipality.

To these new given cases to know yesterday by Health, a new one is united I infect detected in the castellonense locality of Segorbe, where already they are the six people affected by the bacterium.

The four patients of the region of l'Alcoià are outside danger and remain entered in the Virgin hospital of the Irises of Alcoy, according to informed yesterday conseller of Health, Castilian Serafín.

The affected ones are men of 83, 74 and 32 years - coming from Alcoy -, and 69, the one of Cocentaina.

After meeting with the mayor of Alcoy, Miguel Peralta, conseller it explained that the first indications aim that the bacterium was propagated by two different centers.

Also, it seems that I infect is of environmental type and one has centralized in Alcoy, since the patient of Cocentaina has spent long time in muncipio.

The authorities have sealed the two cooling towers which it suspects that they propagated the bacterium and they have extracted samples. One of the centers is located in a company whose system of industrial refrigeration counted on the documentation in rule and, in addition, had made the mandatory workings of disinfection.

On the contrary, the other center is located in a evaporative condenser of refrigeration located in public establishment that, unlike the previous one, was not registered by the authorities.

Inquire into 5 new cases of légionellose in Isère
Wednesday August 7 2002

The prefecture of l.Isère indicated to have opened an epidemiologic and environmental investigation in Isère.

This procedure was started following the discovery in Grenoble and in its suburbs, between July 15 and August 2, of 5 cases of légionellose.

The prefecture specified that the subjects are cured or in the process of cure. The survey in progress is carried out jointly by the medical institute of day before, the interregional cell of epidemiology, the communes and the DDASS. According to the prefecture, the regrouping of the cases in space and time "suggests a common source of contamination" and taking away "were operated on 25 lathes aéroréfrigérantes" which can cause contamination in the event of dysfunction. The results of the analyses will be known in ten days. January 1 at July 15, 2002, 18 cases isolated from légionellose had been recorded on all the department and had been announced to the DDASS, as the law requires it.

The légionellose is a respiratory infection caused by a légionelle bacterium of the kind and generally appears by a pneumonia with fever which can be very serious.

Legionnaires' Disease Update:
Seven Cases Now Confirmed

Health officials today confirmed that the four possible cases of Legionnaires' disease reported yesterday are positive, making a total of seven cases associated with the outbreak in the Waterbury area.

"Our first priority is to continue to identify any individuals who may have contracted this disease and making sure that they are getting treated," said Health Commissioner Dr. Jan K. Carney.

"We are also actively investigating whether there are connections among the cases," Carney said.

At least a dozen other people who had symptoms have been tested and found to be negative.

Legionnaires' disease is not passed from person to person. People get it by inhaling mists that contain the bacterium that causes the disease, Legionella pneumophila

BURLINGTON -- The Vermont Department of Health is investigating a single case of Legionnaires' disease (legionellosis) in a woman in Washington County.

It is unknown where the woman acquired the disease. However, since she has spent time recently in the Dale Correctional Facility in Waterbury, Health Department staff are reviewing health records and building maintenance procedures with the facility staff.

It is the standard practice of the Health Department to investigate any reported case of Legionnaire's disease. Every year in Vermont there is an average of seven sporadic cases reported.

Seven people are hospitalized and the process has begun to detect the possible centers

the Consellería of Health of the Valencian Generalitat confirmed yesterday the existence of ten cases of pneumonía by legionella in the castellonenses municipalities of Segorbe, Alcoy and Concentaina. In first of the municipalities six of the ten cases entered in the province and, of the people affected by the disease, three un man of sixty years, another one of 62 years are concentrated that are in stable situation and a woman of 85 which favorablemente evolves remain entered, both last ones in the Hospital of Sagunto (Valencia), whereas other three affected already were registered. In Alcoy, the affected ones correspond with four men of 83, 74, 69 and 32 years, three of resident them in this locality and a quarter in Cocentaina, that are entered in the Virgin hospital of the Irises.
Adoption of measures The Consellería of Health initiated yesterday the measures of location and isolation of the bacterium. Thus, in Segorbe, five teams of technicians began to gather samples of the cooling towers of seven companies, in the sprinklers, apparatuses connected to the potable water network and ornamentales sources of the locality, to try to determine the origin of the cases. On the other hand, the surveys epidemiologists made to the four patients of Alcoy and Concentaina, "have allowed to locate two possible centers of propagation of the bacterium", according to sources of the Consellería of Health. One of them is a company and the other a public establishment, whose installation already has been sealed. The administration has extracted samples of both to analyze them and is predicted that the results are known in the next days. Health emphasized that "the effectiveness of the monitoring system epidemiologist" of the Consellería "has allowed to detect these cases with the Maxima rapidity".

Update Japan

A Miyazaki prefectural official was cited as saying that up to three people have died of Legionnaires' disease and 224 others are feared to have been infected following an outbreak at a hotspring spa in southwestern Japan.

The story says that Legionella bacteria about 150,000 times over safe levels were discovered at the publicly run hotspring in Hyuga, Miyazaki prefecture, on July 25 after the first patient was diagnosed with the disease.
On Thursday, the disease claimed its first confirmed victim, a man in his 70s, who died after developing pneumonia.

Two other patients, a woman in her 60s and another man in his 70s, died in mid-July and are suspected of having contracted the illness, which causes pneumonia and high fever mostly in children and the elderly.
Health official Jiro Shioigawa was cited as saying authorities are now racing to find the cause of the outbreak but it was most likely due to negligence, adding, "Normally, if a bathhouse manages sanitation properly, this kind of thing doesn't happen."
The spa, Hyuga Sun Park Onsen, was only in operation for about a month after opening on June 20, during which some 20,000 people used its facilities.
Police are investigating negligence charges but are having trouble determining responsibility at the facility, which is majority-owned by Hyuga city with the mayor, Magoharu Yamamoto, acting as its president.

Another bather infected with Legionnaires' disease in Miyazaki

Monday, August 5, 2002

Local health officials said Saturday another person has been infected with Legionnaires' disease after bathing at a spa in Hyuga, Miyazaki Prefecture. The latest confirmed infection raises the total of such infections to 11. The officials also said 23 more people have been added to the list of those suspected to have contracted the disease among the bathers at Hyuga Sun-Park Onsen, lifting the total on the list to 195. Two of them have died.

The spa, which was licensed to operate under the Public Bath House Law, opened to the general public July 1 but halted operations July 24. Some 20,000 people are estimated to have used the facility. Neighbours were invited to use it before the official opening.

A man in his 70s died early Thursday, becoming the first officially confirmed fatality in the outbreak of Legionnaires' disease in Miyazaki Prefecture, prefectural officials said.

The disease has struck visitors to the Hyuga Sun-Park Onsen, which opened to the general public on July 1 but was shut down July 24 following reports of the disease.

******************************
Official overseeing Legionnaires' outbreak found dead

MIYAZAKI - A local health center official overseeing the outbreak of Legionnaires' disease in Miyazaki Prefecture was found dead Wednesday morning at his home in the southwestern Japan prefectural capital of Miyazaki, police said.

Coroners found a cyanide compound in the stomach of the 49-year-old official at the Hyuga Public Health Office, prompting the police to suspect the man, depressed by the outbreak, may have poisoned himself. According to the police, the wife of the official went to his bedroom at around 6 am, and he told his wife that he would be sleeping a little longer because he was a bit tired. His son later went to see the father and found he was not breathing and called an ambulance.

2nd August 2002
England

Barrow-in-Furness

Health officials investigate Legionnaires' outbreak

A further 11 people in Barrow-in-Furness are suspected of having the disease, Morecambe Bay Health Authority says.

Two elderly visitors to a spa in Hyuga, Miyazaki Prefecture, have died after contracting Legionnaires' disease.

A woman in her 60s from Nobeoka and a man in his 70s from Takaokacho, both in Miyazaki Prefecture, were infected with legionella bacteria when they visited a hot spring at Hyuga Sun Park Onsen.

The woman went to the hot spring on July 7, was admitted to a hospital with respiratory problems on July 14 and died July 22. The man bathed at the hot spring on July 4, was admitted to a hospital on July 9 and died July 15.

Of 98 people in the area who have shown symptoms of Legionnaires' disease, 59 have been hospitalized and five have been found to be infected with the legionella bacteria.

The Hyuga public health center tested seven outdoor hot springs at the spa for legionella bacteria on July 19 and found that they contained 150,000 times more than the permissible level set by the Health, Labor and Welfare Ministry.

The facility, a joint venture between the Hyuga municipal government and several private companies, has been closed since July 26 for cleaning.

France
15 July 2002
Epidemic of légionellose in the hospitals of Sarlat and Meaux
Twelve people having remained at the hospital of Sarlat are reached of légionellose.
Eights of these people are currently hospitalized in Sarlat and are in a stationary state.

Two patients reached of légionellose died last week in the hospital complex of Meaux (Seine-et-Marne), where sixteen cases of this disease were detected in ten days. The two patients died in the current of the week: Monday, woman a 90 year old, and Friday, man a 53 years old. On the whole, sixteen cases were diagnosed in the hospital complex, which accomodates approximately 500 people. The origin of this epidemic was detected Friday. Following a series of taking away, carried out the shortly after the first death, an abnormal concentration of bacteria "legionella" was noted in the turns aéroréfrigérantes of the system of air-conditioning of the hospital complex, explained the direction.

In addition, a new case of légionellose was diagnosed Saturday in the hospital complex of Sarlat (the Dordogne), changing to twelve the number of patients reached by this infection. "We fear however that new cases are still discovered", explained the director of the hospital, Jean Romon. The establishment calls any hospitalized person with Sarlat as from June 25 and which presents abnormal signs (fever, pulmonary infection) to approach its attending practitionar. On the twelve old patients from 38 to 94 years, nine are currently hospitalized to Sarlat and three in Périgueux. According to Jean Romon, "their state is stationary but we are anxious because the majority of these people are old of more than 70 years".

The hospital complex of Sarlat had announced Friday the discovery of seven cases of légionellose. A first patient presenting the symptoms of the disease had been announced Tuesday. "A titrates conservatory and in waiting of the investigations, the new hospitalizations will be temporarily suspended but the service of the urgencies will continue to function normally and to ensure the care necessary. Preventive measures were taken as of Friday by the hospital to stop any risk of contamination

France
Sept cas de pneumopathie à legionella ont été diagnostiqués par le Centre hospitalier de Sarlat.
Cinq des malades ont été hospitalisés sur place et deux à Périgueux.

Il semble que tous aient transité antérieurement par l'hôpital de Sarlat.

Bien que n'ayant pas pu déceler la cause de la contamination, l'administration de cet établissement à décidé de désinfecter l'ensemble de ses installations sanitaire et son sytème de climatisation.
La température de l'eau chaude fournie a également été augmentée tout en interdisant temporairement l'usage des douches.

Update Japan

Another bather infected with Legionnaires' disease in Miyazaki Monday, August 5, 2002

2nd August 2002 England Barrow-in-Furness

Health officials investigate Legionnaires' outbreak

Another bather infected with Legionnaires' disease in Miyazaki

Monday, August 5, 2002

2nd August 2002
England

Barrow-in-Furness