At least six confirmed with Legionnaires’ disease in Edinburgh outbreak

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By Bob Duncan

The number of Edinburgh residents confirmed as suffering from the potentially deadly Legionnaires’ disease, has risen to six following an outbreak in the capital.

The two extra cases followed confirmation that four men, aged between 39 and 63, were already being treated in hospital, three in intensive care, and one in a high dependency unit.

Four others are also suspected of having the disease, but have yet to be confirmed.

The source of the outbreak is being investigated by officials from the City of Edinburgh Council’s environmental health department and the Health and Safety Executive.  All eight people so far affected by this outbreak are residents of South West Edinburgh and investigations are being concentrated on this area.

The disease is contracted by breathing in small droplets of contaminated water.  It is not contagious and cannot be spread directly from person to person.

The NHS Lothian health board said Legionella bacteria are commonly found in sources of water, such as rivers and lakes.  They can end up in artificial water supply systems, including air conditioning systems, water services and cooling towers.

However, the health board has reassured residents the source is not thought to be linked to water supplies, adding that steps were being taken to treat cooling towers in the south west Edinburgh area, but only as a precaution until the source is located.

Dona Milne, acting director of public health and health policy for NHS Lothian, said: “We have four confirmed cases of Legionnaires’ disease, which all seem to come from the same point source in the south west of Edinburgh.

“Anybody who develops symptoms of Legionnaires’ disease should contact NHS 24 immediately or go to their GP. The safety of the public is our number one priority and we would urge people to look out for the symptoms of this disease.”

Symptoms Legionnaires’ disease include mild headaches, muscle pain, fever, and sometimes vomiting and diarrhoea.

Once the bacteria infect the lungs, the sufferer will experience a persistent cough – dry at first but later bringing up mucus and even blood – shortness of breath, and chest pains.

About half of those with the disease will also experience changes to their mental state, such as confusion.

Duncan McCormick, consultant in public health for NHS Lothian said: “We have identified with environmental Health and Safety Executive the various installations and possible source of infection in that area of Edinburgh.

“We are certainly in the process of sampling water supplies in that area and doing shock treatment to the water in order to eradicate any germs which are there.”

He also explained that the source was yet to be identified, adding “It is not going to be likely to be a domestic source – its going to be more of a community source such as a leisure facility or industrial site.”

Legionnaires’ disease acquired its name in July 1976 when an outbreak of pneumonia occurred among attendees at a convention of the American Legion in Philadelphia.

However, the first known cases of Legionnaires` disease in Scotland occurred in 1973 in a group of tourists who had been on holiday in Benidorm in Spain, three tourists died from that unknown outbreak.

Then, in an outbreak of legionellosis in Glasgow in 1984, 33 people caught the disease and one died.  26 of the patients lived in the Dennistown district of the city and the cases occurred downwind of a cooling tower up to a distance of 1700 metres.

The following year an outbreak at the Royal Infirmary in Glasgow saw 15 patients and one staff member develop the disease.  The source on the infection was traced to contamination of a cooling tower from which a plume of spray discharged into the intake vents of the two ventilation systems.

In 1994, nine people contracted legionnaires’ disease in south west Edinburgh, and one of these died of the disease.  Cooling towers were suspected to be the source in this outbreak, and several were found to be substandard and badly maintained.

Last week, gardeners were warned Legionella bacteria could be present in compost bags.  One man has died and five others have become ill in the past five years after contracting a rare strain of the bacterium, which appears to come from compost.

Dr Duncan McCormick from the health board said: “I think in this case the links between the cases appear to be more where they are living, which suggests it is unlikely to be due to anything like compost, or any sort of domestic environment.

“I would be able to reassure people, that based on current information, there certainly does not appear to be anything to do with domestic water supplies, or any domestic activities, such a gardening or compost.”

Anybody who develops symptoms of Legionnaires’ disease has been urged to contact NHS 24 immediately or go to their GP.

NHS Lothian said all GP surgeries would be open on Monday, however some will be closed on Tuesday for the Jubilee bank holiday.