Legionnaires’ disease outbreak 2012: Health secretary admits source still not traced

  • Health chiefs questioned over delay in investigating all possible avenues
  • Labourer Robert Air, 56, died from deadly bug in Edinburgh Royal Infirmary
  • Bacteria thought to have been transmitted via droplets of infected water from cloud of gas rising into the air
  • Tens of thousands at risk as epidemic could spread 44 square miles from source
  • Scotland’s health secretary hopes cases peak over the weekend
  • Symptoms include coughing, chest pains, fever and chills

By
Phil Vinter and Emma Reynolds

14:03 EST, 5 June 2012

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17:01 EST, 8 June 2012

A whisky distillery last night found itself at the centre of the Legionnaires’ disease outbreak after failing safety checks on a cooling tower.

The North British Distillery Company was yesterday served with an Improvement Notice by the Health and Safety Executive (HSE).

The watchdog found the firm’s tower had not been properly treated with chemicals to kill bacteria, including legionella.

Scotland’s health secretary said the number of cases could still rise, despite a chemical clean-up of the industrial site thought to be responsible.

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Checks: An Edinburgh distillery yesterday, one of the possible sources of the Legionnaires disease outbreak

Checks: An Edinburgh distillery yesterday, one of the possible sources of the Legionnaires disease outbreak

An HSE statement said the improvement notice does not mean the tower concerned is where the outbreak originated.

The firm has already taken all three of its cooling towers at the site out of operation.

Scottish Health Secretary Nicola Sturgeon has said it is ‘not always possible to conclusively determine the precise source of an outbreak’.

The dead man has been named locally as
Robert Air, 56, from the Seafield area of Edinburgh, who had reportedly
been working as a labourer on a building site in Gorgie before becoming
unwell.

Another
14 patients are critically ill in intensive care following the
outbreak, with 28 cases confirmed and 46 suspected. Ten people have now been discharged from hospital.

It can take up to two weeks for people to show symptoms after being infected with the disease. The potentially fatal infection could spread up to 44 square
miles from the source, affecting tens of thousands of people.

Two patients are being treated outside of the NHS Lothian area – in the Highlands and in the North of England.

Ms Sturgeon said: ‘I want to stress that, although these patients are being treated elsewhere, they are considered part of the south-west Edinburgh outbreak. They have had association with the affected area.

‘I would hope that over the next few days those investigations will start to deliver more specific answers on where the source of the outbreak might be.’

Deadly: A conceptual image of Legionella Pneumophila bacteria, which causes Legionnaires' Disease

Deadly: A conceptual image of Legionella Pneumophila bacteria, which causes Legionnaires’ Disease

Legionnaires’ is a potentially fatal lung infection caused by the Legionella bacteria. It is caught by breathing in contaminated water droplets and cannot be spread from person to person.

Scottish health authorities believe the bacteria may have found their way into one of several cooling towers in the south-west of Edinburgh. The tower then emitted a cloud of vapour with the bacteria in the tiny water droplets.

The outbreak is believed to be the worst of its kind to hit Scotland for 30 years. Most of the victims diagnosed so far are men aged from their mid-thirties to mid-eighties, mainly living in the Dalry, Gorgie and Saughton areas in the south-west of the city.

All those affected are men and women aged between 33 and 74.

A spokesman from the North British Distillery in Edinburgh said: ‘Our thoughts are clearly with the families of those affected by this situation.

‘The
North British Distillery is actively working with the relevant
authorities on the matter and supporting their ongoing inquiries to
ascertain the source of the Legionella bacteria.

‘Industrial
cooling towers are only one potential source of infection, and the
North British Distillery is one of a number of sites in the area with
industrial cooling towers.

Outbreak: A man in his 50s has died and 15 people are in a critical condition after an outbreak of Legionnaires' at the Edinburgh Royal Infirmary

Outbreak: A man in his 50s has died and 15 people are in a critical condition after an outbreak of Legionnaires’ at the Edinburgh Royal Infirmary

‘The
site has been inspected and nothing of concern was found. However, we
are awaiting the results of the analysis of the samples taken by
Edinburgh City Council Environmental Health Department.

‘We wish to reassure the local community that we will comply fully with any guidance issued by the relevant agencies.’

Ms Sturgeon said 16 cooling towers
identified as possible sources of the outbreak were chemically treated
last week and a fresh round of chemical treatment is under way in the
capital.

She said: ‘No link has been identified
between these patients other than a general association with the
affected area in the south-west of Edinburgh.

‘What
that does is underline the view that the source of this infection is an
outdoor community source and not an indoor-specific source, such as… a
spa in a hotel.

A map showing the location of the Legionnaires' disease outbreak

A map showing the location of the Legionnaires’ disease outbreak

Dr
Duncan McCormick, chairman of NHS Lothian’s incident management team
said: ‘We’re doing everything we can in terms of early diagnosis,
appropriate treatment and intensive care, but I think we can’t rule out
any further deaths at this stage.’

Legionnaires’
is three times more common in men than women and mostly affects the
over 50s. The elderly, smokers, and those with cancer, diabetes and
kidney disease are also at higher risk.

KILLER BUG SPREADS LIKE WILDFIRE THROUGH WATER SUPPLY

Legionnaires’ disease is a potentially fatal lung infection caused by the bacteria legionella.

The bacteria is commonly found in any freshwater areas but can sometimes find its way into artificial water supply systems.

It is contracted when small droplets of contaminated water in the air are breathed in, but is not spread from person to person.

The elderly, smokers, diabetes sufferers, those with kidney disease and cancer patients are most at risk, and men are three times more likely to contract the disease than women.

Symptoms
of the disease include headaches, muscle pain, high fever, chills, a
persistent cough, shortness of breath, chest pains and sometimes
vomiting and diarrhoea.

About half of those who contract the disease experience changes to their mental state, such as confusion.

Symptoms can start between two and 14 days after exposure.

The disease is treated by intravenous antibiotics.

Around 10% of people victims will die from arising complications.

Large
buildings such as hotels, hospitals and museums are more vulnerable to
contamination because they have larger, more complex water supply
systems, which can let the contamination spread quickly.

Initial
symptoms include muscle pain, a fever, a persistent cough, chest pains
and sometimes vomiting and diarrhoea. Although it can be treated by
antibiotics, about one in ten patients will die.

Once it has infected your lungs,
Legionnaires’ causes a persistent cough and the coughing up of mucus
or possibly blood followed by chest pains, and sometimes vomiting and diarrhoea.

Around half of those with the disease risk changes to their mental state, and may find themselves confused.

It
is so called because it was identified at a hotel hosting a convention
of the American Legion veterans organisation in Philadelphia in 1976.

‘I would like to express my sincere condolences to the family of the patient who died,’ said Dr McCormick.

‘I would urge anyone who develops symptoms of Legionnaires’ disease to contact NHS 24 or their GP.

‘People who fall into certain risk groups, these are males who are adults, who have an alcohol, drinking habit and have an underlying illness such as diabetes, or heart disease or lung disease – these people are at greater risk.

‘These people should be very much aware that if they start feeling symptoms of flu-like illness, together with diarrhoea, cough and confusion, they should be consulting their GP or NHS 24 as soon as possible.’

The first case was identified on Monday May 28, and since then the numbers have soared.

Dr McCormick said there was no threat to the city’s public water supply.

‘The public water supply in Edinburgh is extremely closely monitored and in addition it’s not possible to contract Legionnaires’ disease through drinking water.

‘It’s contracted through the inhalation of water vapour in the form of an aerosol and that doesn’t and that doesn’t happen through drinking water supplies.’

VIDEO: Latest update from Scottish Health Secretary Nicola Sturgeon 

Here’s what other readers have said. Why not
debate this issue live on our message boards.

The comments below have been moderated in advance.

There is a reason it is mainly middle aged men in this area who have been affected by this and it is very controversial so i wont say what it is.

Yesterday those most at risk,were the over 50,s who have chest problems,or an alcohol problem.Today the scottish health secretary stated, those most at risk are,men over 50 or over,those with chest infections,and of course smokers.They don,t miss a trick these health experts do they.I would have thought alcohol was safer than scottish water at the moment.On a more serious note it,s very sad that one person has died and so many are ill.

The majority of cooling towers are very well looked after and there is strict regulation of how they should be managed set out in the HSE’s Approved Code of Practice (L8) in terms of chemical usage, cleaning regimes and the type of pack that should be installed and it’s surprising to see an outbreak of legionaires disease being linked to cooling towers and I hope they find out what has gone wrong and that it isn’t due to poor system checks. The reassuring thing is that anyone in Edinburgh with cooling towers should have had them dosed with a biocide by now to kill off any legionella species present in their systems so it shouldn’t be unsafe to go outside! Legionella bacteria are naturally present in mains water supplies though and the bigger risk is from showers that don’t get used or cleaned regularly. Far more instances of legionella growth are seen in infrequently used showers than cooling towers.

Just seen a comment on this Legionnaires issue from the SNP President (forget her name) and she never once mentioned that it was the fault of, Westminster or The Conservatives – Can we claim a miracle , as this is generally the SNPs default position?
– Lewy,, Birmingham, 6/6/2012 15:17 …………………………………… there’s always one !

There must be a common denominator! That is a SAME place where everyone who has contacted this disease must have visited at one time or another in the city. Look at the wind direction for the last month correlate this with the movements of the affected to try to localise the possible up wind direction and check out the possibilities. I hope they are doing this as they dont tell you this on the News. If the afflicted live miles apart and there are no common denominator this would point to more than one source which is very disturbing.

I caught this awful disease from a jacuzzi in 1986 – they need to sort the source out quickly.

How can this happen in this day and age when all industrial cooling towers are tested for legionairs. Condolences to the mans family.

Good to see the DM can’t even get the area of Saughton right in the map…they’ve put it over Roseburn.
Saughton is further South West than Gorgie or Dalry.

The headline has been changed, last night it said “Power Station” it now reads “Cooling Towers”.

Just seen a comment on this Legionnaires issue from the SNP President (forget her name) and she
never once mentioned that it was the fault of, Westminster or The Conservatives – Can we claim a miracle , as this is generally the SNPs default position?

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