NHS L0thian is now investigating 17 confirmed cases and 15 suspected cases of Legionnaires’ disease. One patient, a man in his 50s with under lying health conditions, has died while being treated at the Royal Infirmary of Edinburgh.
Thirteen men and two women aged between 33 and 74 are in a critical condition with the disease and are being treated in intensive care in hospitals in Lothian. One man has recovered and has been discharged.
Although unconfirmed, 15 other cases – ten men and five women – are also being investigated. All of these patients are being treated in hospitals in Lothian. The majority of the confirmed cases are linked geographically to the Dalry, Gorgie and Saughton areas. Investigations into the other cases and possible links with the area are ongoing.
The source of the outbreak continues to be investigated by officials from the City of Edinburgh Council’s Environmental Health Service and Scientific Service and the Health and Safety Executive.
Industrial cooling towers have been identified as a potential source of the infection and the cooling systems at four facilities in the area have been subject to an additional chemical treatment. Further inspections of these facilities will be carried out by the Environmental Health Service and the Health and Safety Executive over the coming days to ensure control measures continue to be effective.
Samples have been taken from these four facilities, but legionella is a difficult bacteria to culture and it may take up to ten days before results of the samples are available. Other possible sources are not being ruled out.
Dr Duncan McCormick, Consultant in Public Health Medicine and Chair of the Incident Management Team, said: “I would like to express my sincere condolences to the family of the patient that died. Investigations into the possible source of this outbreak are on-going. Meanwhile, medical staff have been actively identifying possible cases to allow us to ascertain the full extent of this outbreak.”
He continued: “I would like to reassure the public that household water supplies are safe and that Legionnaire’s disease cannot be contracted by drinking water. Older people, particularly men, heavy smokers and those with other health conditions are at greater risk of contracting the disease. I would urge anyone who develops symptoms of Legionnaires’ disease to contact NHS 24 or their GP.”
The first case was identified on Thursday 28 May. The symptoms of Legionnaires’ disease can begin anytime from between 2-14 days after exposure to the bacteria.
Legionella bacteria sometimes find their way into artificial water supply systems, such as air conditioning systems, hot water services, and cooling towers. Given the right conditions, legionella bacteria can contaminate these water systems.
Legionnaires’ disease is contracted by breathing in small droplets of contaminated water. However, the condition is not contagious and cannot be spread directly from person to person. It cannot be contracted through drinking water.
Symptoms usually begin with an initial phase lasting 1-2 days, in which you experience mild headaches and muscle pain. This is followed by the onset of more severe symptoms including high fever – usually a temperature of 40C (104F) or above – , more severe muscle pain and chills.
Once the bacteria begin to infect your lungs, you may also experience a persistent cough (usually dry at first but as the infection develops you may start coughing up mucus or possibly blood), shortness of breath and chest pains.
About 30% of people with Legionnaires’ disease will also experience gastrointestinal symptoms including nausea, vomiting, diarrhoea, and loss of appetite. About half of those with Legionnaires’ disease will also experience changes to their mental state, such as confusion.
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