Legionnaires’ Disease finds itself making an untimely return to the front pages again recently, after an unprecedented spate of headline-grabbing cases of the potentially fatal bacterial infection having coming to prominence in the media; not least the high profile outbreak at Disneyland in California. This latest episode tragically saw two victims of the largely unseen health condition lose their lives as a consequence of contracting the disease, whilst scores more are recovering after being infected in the past couple of months at the famous American family holiday destination. As we pen this blog, some 15 confirmed cases of Legionnaires’ Disease had been reported, and amongst those 11 cases have been directly linked to the iconic Disneyland resort. As a precautionary measure we learn that Disneyland officials have closed two cooling towers at the site, which were discovered to contain what was described by health experts as ‘elevated levels’ of the bacteria. In addition to this it’s our understanding that public health professionals are in the process of carrying out vital inspections to nearby properties and businesses which are not associated with the hugely popular theme park.

However the Californian incident is not an isolated one, as globally there have been an increasing number of cases of Legionnaires’ Disease of late. Take the Spanish resort of Palmanova for example, where a British tourist died after contracting the infectious condition and 13 others British nationals fell seriously ill at the same time. In total some 19 tourists have fallen victim to the disease in Palmanova, a Spanish destination which remains a favourite of holidaying Brits, and which is situated very close to another Mediterranean hot spot, Magaluf. Elsewhere, and in Lisbon a hospital has been connected with the deaths of two people, while another 32 have become sick as a result of contracting Legionnaires’; just a week after it was first detected in the Portuguese facility, according to respected news agencies. Meanwhile – and closer to home – a 69-year old woman succumbed to Legionnaires’ after contracting it during a hotel stay in Shropshire. Having spent a night in a Ludlow hotel, the grandmother was later to have found to have been exposed to the disease via the unwitting inhalation of droplets of contaminated water.

In light of growing concerns, and amid a heightened sense of worry over Legionnaires’ (and more pertinently just how, where, when and why individuals might become susceptible to its possible grip), we have set about answering some of the all-important questions on people’s minds right now; so as to help YOU distinguish the facts and figures from the myths which also tend to circulate at times like this. Starting at the beginning……

What exactly is Legionnaires’ Disease?

In summary, Legionnaires’ is a lung infection which can seriously compromise the health of those affected by direct exposure to it, with its root cause lying in Legionella bacteria. At any one time there might be negligible traces of the bacteria present in water sources like ponds and rivers, yet which pose no threat to the public’s health in such relatively small volumes. However in the event of the bacteria entering an environment which affords it the perfect conditions to prosper (such as stored water reservoirs within domestic and business properties which are privy to fluctuation temperatures, as well as air conditioning systems), the prognosis for human interaction – and thereafter – falling prey to Legionnaires’ is ramped up, as the bacteria multiplies quickly. While the disease is a treatable one if identified soon enough, courtesy of antibiotics typically prescribed for  pneumonia, symptoms may become complicated further by underlying respiratory conditions in the elderly population affected.

How serious is the disease and how common is it?

Despite these recent cases gaining traction in the press and beyond, Legionnaires’ Disease is relative rare in occurrence, but that’s not to underestimate its potential to lead to serious illness if and when someone contracts the infection. Statistically-speaking Legionnaires’ results in grave clinical diagnosis’ (and possible, ultimate demise) in the region of 10 – 15% of otherwise healthy individuals who are exposed to it. But of course, as we mention elsewhere in this blog, the actual number of deaths reported may be higher in some groups of patients, specifically those who present weakened immune systems.

Why Legionnaires’ Disease, in Terms of its Name?

This dates back to the time of a significant outbreak in Philadelphia in 1976, whereby a number of Legionnaires were in attendance at a state convention of the American Legion. Thereafter the medical and scientific profession adopted the name with reference to this particular group of people, and subsequently the bacterium causing the illness was identified and named Legionella Pneumophila.

Just How Widespread is Legionnaires’?

Cases of Legionnaires’ aren’t rare as previously implied, with all industrialised countries globally having reporting cases in recent history. Again, from a statistical perspective outbreaks of Legionnaires’ in most countries are increasing on an annual basis, with some 5000 episodes recorded annually across the EU and EEA/EFTA countries alone.

How Might I Contract Legionnaires’?

Legionnaires’ is predominantly transmitted to humans if and when they inhale small droplets of infected water, with the majority of cases historically traced to plumbing assemblages which have been inadvertently subjected to conditions which prove favourable for rapid growth of the Legionella bacterium. Think along the lines of cooling towers (as per the well-documented Disneyland episode), whirlpool spas, hot tubs, humidifiers, hot water storage tanks, and evaporative condensers of large air-conditioning systems. As much as 10% or more of cooling towers may be contaminated in a large conurbation, for instance, yet most are never found to cause outbreaks of the disease. Why some are more prone to outbreaks owes a lot to a range of conditions occurring coincidentally. A perfect storm scenario, almost. Factors key to an outbreak in this situation include the contamination of the cooling tower, weather conditions prevalent (level of humidity, sunlight, temperature and wind direction, etc) and susceptibility of people being located in a position where they can breathe in contaminated water vapour. 

So, who falls into the ‘At Most Risk’ Category?

Groups considered most at risk from Legionnaires’ Disease chiefly include those from middle-age upwards, especially cigarette smokers and individuals who suffer with chronic lung diseases or impacted immune systems (or for that matter, who routinely administer medicines that weaken their immune systems, such as immunosuppressive drugs. As an important footnote, please be aware that Legionnaires’ CANNOT be spread from person to person, just to clarify.

How Would I Know If I Had Legionnaires’ and What Are the Symptoms to look out for?

With regards to signs to be vigilant for, Legionnaires’ physically manifests in the form of flu-like symptoms, at least in the initial stages of infection; and primarily come to bear as headaches, muscle pain, high temperatures, tiredness and chills. However once the bacteria begins to spread to the sufferer’s lungs, then the signs become more outwardly consistent with those more commonly associated with pneumonia; for example chest pains, persistent cough and shortness of breath. After the incubation period, it usually takes between 6 - 7 days for the full blown infection to kick-in.

What Should I Do if I Think I May Have Contracted Legionnaires’?

Contact your GP or local health department ASAP, pure and simple. Rest assured though, most individuals who become exposed to Legionella bacteria DO NOT become ill. However, should you have reason to believe you may have contracted the bacteria, make speaking with your doctor/local health department a matter of much urgency.

How is Legionnaires’ Disease Treated When Confirmed?

While Legionnaires’ can be deadly given the right set of circumstances, we need to stress that in the majority of cases it’s treatable with a course of antibiotics. And it’s important to realise that most people who contract the bacteria return to full health providing they get an early clinical diagnosis and thereafter receive the necessary treatment then and there. That said, in some cases victims may require time in hospital to better aid the recovery process and monitor the individual, more so it they have underlying health issues which could impact the recuperation.

What can People do to Better Protect Themselves against Legionnaires' Disease?

There’s no fail safe means by which to effectively bubble-wrap yourself against the potential threat of Legionnaires’, however it’s vitally important to maintain water systems properly, including keeping the water temperature and chemical balance at appropriate levels to inhibit bacterial growth. These protocols and actions obviously fall within an individual’s own remit within a domestic space, yet in the wider environment become the responsibility of acknowledged postholders whose job it is to safeguard areas where public health could become compromised by the onset of Legionella bacteria.

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