27 March 2011

SCOTLAND: LEGIONELLOSIS

PRO/EDR> Legionellosis, hotel - UK: (Scotland)
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LEGIONELLOSIS, HOTEL - UK: (SCOTLAND)
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A ProMED-mail post
<http://www.promedmail.org/>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org/>
Date: Sat 26 Mar 2011
Source: The Press & Journal [edited]
<http://www.pressandjournal.co.uk/Article.aspx/2197354?UserKey=3D>

A man is in hospital with the potentially fatal Legionnaires' disease
after using the leisure centre at a 4-star hotel in Dundee. Some 66
staff and visitors at the Landmark Dundee have also experienced
flu-like sickness, NHS [National Health Service] Tayside confirmed
last night [25 Mar 2011].
The man who was confirmed positive for the disease is being treated
in Ninewells Hospital.
The health authority and Dundee City Council environmental health
officers said last night [25 Mar 2011] they had carried out
investigations at the hotel after staff and guests reported feeling
unwell. NHS Tayside said that before the single confirmed case, there
was no evidence of _Legionella_ infection in any samples taken.
Consultant in public health medicine for the health authority Dr
Christopher McGuigan said: "To date, 66 people who work in or have
visited Landmark Dundee are known to have experienced flu-like
illness, which has, for the majority, been short-lived and managed
symptomatically at home. We are not recommending that people should
stay away from the hotel as the investigations are focusing on the
leisure club, which has been closed since the evening of Thursday, 17
Mar 2011. We have been working closely with the hotel since the
investigation started late last week, and we are systematically
carrying out all appropriate health and environmental tests."
NHS Tayside has asked anyone who has visited the hotel over the last
2 weeks, and who has been unwell with a flu-like illness -- for
example, high temperature, chills, cough, headache or shortness of
breath -- to seek advice.
Legionnaires' disease, a potentially fatal form of pneumonia, is
caused by types of bacteria commonly found in the environment. People
can become infected when they breathe in air that contains
_Legionella_ bacteria which have been dispersed into the air in very
fine droplets of water.
Most people exposed to these common bacteria do not become ill, and
the disease cannot be spread from person to person. Contaminated water
is usually the source of infection.
[Byline: Rebecca Buchan]
--
Communicated by:
Denis Green <legion@q-net.net.au>
[For a discussion of Legionnaires' disease (LD) and Pontiac fever
(PF), please see the prior ProMED-mail post Legionellosis - USA (02):
(CA) conference, susp 20110304.0713.
Outbreaks of legionellosis are usually either LD or PF; combined
outbreaks of both LD and PF are unusual [1-4]. Why some people
apparently exposed to the same source develop Legionnaires' disease
and others develop Pontiac fever has not been explained.
1. Thomas DL, Mundy LM, Tucker PC. Hot tub legionellosis:
Legionnaires' disease and Pontiac fever after a point-source exposure
to Legionella pneumophila. Arch Intern Med 1993;153:2597-9.
2. Goldberg DJ, Fallon RJ, Green ST, Wrench JG. Pontiac fever in
children. Pediatr Infect Dis J 1992; 11:240-1.
3. Girod JC, Reichman RC, Winn WC, Klaucke DN, Vogt RL, Dolin R.
Pneumonic and nonpneumonic forms of legionellosis. The result of a
common-source exposure to Legionella pneumophila. Arch Intern Med.
1982;142(3):545-7.
4. Benin AL, Benson RF, Arnold KE, Fiore AE, Cook PG, Williams LK,
Fields B, Besser RE. An outbreak of travel-associated Legionnaires
disease and Pontiac fever: the need for enhanced surveillance of
travel-associated legionellosis in the United States. J Infect Dis.
2002; 185(2):237-43.
A excellent review of the topic can be found at: Edelstein PH. Urine
Antigen Tests Positive for Pontiac Fever: Implications for Diagnosis
and Pathogenesis. Clin Infect Dis 2007; 44 (2):229-231. Available at:
<http://cid.oxfordjournals.org/content/44/2/229.full>.
The Landmark Hotel, located on the outskirts of Dundee, Scotland, has
3 bedrooms situated in the old mansion house with the remaining 100
bedrooms located in an extension. The hotel has a "leisure club" with
an indoor heated pool, spa, sauna, solarium, and a 10-station
gymnasium (<http://www.gbstay.com/hotel/AAB104398.htm>).
Dundee, a city in the Tayside region of Scotland, lies within the
eastern central Lowlands on the north bank of the Firth of Tay
(<http://en.wikipedia.org/wiki/Dundee>). Ninewells Hospital, a
teaching hospital on the western edge of Dundee, is administered by
NHS Tayside (<http://en.wikipedia.org/wiki/Ninewells_Hospital>).