Published Date: 2003-06-11 23:50:00
Subject: PRO/EDR> Legionellosis - Spain (Valencia)
Archive Number: 20030611.1439
LEGIONELLOSIS - SPAIN (VALENCIA)
A ProMED-mail post
ProMED-mail, a program of the
International Society for Infectious Diseases
Date: Mon, 9 Jun 2003 16:56:17 +0800
From: Denis Green <email@example.com>
Source: ABC.es, 9 Jun 2003; [edited]; [translated by Maria Jacobs, ProMED-ESP]
Alarm in Valencia's health department after 2 new outbreaks of Legionella
One person has died and 24 others have become infected as legionellosis has
reappeared in the Autonomous Community of Valencia recently. The death of
one person and the 10 cases of infection diagnosed since 28 May 2003 have
revealed the existence of 2 new outbreaks.
The first was an outbreak in Alcoy (the eighth since 1999) and nearby
areas, followed by an outbreak in Castellon that originated in the Oncology
Department of the Provincial Hospital [illustrating the well-known
propensity for legionellosis to be a hospital-acquired infection - Mod.LL].
The bacteria seem to be prominent in Valencia, and particularly in the
industrial zone of Alcoy in the province of Alicante, where almost 300
cases of infection have been registered since the disease was first
detected in 1999.
On 29 May 2003, a patient hospitalized in the oncology unit died after
becoming infected by the bacteria. Subsequently, another 6 cases were
reported, none of them particularly severe. 3 occurred in visitors of
hospitalized patients, and a 4th in a woman who apparently was infected
in the rehabilitation area adjacent to the oncology ward. It was reportedly
not difficult to trace the source of infection to the hot water pipe of the
shower in a hospital room of the center, where the first patient (with lung
cancer) who contracted the disease died, and to the hot and cold water
pipes of a shower in a changing room. The health department gave assurances
that measures were being taken in the hospital, including water
hyperchlorination, higher water temperatures in faucets and showers, and
cleaning and disinfection of the rehabilitation pool. In addition, samples
of almost 100 possible foci were obtained.
Nonetheless, Health Secretary Serafin Castellano does not discount the
possibility of new cases over the next few days, given that the incubation
period for the disease has not been determined. The alert continues in
Alcoy, although the 10th case in only 3 weeks was confirmed on 19 May
2003, and no new cases have been reported since. Its control has required
extensive deployment of resources in order to close a large number of
refrigeration towers and carry out necessary tests.
While in Alcoy the situation seems to be resolving, the bacteria have
appeared in the nearby locality of Ibi, which also is home to numerous
industries that require large refrigeration systems. On 21 May 2003 a case
was detected there; another was detected in Onil, in the same district.
What the local government initially regarded as an isolated incident was
confirmed a few days later as the first outbreak of legionella in Ibi's
history, despite the Mayor's assurances that Ibi has none of the
unfavorable geographical conditions of Alcoy.
The disease has already affected 5 persons in Ibi and continues to spread
in the area. On 5 Jun 2003, a case was detected in Muro de Alcoy, an urban
center that had outbreaks in June 2000 and November 2002. Another case was
reported on 6 Jun 2003 in the locality of Planes.
The possibility of further spread of legionella has alerted other areas,
particularly Cocentaina, which has had outbreaks of the disease in previous
years. In fact, a resident of this municipality contracted legionella
pneumonia in Alcoy.
[Byline: L. Pardo and E.J. Blasco]