Published Date: 2012-06-12 02:10:01
Subject: PRO/EDR> Legionellosis - UK (06): (Scotland)
Archive Number: 20120612.1164841
LEGIONELLOSIS - UK (06): (SCOTLAND)
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Mon 11 Jun 2012
Source: heraldscotland [edited]
Health chiefs believe the worst of the legionnaires' outbreak may be over, as new figures show cases of the potentially fatal disease appear to be tailing off. The numbers of newly confirmed and suspected cases rose by 2 in the 24 hours to midday yesterday [10 Jun 2012], compared with the rapid rises seen at the height of the health scare last week.
It takes the total number of people who have contracted the disease since the 1st case was identified on 31 May 2012, to 82. This includes 15 patients currently in intensive care -- unchanged from Saturday [9 Jun 2012] -- and 26 who are being treated on general wards. The figures also include 16 people being treated in the community, 19 who have recovered and been discharged from hospital, and a labourer, 56 years old, who died last week.
Contaminated water vapour from cooling towers has been blamed for spreading the disease. Health secretary Nicola Sturgeon said: "These latest figures are reassuring and in line with expectations, and although it is too early to be definite they do suggest we are now in the later stages of this outbreak. All those involved are responding extremely well.
"NHS [National Health Service] Lothian services are coping with the demands on them and the City of Edinburgh Council and the Health and Safety Executive continue to make significant progress in their investigation to identify the source."
Dr Duncan McCormick, consultant in public health medicine for NHS Lothian, added: "We are pleased with the slow down in the number of cases presenting and we hope this will continue over the coming days."
The Scottish Government's Resilience Room, which has been monitoring the outbreak, will meet again today [11 Jun 2012].
The North British Distillery in Gorgie, one of 6 sites being inspected for traces of the virus [_Legionella pneumophila_, the cause of legionnaires' disease is a Gram negative bacterium, not a virus], has been closed temporarily after being issued with an improvement notice by the Health and Safety Executive.
[byline: Helen McArdle]
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[The number of confirmed and probable cases of legionnaires' disease in Edinburgh has risen from 80 (Legionellosis - UK (05): (Scotland) more cases, fatal 20120609.1162615) to now 82; there is still only one death from this disease. It is apparent that the number of new cases of legionnaires' disease has begun to tail off in the past several days, about one week after 16 cooling towers on 4 sites near Edinburgh that were identified as a potential source of the outbreak were chemically treated. This decline is to be expected if the source were eliminated, considering that the incubation period for legionnaires' disease is about one week (2 to 10 days). For a discussion of legionnaires' disease, see ProMED-mail post Legionellosis - UK (02): (Scotland) 20120605.1156972.
The majority of cases were said to be residents of Stenhouse, which is located west of the center of Edinburgh, between Gorgie and Sighthill. For a map showing these communities, see http://www.maplandia.com/united-kingdom/scotland/scotland/city-of-edinburgh/gorgie/. The effect of the wind direction on plumes from these cooling towers in relation to where these cases occurred will have to be studied.
The diagnosis of all confirmed cases was reported to have been made on the basis of a positive test for _Legionella pneumophila_ urinary antigen. Consequently, clinical isolates are not available for genotyping. Genotyping of patient and environmental isolates has become a helpful tool to establish transmission pathways. The predominance of one genotype of legionella isolated from patient specimens would suggest transmission from a common source. Because legionella may be found in environmental samples without linkage to any cases of legionellosis, the actual causative infectious reservoir can be confirmed by matching the genotype of clinical and environmental isolates (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC86783/ and http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730281/).
Scotland can be located in the interactive HealthMap/ProMED-mail map at http://healthmap.org/r/2wlL. - Mod.ML]