Published Date: 2012-07-13 16:20:59
Subject: PRO/EDR> Legionellosis - UK (09): (Scotland) more cases, fatal
Archive Number: 20120713.1200937
LEGIONELLOSIS - UK (09): (SCOTLAND) MORE CASES, FATAL
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 12 Jul 2012
Source scotsman.com [edited]
The legionellosis outbreak has claimed its 100th victim, the Scottish Government revealed.
Health experts said this was the 1st new case for a week and believe the worst of the outbreak is over. 3 men with Legionnaires' disease have already died and 2 people remain in intensive care. Health Secretary Nicola Sturgeon said: "The latest case of Legionnaires' has been ill for some time, and has now been identified as a confirmed case. Over recent days as expected, we have not seen as many cases of Legionnaires' [disease] as we did at the peak of the outbreak, and this continues to offer reassurance that the outbreak remains under control."
A total of 52 people are confirmed as having the disease and 48 are suspected to have the bug. The outbreak began in Edinburgh at the end of May  and investigations to locate the source of the disease are on-going. Health and safety experts still believe the outbreak began in an industrial cooling tower in the south west of the city but experts have warned the exact source of the bug might never be traced.
A number of victims have already started legal proceedings to find out how the disease was able to get into the air and why more was not done to prevent the outbreak. Some have revealed they will seek compensation for their ill-health if and when a company is found to have been responsible for the potentially fatal disease.
All 3 men who have died were all from the Edinburgh area and health experts said they had underlying health conditions.
Dr Richard Othieno, Consultant in Public Health Medicine, NHS Lothian, said: "While this is the 1st new case in more than a week, it is not unexpected. As the outbreak draws to a close we can expect to see a small number of cases coming forward who have experienced mild symptoms initially and have sought medical attention later in their illness."
[Byline: Natalie Walker]
ProMED-mail from HealthMap alerts
[The total number of cases of Legionnaires' disease in Edinburgh has now risen to 100, with 52 confirmed and 48 suspected cases. There remain 3 fatalities.
For a discussion of Legionnaires' disease, see ProMED-mail post Legionellosis - UK (02): (Scotland) 20120605.1156972.
The news release above implies that all cases acquired their infection before remediation on 2-3 Jun 2012 of 16 cooling towers, the suspected sources of the outbreak, located south west of Edinburgh, saying that these late appearing cases had typically been ill for some time and had links to the south west of Edinburgh. The 16 cooling towers on 4 sites are: the North British Distillery, Wheatfield Road, Gorgie; Macfarlan Smith (pharmaceuticals), Wheatfield Road, Gorgie; Aegon (insurance), where towers are used to cool servers, in Lochside Crescent, South Gyle; and Burtons Foods, Bankhead Place, Sighthill.
A subtitle for a photo in the news report above states the North British Distillery in Gorgie is a "confirmed site tested for the bug," which may imply that samples taken from this site grew _Legionella pneumophila_. 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 environmental and clinical isolates (see
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2730281/). However, this may not be possible because the diagnosis of all confirmed cases previously had been reported to be made on the basis of a positive test for _L. pneumophila_ urinary antigen. Consequently, clinical isolates are not available for genotyping.
The majority of cases in prior posts 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.
Edinburgh can be located in the interactive HealthMap/ProMED-mail map at
http://healthmap.org/r/2wlL. - Mod.ML]