The European Working Group for Legionella Infections (EWGLI) this year held its meeting in Rome, hosted by the Istituto Superiore di Sanita. There were representatives from many countries of the world and presentations detailing where outbreaks occurred, the epidemiology and actions taken. Presentations included treatment therapies and insights into the way LD bacteria are hosted in biofilm found within water systems.
It is expected that the rising trend in reported cases continued in 2004 and that around 5,000 cases will be reported from Europe as a whole. The ratio of men to woman infected was around three to one and the age group was 50 to 59 years with a fatality of 5.1%.
Legionella pneumophila is an organism that resides in aquatic environments and will invade amoeba and protozoa. Infection occurs when the bacteria is transmitted in aerosol (water spray) and is inhaled where it produces symptoms similar to pneumonia with an incubation period of between two and 10 days or more. Early diagnosis and treatment are essential to avoid fatalities.
Concern was expressed regarding the use of whirl or spa pools due to the risk of infection posed by poor disinfection and cleaning with water temperature generally conducive to rapid multiplication of bacteria supported by body waste, sweat, makeup and cosmetics which produce a bacterial soup which is then turned into a fine aerosol by the water and air jets directly under the noses of bathers and the surrounding area. These devices have been responsible for multiple infections and fatalities.
Legionnaires’ disease continues to be of great concern due to the nature of the way bacteria is disseminated from showers, taps, fountains and cooling towers where depending on climatic conditions the water droplets may be carried over long distances to cause infection remotely from the source.
John Hayes is chairman of the London Branch of IHEEM and represented the Institute at the meeting in Rome.
