Legionella – fighting a resourceful foe

waterborne contamination prevention, and emergency response, described how the bacterium and its effects were first “discovered”, offered valuable advice on how to minimise the risk of its growth and spread, and highlighted some of the alarming findings he had seen throughout a long career in the field, much of it spent providing guidance and advice to hospitals and other healthcare facilities both on Legionella, and a range of other water health and hygiene matters.

Apparently now widely known as “the Red Adair of Bug Busters”, David Harper began his seminar presentation by briefly describing his own career, before moving on to the crux of his presentation. He explained that, having served his apprenticeship as an electrical engineer, he entered the field of water safety and hygiene in the early 1960s as an engineer at the Atomic Energy Authority in Harwell, subsequently moving into hospital engineering later that decade. His varied career since, working for organisations including the Health Protection Agency, has seen him involved in numerous investigations into outbreaks not only of Legionnaire’s disease, but also Sick Building Syndrome. In his “very early days”, meanwhile, he had also helped investigate the implications of “AIDS” in the engineering field. Now recognised as among the leading authorities on Legionnaires’ disease, both in the UK and abroad, in terms of the engineering aspects, he is regularly consulted during investigations, and has written many papers on the subject, and wider water system management, covering both the medical, and legal, aspects. He is registered as an Expert Witness for the legal profession, and provides training on the subject up to PhD level. He also gives talks, lectures, and workshops to staff working in a wide range of disciplines worldwide and, as a member of the Communicable Disease Surveillance Centre (later part of the Health Protection Agency, told the seminar audience he had been involved in “solving” many outbreaks of Legionnaires disease, “including almost every major outbreak” which had occurred to date. He had also, he explained, had experience of Legionnaires’ disease himself, having at one stage been hospitalised for a week and a half with the disease. One of his key overriding messages at the seminar was that it had been shown that diagnosis of a single case of hospitalacquired Legionella could prompt the recognition of endemic Legionnaires’ disease at a facility. Such discoveries were thus “an important sentinel of additional undiscovered cases”. While the first recorded outbreak of Legionnaires’ disease had been at the Bellevue-Stratford Hotel in Philadelphia in the US in July 1976, on the 200th anniversary of the American Legion – hence the illness’s name, David Harper recalled how, “on going to work as usual” at the Kingston General Hospital in Kingston-upon-Thames in Surrey on 11 July, 1979, he had been greeted with the news that three people had just died in the hospital, apparently victims of Legionnaires’ disease. At the time he admitted he had been entirely ignorant of the disease, whereas today, so sophisticated were testing methods that, typically, DNA samples could very rapidly not only confirm infection of a patient or patients within hours, but also identify which one of the various serogroups was involved.

Cooling towers suspected