Legionnaires’ disease outbreak in Tamworth

Monday, 24th September 2018

Public and environmental health experts from Public Health England (PHE) West Midlands, the Health and Safety Executive, the NHS in Staffordshire and Tamworth Borough Council are jointly investigating two laboratory confirmed cases of Legionnaires’ disease in Tamworth.

Both patients are recovering. PHE is also investigating four separate recent cases of Legionnaires’ disease identified in the last six months, all of whom are now fully recovered, in case they are linked to a wider community cluster.

Dr David Kirrage, lead consultant with PHE West Midlands Health Protection Team, said: “While we do not currently have a direct link between these cases, the evidence we have points to the possibility that there is a common source. We are taking detailed histories of the movements of the individuals to see if there are similar patterns which would help to identify a common local source of infection.

“Legionnaires’ disease is a rare but potentially life threatening illness. It is caused by a bacterium commonly associated with water systems and cannot be passed from person to person.

“As a precaution we are working with the Health and Safety Executive and Tamworth Borough Council to identify and control any possible sources of the disease.”

The action to date includes:

  • Identifying, sampling and advising on the disinfection of potential sources of the bacteria, such as cooling towers in areas around Tamworth that the cases may each have visited
  • Alerting health care staff, including GPs in the areas in which the patients live, to look out for others who may have similar symptoms
  • making people aware of the symptoms of Legionnaires’ disease.

Legionnaires’ disease is caused by a bacterium called Legionella pneumophila. Although these bacteria are widely distributed in the environment they can lead to human illness if sources such as wet air conditioning systems are not well maintained.

The disease cannot be spread from one person to another.

The early symptoms include a ‘flu-like’ illness with muscle aches, tiredness, headaches, dry cough and fever which can then lead to pneumonia. As with any pneumonia, the patient can become very unwell. Diarrhoea and/or confusion may occur, as well as chest and breathing symptoms although it can be effectively treated with a course of antibiotics.

People are advised if they are feeling unwell with any similar unexplained symptoms to go and see their doctor, ring NHS111 or visit the NHS website: www.nhs.uk.

About Legionnaires’ disease

Legionella is a type of commonly occurring bacterium and can be found in around 10-20% of domestic hot water systems. Legionnaires’ disease is a severe and uncommon form of pneumonia caused by Legionella bacteria.

The majority of cases are reported as single (isolated) cases but outbreaks can occur. There are 350-400 cases a year reported in England and Wales, mainly in older adults. More information about Legionnaires’ disease is available on www.nhs.uk

Who is affected?

All ages can be affected but the disease mainly affects people over 50 years of age, and generally men more than women. Smokers and those with compromised immune systems are at a higher risk. 

What are the symptoms?

The early symptoms of Legionnaires’ disease include a ‘flu-like’ illness with muscle aches, tiredness, headaches, dry cough and fever. Sometimes diarrhoea occurs and confusion may develop. The incubation period normally ranges from 2 to 10 days. In rare cases some people may develop symptoms as late as three weeks after exposure.

Can you die from it?

Deaths can occur in 10 to 15% of the general population and may be higher in some groups of vulnerable patients.

How do you get it?

People become infected when they inhale legionella bacteria which have been released into the air in aerosolised form from a contaminated source. Once in the lungs the bacteria multiply and cause either pneumonia or a less serious flu like illness (known as Pontiac fever).

Where do the bacteria live?

The bacteria are widely distributed in the environment. They can live in all types of water including both natural sources such as rivers and streams, and artificial water sources such as water towers associated with cooling systems, hot and cold water systems and spa pools.

They only become a risk to health when the temperature allows the legionellae to grow rapidly, such as in water systems which are not properly designed, installed and/or maintained.

Can the bacteria be prevented?

Control and prevention of the disease is through treatment of the source of the infection, i.e. by treating the contaminated water systems, and good design and maintenance to prevent growth in the first place.