Outbreak of Legionnaires’ disease in West Fife: Review of environmental guidelines needed

Hyland, J.M.; Hamlet, N.; Saunders, C.; Coppola, J.; Watt, J.

doi:10.1016/j.puhe.2007.05.005

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Volume 122, Issue 1 , Pages 79-83, January 2008

Outbreak of Legionnaires’ disease in West Fife: Review of environmental guidelines needed

Public Health Department, NHS Fife, Cameron House, Cameron Hospital, Windygates KY8 5RG, UK

Received 27 November 2006; received in revised form 6 April 2007; accepted 11 May 2007.

Summary

Objectives

The objectives of this study were to investigate the source of and outbreak of Legionnaires’ disease in West Fife in 2004; to control the spread of legionella from this source; and to make recommendations for future practice based on the findings from the investigation.

Study design

Outbreak investigation.

Methods

A multi-agency team investigated links between the cases of legionellosis using detailed interviews, movement mapping, a timeline and extensive environmental sampling.

Results

The investigation found evidence that individuals affected by legionella during this outbreak had been in, or near (within 800m), sullage tanks in Rosyth Dockyard within a period of 4 months.

Conclusions

In the absence of laboratory isolation of Legionella spp. from the human cases, it was impossible to state definitely that a previously unrecognized source of environmental legionella aerosolization was responsible for the outbreak. However, strong epidemiological and environmental evidence would support this hypothesis.

Keywords: Legionella, Outbreak, Aerosolization