Legionnaires’ disease

Two outbreaks of Legionnaires' disease are in the news: - Thirteen deaths have occurred among 85 patients who contracted Legionnaires' disease in the northern French prefecture of Pas-de-Calais. The main cause of the outbreak is a cooling tower at Noroxo petrochemical factory in Harnes, which was subsequently closed down and decontaminated. However, 2 other sites were also involved in this outbreak: a cooling tower at a McCain food factory and a car-washing facility. Several factors remain to be elucidated: the incubation period was in some cases far longer than the usual 10-day period, and several persons living up to 10 km away from the incriminated sites were contaminated whereas the usual recognized range is of the order of 1 km. - In Barrow, UK, 150 civil compensation claims have been filed: 7 people died and many others were infected with legionella in the town's art complex in 2002. A council official has been charged with manslaughter and the council could face a total compensation claim of £100 000. It is important to bear in mind firstly that most outbreaks are only remotely related to air conditioning and secondly that such outbreaks would not occur if maintenance of plants (hot-water circuits, cooling towers, etc.) is performed in compliance with good practice recommendations. The US Department of Labor (www.osha.gov/SLTC/legionnairesdisease/) regularly publishes estimates on the number of cases in the US. The US National Institute of Environmental Health Services has published a synopsis on Legionnaires' disease: it deals with the history of the disease, the clinical picture and the technology incriminated: www.niehs.nih.gov/externalLfaq/legion.htm For a full insight into the clinical aspects, diagnosis and treatment of Legionnaires' disease: www.emedecine.com/emerg/topic295.htm We invite readers to send in information on Legionnaires' disease: we aim to publish information on the incidence, the causes and the remedies and would like to keep our Web site updated with key information on this major issue: iifiir@iifiir.org