legionnaires Disease Case Studies

Legionnaires Disease in Ireland

As of 01 January 2004 Legionnaires Disease became a statutory notifiable disease in Ireland as defined by the Infectious Disease Regulations 1981 under the Infectious Diseases (amendment) (No. 3) Regulations 2003. However, it still appears to be rare in Ireland and when compared with other European countries, according to the Irish Medical Journal (ISBN 0332-3102) the levels become conspicuous suggesting a major degree of under reporting or miss-diagnosis. This could be because patients present with pneumonia-like symptoms so if they show signs of improvement when treated with antibiotics commonly used in the treatment of pneumonia then further tests for diagnosis are omitted.

Between 2001 and 2007 there were 67 reported cases of Legionnaires Disease in Ireland culminating in five deaths. These cases were in people aged 18 to 80 with 67.2% in males and 32.8% in females. The median age for females was 45 while that of males was 49 with 61.2% of cases being defined as travel related, 31.3% community acquired and 7.5% of cases originating in hospitals and occurring in patients who had been hospitalised for at least ten days prior to the onset of symptoms.

On 27 April 2003 a 64 year old woman died of Legionnaires Disease at Waterford Regional Hospital. After being admitted to hospital in March 2003 the patient was diagnosed as having Crohn's Disease but a routine x-ray taken in April showed that the patient was also suffering from pneumonia. Further tests confirmed on 21 April that she had Legionnaires Disease. To prevent the spread of the disease around the hospital measures were taken to raise the temperature of the water, remove any unused pipes, apply chloride treatment to the water, and install a better water circulation system including balance valves. The South Eastern Water Board carried out a full investigation at the hospital and concluded that the patient had contracted the disease from water droplets in the en-suite shower of her private room. Although no further cases were identified two new samples of legionella bacterium were found on a shower unit and a tap in different areas of the hospital by 08 May. The shower unit and the tap were both replaced and patients were moved as a precautionary measure.
In 2008 RTE reported that two members of staff at the Allianz Insurance Company in Dublin had contracted the disease. The first case was diagnosed on 27 June in a male member of staff in his late 40's with the second case confirmed on 07 July as being a male member of staff in his mid 50's. Tests linked the disease to one of the cooling towers used as part of the air conditioning system which was found to have high levels of the legionella bacterium. The cooling were shut down immediately and staff were notified of the outbreak whereupon a further five members of staff were tested as a precautionary measure but all were later released from hospital.