NSW: Legionnaires outbreak gaining momentum

AAP General News (Australia)
02-18-2005
NSW: Legionnaires outbreak gaining momentum

By Lisa Macnamara

SYDNEY, Feb 18 AAP - Health officials on the NSW south coast are on high alert amid
an outbreak of the potentially fatal legionnaires' disease in the region.

But authorities have downplayed concerns it could be a repeat of 1987 when 13 people
died in the area in the world's third largest outbreak of the disease.

There are now nine confirmed cases of legionnaires' in the Illawarra, with a further
six under investigation.

A 68-year-old man was yesterday in a stable condition in Wollongong Hospital after
developing symptoms of the disease.

His was the latest case announced by the South Eastern Sydney and Illawarra Health
Service (SESIHS), which is at the forefront of the second outbreak to hit the region since
1987.

The latest case emerged after four other patients were identified, including a 69-year-old
woman from central Wollongong who became ill on January 25.

Added to the list last weekend were a 65-year-old man from central Wollongong, a 54-year-old
man from Warilla in the city's south and a 72-year-old man.

Local GPs have been put on alert to look for symptoms, and health officials are working
furiously with the city council to uncover the outbreak's source after four initial cases
were confirmed a week ago.

They were four men, aged from 31 to 84, who contracted the disease between December
30, 2004 and January 25 this year.

The SESIHS yesterday began an in-depth epidemiology study to track the movements of
patients over a 10-day incubation period.

"These movements will then be plotted on a map and we will be examining all of the
maps to look for any common areas," Illawarra Public Health Unit director Sarah Thackway
said.

But the make-up of legionnaires' made the task of finding the cause difficult, she said.

"While every effort is being made to identify the source of this outbreak, the nature
of the legionella bacteria is such that it is unlikely that we will ever be able to pinpoint
the source," she said.

Indeed, Ms Thackway admitted there may be multiple sources with a possibility of cross-contamination.

News of the outbreak occurred less than a week after the SESIHS discovered three air-conditioning
cooling towers in the Wollongong CBD tested positive for the legionella bacteria.

The towers were later cleaned and disinfected, Ms Thackway said.

"We consider the health risk to people entering the CBD to be minimal," she added.

Legionella pneumophila is most commonly contracted by breathing in air from contaminated
water sources.

The elderly, heavy smokers or drinkers, and those with low immunity are considered
to be at most risk, but the disease is treatable with antibiotics.

In 1987, 13 people died in the Illawara and 53 cases of legionnaires' were recorded.

It was classed as the world's third largest outbreak.

But the health service's senior environmental health officer, Curtis Gregory, has dismissed
suggestions the current outbreak could become like the last.

Apart from the scale of the disease, it's the city's reaction this time around that
separates it from 1987.

"So far all our cases are recovering well and most have been discharged from hospital,"

Mr Gregory said.

"Our patient care is good - not that it wasn't in `87 but we've been able to intervene
a lot earlier in the cases because we've got the response protocol now."

The response protocol is important because when people were presenting with symptoms
in 1987, the city wasn't prepared, he said.

"Simply because they hadn't been exposed to it before, it took them a little while
to work out what they were dealing with," Mr Gregory said.

"In this instance we've known really quickly and that meant we've been able to have
a really positive response in terms of patient care, identification of additional cases
and also making sure their needs have been met in terms of having information about the
disease."

The 1987 outbreak was also the catalyst for legislation governing the control of legionnaires'
disease.

The job at hand now is to locate the source or sources of the outbreak via the health
service's epidemiological study.

Wollongong Mayor Alex Darling said it was still "business as usual" for the city.

"Our first priority has naturally been to identify and treat anyone affected by this
illness and ensure any potential risks are eliminated," Cr Darling said.

"We also want to send a clear message to visitors that our shops, offices, restaurants
and other buildings are open and operating as normal."

The SESIHS's investigation into potentially new cases is continuing.

AAP lmc/jel/kp/pb/sd

KEYWORD: LEGIONNAIRES (AAP BACKGROUNDER)

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