3 November 2011

Legionnaires’ disease cluster in Corfu, Greece - update

This updates the Clinical Update: Legionnaires’ disease cluster in Corfu, Greece, 10 October 2011.

Since early October 2011, the Legionella section of the Health Protection Agency (HPA), together with the European Centre for Disease Prevention and Control (ECDC), have been investigating cases of Legionnaires’ disease in England and Wales, associated with travel to the Greek island of Corfu [1]. As of 2 November, the HPA have identified 14 cases of Legionnaires’ disease and a further case of non-pneumonic legionellosis in English and Welsh tourists who holidayed in Corfu. These travellers, whose ages vary from 39 to 79 years, visited a number of different areas of the island [2]. No new cases have been identified in travellers returning from Corfu since 12 October 2011.

Extensive investigations into a possible source or sources continue to be undertaken by the Greek public health authorities, with assistance and advice from the HPA and ECDC. It is possible a definitive source may not be found.  

Advice for travellers

Legionnaires’ disease is a bacterial infection which usually causes pneumonia. Symptoms include cough, shortness of breath and fever. Gastrointestinal upset can also occur. The disease is more frequent in the elderly, smokers and anyone with pre-existing lung disease or a chronic medical condition.

Legionella spp. bacteria are distributed widely in the environment. They can live in many types of water, including natural sources like rivers and streams and artificial sources such as water cooling towers, hot/cold water systems and spa pools. Tourists can become exposed to the bacteria if water systems are not properly maintained and become contaminated.

The risk in Corfu is thought to be low and tourists are not advised to change their travel plans if visiting the island, but to be aware of the potential risks [2]. Anyone visiting Corfu who develops a flu-like illness during their stay or up to 14 days after their return home or who thinks they may be infected must seek prompt medical attention.

Further information about Legionnaire’s disease is available in NaTHNaC’s Health Information sheet: Legionellosis.

Country-specific health advice for Corfu can be found on the NaTHNaC Country Information Page for Greece.

Advice for health professionals: returned travellers

Legionnaires’ disease should be considered as a potential diagnosis for cases of atypical pneumonia throughout the year. A history of travel should act as a specific prompt for clinicians to evaluate for Legionella infection, when appropriate symptoms are present.

Information for health professionals assessing individuals with suspected Legionnaires’ disease is available from the Health Protection Agency.

References

1. Health Protection Agency. Legionnaires’ disease cluster associated with Corfu. HPR 7 October 2011; 5, 40. [online]. Available at: http://www.hpa.org.uk/hpr/archives/2011/hpr4011.pdf

2. Health Protection Agency. Update on Legionnaires’ cluster in UK travellers returning from Corfu. 2 November 2011. HPA Press release [online]. Available at:

http://www.hpa.org.uk/NewsCentre/NationalPressReleases

/2011PressReleases/111102LegionnairesupdateCorfu/

Links:

UK Health and Safety Executive: Legionnaires’ disease

Health Protection Agency: Guidelines for investigating single cases of Legionnaires’ disease.

NaTHNaC Health Information Sheet: Legionellosis