3 February 2012
Legionnaire’s disease cluster: Costa Blanca, Spain
The Health Protection Agency (HPA) has received notification of eleven cases of Legionnaire’s disease in English tourists, and a further four Spanish cases, associated with a hotel in Calpe, Costa Blanca, Spain . All but one of the Spanish cases occurred in January 2012 and three of the English cases are reported to have died from their infection.
Control measures have been implemented and the hotel has been closed to all guests as of 2 February 2012 while investigations are ongoing.
Legionnaires’ disease is a bacterial infection usually causing pneumonia. Symptoms include cough, shortness of breath, and fever; gastrointestinal upset can also occur. The disease is more frequent in the elderly, smokers and those with pre-existing lung disease or chronic medical conditions.
Legionella spp. bacteria are distributed widely in the environment. They can live in many types of water including natural sources such as rivers and streams, and in artificial sources such as water-cooling towers, hot and cold water systems and spa pools. Tourists can become exposed to the bacteria if the water systems are not properly maintained and become contaminated.
Further information about Legionnaire’s disease is available in NaTHNaC’s Health Information sheet: Legionellosis.
Advice for travellers
The risk to tourists to Costa Blanca is low.
Travellers visiting Costa Blanca who develop an influenza-like illness (fever, cough, shortness of breath) during their stay or up to 14 days after their return home, and who believe they may be infected, should seek medical care for appropriate investigations and possible treatment. There are several effective antibiotics.
Advice for health professionals
Legionnaires’ disease should be considered as a potential diagnosis for cases of atypical pneumonia throughout the year. When appropriate symptoms are present, a history of travel should act as a specific prompt for clinicians to evaluate for Legionella infection.
Clinicians are advised to consider arranging urinary antigen testing of all suspected cases .
Information for health professionals assessing individuals with suspected Legionnaires’ disease is available from the Health Protection Agency.
A letter from the Department of Health (DH) alerting health professionals of these and possible further cases was circulated on 19 January 2012, and can be accessed via the DH website.
1. Health Protection Agency. Legionnaires’ cluster associated with a hotel in Spain. 3 February 2012. [Accessed 3 February 2012]. Available at: http://www.hpa.org.uk/NewsCentre/NationalPressReleases/
2. Department of Health. Legionnaire’s Disease. 19 January 2012. [Accessed 23 January 2012]. Available at: https://www.cas.dh.gov.uk/ViewandAcknowledgment/View