I am currently following the legionnaire's outbreak on the news. On Saturday there were 36 confirmed cases of legionnaire's disease, all living or working in the west of Edinburgh. There are 15 people in intensive care due to the disease and 1 person, Robert Air, has died due to it. It was predicted that the levels of the illness would peak this weekend as the possible causes of the outbreak are being shut down, investigated and treated. The last outbreak of a large number similar to this was from a cooling tower, which is capable of distributing the virus over a long distance via water droplets which are inhaled. Although they are investigating the source of the outbreak, it is possible that the source may never be identified, as past experiences have shown. This would be very undesirable as it would not aid to the further prevention of similar outbreaks.
Legionella bacteria grow well in warm temperatures, 35 to 46 degrees, but presence of this should only be seen as a problem if there are notably high levels of the bacteria. In addition many people may inhale the bacteria and show little to no symptoms.What makes some people more susceptible to the illness? Well, obviously those who are immunocompromised are more likely to suffer from symptoms, as are those who smoke or have lung illnesses. Most sufferers are middle aged or older. Aside from major outbreaks, it can be difficult to diagnose this disease due to the rarity and wideness of the symptoms, approximately 90% of cases go undiagnosed!
So how are the authorities dealing with this outbreak? Firstly they are treating the patients with antibiotics including erythromycin and clarithromycin. The patients are sustained with fluids to avoid dehydration and an oxygen supply. To prevent further spread, the treatment of possible sources, 3 buildings with cooling towers in the area begins as soon as possible, before confirmation of the presence occurs. Treatment involves using chemicals to kill the bacteria, although all buildings should follow the guidelines to prevent the spread and growth of bacteria, by keeping the water below 20 degrees and by keeping free of impurities and preventing stagnation. This includes households although large factories carry a higher risk. Water samples will be taken from these suspected sources and swabs taken from the cultures will be grown on a variety of agars over a long period of time in the preferred growth conditions in incubation.
I aim to follow the outbreak over time and hope that this raises awareness for the good practice to prevent the spread and increase the efficiency of diagnosis. I hope that the predictions of the numbers decreasing are realised because this disease has a very high mortality rate, of 5% and otherwise, the symptoms are, like most diseases, unpleasant. The outbreak of the disease must be terrifying for those in the area, not knowing if they, or their relatives, will fall ill. It is not the most friendly of diseases.
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