The number of confirmed cases of Legionnaires’ disease following a deadly outbreak has risen to 24, the Scottish Health Secretary said today.
Cases increased to 24 by last night while a further 27 people are suspected to have the illness, Nicola Sturgeon told the Scottish Parliament.
Of the total 51, 14 are being treated in intensive care.
The single death from the outbreak was named locally as Robert Air, 56, from the Seafield area of Edinburgh.
Scotland’s leading bacteriologist Professor Hugh Pennington warned today that there would almost certainly be more deaths to come, with the disease expected to reach its peak this weekend. “I think there will be more deaths,” he said.
“The mortality rate is 10 per cent, which is one of the worst for infectious diseases, and for those with existing health problems it is a lot higher.
“I am worried about the people in intensive care and there will be people exposed last week who are not in hospital yet”.
The hunt is continuing for the source of the infection, and Professor Pennington said those responsible should face prosecution.
“This is not an act of God, this is a failure of maintenance by someone.
“Any business that is running a dodgy cooling tower could be prosecuted – and rightly.”
Ms Sturgeon said: “It remains the case that there is no identified link between these cases other than an association with the affected areas in the south west of Edinburgh.”Two people who have contracted Legionnaires’ have been discharged from hospital.
The other patients are being treated for the disease either in general hospital wards or in the community.
Ms Sturgeon passed on her condolences to the family of the dead man.
She said the outbreak of the disease in the capital was the worst the country has seen since the 1980s.
She told MSPs at Holyrood: “In Scotland, we would normally expect to see around 30 to 40 legionella cases each year. Typically around half of these cases are contracted abroad, but we also see indigenous cases, and it is not unusual to see single sporadic cases of community-acquired legionella.
“Across Europe, outbreaks are not uncommon, with dozens of outbreaks per annum and thousands of cases.
“However, outbreaks of the size we are currently seeing here in Edinburgh are rare in Scotland - the last time we had an outbreak of this scale was, I understand, in the 1980s in Glasgow.”
She explained that Legionnaires’ disease was an “uncommon but serious form of pneumonia, caused by bacteria that are distributed widely in both natural and artificial water supplies”.
Ms Sturgeon said: “In most cases, the disease is caused by the inhalation of water containing the bacteria and common sources can be showers, air conditioning, cooling towers, or humidifiers.”
Investigations have centred on four industrial cooling towers in west Edinburgh, including those at Burton’s Foods off Calder Road, pharmaceutical firm MacFarlan Smith in Gorgie and the North British Distillery.
People showing symptoms of the disease are being asked if they attended Hearts’ Scottish Cup victory parade, any Jubilee street parties or other large gatherings in a bid to discover any links between those with the bug.
But NHS Lothian said the only common factor established so far was that all those affected lived or worked in the Dalry, Gorgie or Saughton area.
City resident Leanne McLaren has told friends on Facebook how her father was struck down with the illness several days ago and had been recovering in the bed next to the man who died.
She wrote: “It couldn’t get any worse, they have found the legionella bug in his body [legionnaires’] so that’s what the pneumonia is. He’s on a ventilator now and the public health board will be investigating to find out where he got it.”
In a later post she said her father was being moved to St John’s Hospital in Livingston as the ERI created room to cope with the influx of new legionnaires’ patients.
But after the illness claimed its first life she said medical staff had reversed that decision.
Patients are being treated at three hospitals – ERI, St John’s and the Western General. Last night the ERI enacted its its emergency plan which involves clearing some wards and using them as intensive care units.
Samples have been taken from cooling towers at four industrial sites thought to be the most likely source, but the results will take up to ten days. Even then, it may not be possible to confirm where the disease came from.
In the meantime, the towers have been flushed with a high-chlorine solution to kill the legionella pneumophila bacteria, which cause the disease.
With an incubation period of up to 14 days, it is thought that more people could already be infected and not yet be showing symptoms.
Dr McCormick, consultant in public health medicine for NHS Lothian, said he hoped the single fatality so far would be an “isolated case” but could not “guarantee it”. And he added that investigations “frequently do not find the source”.
“The disease frequently affects people who have underlying health issues, particularly men who smoke, drink or have chronic illnesses such as liver disease or bronchitis,” he said.
“If we are correct about the source of the outbreak being the cooling towers, we would expected to see people with symptoms present themselves over the next five or six days, followed by a decline in the number of cases. But we would expect an increase in the number of cases before then.”
Business carries on as usual but many questions remain
CAFES thronged with lunch-time diners and roadways clogged with midday traffic. Pubs open and pavements bustling – had Gorgie Road not seen the news?
In the throes of a legionnaires’ outbreak, residents and businesses ploughed on regardless, but privately some spoke with genuine fear over the escalating crisis, asking: “When will it end?”
Scott Taylor, 45, owner of Scott’s Jewellers in Gorgie, said he had returned from holiday to find the area gripped with discussions about a peculiar disease.
“I have just come back from holiday and just heard all the talk about it. I’m most worried about my wife, who has a bad lung condition – something like this would probably kill her.
“All the customers are talking about it and everyone seems to be quite concerned.
“I don’t think there’s been enough information being put out there, it could be all across the city now and that’s what’s worrying.”
The area’s main visitor attraction – other than Tynecastle Stadium – had seen a quiet day’s trade. But footfall at Gorgie City Farm may have been as affected by wet weather as concerns over illness.
Andrew Tweedie, general manager at the farm, said “It’s been a miserable day outside so that is probably why it is quiet today.
“But I have spoken to people at the council’s environmental health department who advised us that there was no significant risk to the public and no need for the farm to take additional precautions and we opened as normal.
“Obviously our thoughts are with people who are unwell.”
Gorgie veteran hairdresser, Sam Rizzo, said questions were being asked about industrial cooling towers in the area.
“People have been saying it must be the fault of some company with these cooling towers. I’ve had people telling me to shut the shop door to keep the air out but I can’t see what difference that would make anyway.”
Agnes Buchanan, 73, said she remembered the last outbreak of the disease.
“I remember everyone was really frightened last time and this is wors.”
Allen Wilson, health and safety expert on dealing with legionnaires’ disease
It is unlikely that they will find the source as the perpetrator is likely to have now chlorinated and cleaned the tower.
Sadly, due to cutbacks within councils, environmental health officers and also the Health and Safety Executive, many cooling towers are not being checked.
In the outbreak last year in mid- Wales, the source was never identified. In a statement, the authorities claimed that they had 100 staff searching for the source.
If, however, they had just a couple of staff carrying out proactive inspections, it is likely that the outbreak would never occurred.
I believe this type of outbreak will become more commonplace as time goes by.
The legionella bacterium attaches itself to positive charged water droplets or bubbles and becomes airborne. Experts believe that inhaling less than ten of these microscopic droplets (they are about one third of the size of a red blood cell) can cause this virulent form of pneumonia.
This disease can and has killed.
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A dedicated NHS 24 helpline has been set up for anyone who fears they may have symptoms of legionnaires