Legionnaires’ outbreak: Shock at first death

Robert Air, also known as Bert Air, who died of Legionnaires' disease
Robert Air, also known as Bert Air, who died of Legionnaires' disease
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THE first victim of the city’s legionnaires’ outbreak died within hours of reaching hospital it emerged today – as the casualty count continued to rise.

Construction worker Robert “Bert” Air, 56, had been rushed to Edinburgh Royal Infirmary with suspected pneumonia on Tuesday morning before the true extent of the legionnaires’ crisis was known.

The father-of-two, who was originally from the Magdalene area of the city, passed away hours later and is thought to have contracted the illness while working at a building site in Gorgie Road.

Last night Mr Air’s brother Ronald said he was “devastated” by the death, as the tally of confirmed cases rose to 21, with a further 19 cases suspected.

“It was all over in 24 hours,” he said. “It was too quick. I keep thinking if he had gone to hospital sooner could something have been done?”

He went on to describe his brother as “a happy-go-lucky person”, and said: “He always got on with people wherever he worked. That was the sort of person he was. A nicer man you couldn’t meet.”

Colleagues today spoke of their shock at the tragic death. One co-worker, who declined to be named, said: “It really has come as a shock to everyone. Around half a dozen of us have now been tested for the illness. A few of the lads were feeling a little fluey and went to get checked. It turned out that one of them had contracted the illness but they gave him antibiotics and he came back to work.”

Mr Air was known to be a familiar sight around Leith, where he regularly walked his Shih Tzu dog Missy, and was a regular in the Links Tavern.

Several site workers took to wearing surgical face masks following Mr Air’s death, though the precaution was mostly abandoned later in the day.

John Smart, chairman and MD of Smart Construction, which is developing the site, paid tribute to Mr Air. “Bert was a good, conscientious employee and will be missed,” he said.

Ex-wife Christine Robertson said: “My daughter phoned me yesterday upset and telling me that Robert was dead. She was in shock at the news.”

Efforts are continuing to find the source of the outbreak, with samples from 16 cooling towers at four sites across the city being tested for legionella bacteria.

Health Minister Nicola Sturgeon yesterday revealed 21 patients are now confirmed as having the disease, with a further 19 suspected cases. One man has died, 12 are in intensive care, and two have recovered and been discharged. MSPs are expected to be given a further update later today.

NHS public health consultant Dr Duncan McCormick said a reduction in the number of people in intensive care over the previous 24 hours was “a sign that the treatment is working, while intensive care colleagues have commented that the antibiotic is working well”.

The disease has an incubation period of up to 14 days, so there are likely to be further cases.

Dr McCormick said he hoped the number of new cases would drop in the next five to six days.

Ms Sturgeon said: “To some extent how many cases we will see will depend on whether there was a single incident of a cooling tower emitting a contaminated cloud, or whether it was something that was ongoing for a few days before we did the shock treatment [cleaning process]. If it’s the former, we will hopefully see the cases starting to peak early. If it’s the latter it may take longer.”

One of the questions people were asked when they showed symptoms of the disease was whether they had attended Hearts’ Scottish Cup victory parade on Sunday May 20.

But NHS Lothian said many of the patients had not been at the celebrations and the only common factor linking those diagnosed with Legionnaire’s was that they lived and worked in the identified area of the city.

Testing has continued at the four sites in the affected areas which have water cooling towers. Burton’s Biscuit Company on Sighthill Industrial Estate and Macfarlan Smith and North British Distillery, both in Wheatfield Road, are among those undergoing inspection. Pensions, investment and insurance firm Aegon UK in Lochside Crescent has been confirmed as the fourth site.

Ms Sturgeon said yesterday that a three-pronged approach was continuing to try to identify the origin of the outbreak – epidemiologists are looking at the pattern of cases to narrow down the most likely source; the testing of microbiological samples from the cooling towers; and a Health and Safety Executive inquiry into the management and testing regimes at the plants.

The owners of premises with cooling towers are required to register them with health and safety officials so that they can be swiftly traced in the event of a legionella outbreak. They are also required to carry out their own regular testing and cleaning to prevent the disease, with regular checks also carried out by the HSE for industrial sites, and the city council for other sites, including Aegon.

Mike Harris, engineering manager of Aegon, said he was “very confident” that the towers at the firm’s offices were not the source of the outbreak. He said: “We dose them continuously with chemicals to prevent this. We take samples three times a week, as laid down by the government recommendations. Over and above that, they’re looked at by specialist contractors once a month and every quarter are checked independently.

“We take a sample on a Friday, Monday and Wednesday and incubate for three days and check it. One was taken on Friday and was clear when checked on Monday. We checked our Monday tests this morning and they were fine.”

Deborah Boni of Macfarlan Smith said: “The routine clean was last done at the beginning of May and the last sample was on May 14 – it was clear.”

A Burton’s Biscuit Company spokeswoman said the firm was not currently confirming when its last testing and cleaning had been done. North British Distillery was asked for the same details, but did not reply.

Health and safety expert Allen Wilson said that, in many parts of the country, there were fewer official spot-checks than in the past: “Sadly, due to cutbacks, many cooling towers are not being checked.”

Linlithgow-based firm Albagaia said it produced a test that would detect the legionella bacteria within 25 minutes at the scene of an outbreak.

Public health experts working on the Edinburgh outbreak have said it could take up to ten days to get the results of their own tests back. But Dr McCormick said: “With the 25-minute test, it’s not possible to get a result that would be meaningful for this investigation.”

Authorities co-ordinate to stem disease

When the first case of legionnaires’ disease was confirmed on Thursday, doctors did not automatically assume there was an outbreak – Scotland sees up to 40 cases annually.

However, when the third and fourth cases were confirmed on Sunday, NHS Lothian, the Health and Safety Executive and the city council put in place an Incident Management Team to deal with the outbreak.

Patients and relatives were interviewed to find out what they might have in common and investigations focused on water cooling towers.

On Tuesday evening, Health Secretary Nicola Sturgeon ordered the response to be taken over by the Scottish Government Resilience Room.

NHS Lothian has brought in its emergency plan to free up extra beds and NHS 24 have launched a dedicated phone line to deal with queries, on 08000 858 531.