Barrow-in-Furness
August 2002
 


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Legionnaires` Disease Outbreak

The Health Authority have notified the Borough Council of an outbreak of Legionnaire's Disease in the Borough. The common factor of those suffering from the disease is that they have recently visited the town centre of Barrow.

The disease is contracted through airborne water droplets, often associated with air conditioning plants.
There is only one such plant in Barrow's town centre, and that is located on the roof of Forum 28 in Duke Street.

As a precautionary measure, this air conditioning plant was closed down at 4.40 p.m. on Thursday 1st August. No further infections could result from this this potential source.


Anyone who is worried they have the disease should contact their GP or ring NHS Direct on 0845 4647.

Anyone from outside Barrow who has visited the town since 1 July 2002 could have contracted the disease and if they displayed any pneumonia-like symptoms, they should also contact their GP.

Furness General Hospital has set up its own helpline to deal exclusively with Legionnaire's Disease enquiries - 01229 491 222, 223, 224 or 225.


4th August 2002

Latest information - facts


There are currently 62 patients in hospital. Of these:
 

BBC NEWS  LONDON 4th August 2002


15 August 2002

DISEASE TOLL HAS NOW REACHED 130
 

More than 130 people have been struck down by Legionnaires' Disease confirming fears by health experts that this could be the biggest outbreak in Britain.

The epidemic has claimed three lives in Barrow and the deaths have been felt acutely by the community.

However, experts still say the number of victims in this outbreak has been mercifully low.

The death rate for patients suffering from Legionnaires' Disease on average is in the region of 10 to 15 per cent.

Medics say swift response of Morecambe Bay Hospitals Trust in dealing with this epidemic has been the key to minimising the devastating effects of this killer disease.

The strain identified in this outbreak is a type one pathogen, the one that it cited in most of the big epidemics.

The success rate has been largely dependent on the co-ordinated response of hospitals across the country in identifying people with classic symptoms of the disease and treating them promptly.

Furness General Hospital, in Barrow, introduced a policy of closely monitoring patients suspected of having the disease and admitting them to intensive care as soon as they showed signs of deterioration.

Furness General Hospital medical director Dr Andy Luksza said: "The strain of Legionnaires' is the one, which is usually identified in outbreaks.

"It's a type one pathogen and it's one that's cited most commonly in most of the big outbreaks.

"Of the 130 people who have tested positive 30 required intensive care.

"What's been very different in managing patients in this outbreak is nationally we've introduced an early warning system.

"Twice every day members of the intensive care team would go and see all patients and if there was evidence they were deteriorating they would be seen by intensive care consultants.

"So patients were transferred to intensive care units and managed in a structured way rather than being managed on the general wards."

Two people are still critically ill with the disease and are dependent on ventilators.

A third person, Georgine Somerville, of Gloucester Street, Barrow, died on Tuesday.

An inquest to investigate the sudden death of the grandmother of three is due to be opened soon.


Legionnaires' disease cases rise

Four more people have tested positive for Legionnaires' disease bringing the total number of confirmed cases to 121.

The outbreak is now the worst in Britain for ten years and more people are expected to test positive for the bacteria over the weekend, said a spokesman for Morecambe Bay Hospital NHS Trust.

The total number of hospital patients displaying clinical symptoms of the disease, but not yet confirmed cases stands at 40 and 161 suspected or confirmed cases have now been treated by Furness General Hospital, after a total of 1,649 people were tested.

Fourteen patients are still in intensive care, and nine people are classed as high dependency, of which three are giving cause for concern.

A hospital spokesman said that they were continuing to see a reduction in the number of new suspected cases and the condition of the majority of people was improving, with 53 people being discharged after treatment.

Chief executive Ian Cumming said: "Since last Friday the Furness General Hospital has admitted over 330 patients suspected of having Legionnaires Disease.

"Thankfully, over half of these people proved not to be infected with Legionella Pneumophila and were discharged quite quickly.

"Three-hundred-and-thirty additional medical admissions to Furness General Hospital in a week is a phenomenal workload for our staff to cope with, but they have done so magnificently.

"Although we believe that the worst is over in terms of new cases presenting in this terrible outbreak, we will continue to see an increase in the positive test figures as results continue to come back from the laboratory."

Eighty-seven people remain in hospital and 19 suspected cases have not yet been admitted.


'Worst Is Over' in British Legionnaires' Outbreak
8 August , 2002
 

LONDON

British hospital officials tackling the country's worst outbreak of Legionnaires' disease for 17 years said on Thursday the number of new cases was beginning to tail off.

The hospital that is dealing with many of the victims, Furness General Hospital in northwestern England, said there had been a reduction both in the number of patients displaying symptoms of the deadly disease and of those testing positive.

"We are cautiously optimistic that the worst of this terrible outbreak is over," said the hospital's chief executive Ian Cumming.

He added, however: "It will be several days before we stop seeing new cases of Legionnaires' disease and many more weeks before we will have discharged all the people involved."

One 89-year-old man has died in the outbreak, and 110 have tested positive for the 'flu-like illness, which is a form of pneumonia.

The hospital said in a statement two patients were giving cause for concern, and a further 12 were poorly but stable.

Barrow-in-Furness health officials have tested 1,251 people for the disease, which they suspect began in an air-conditioning unit at a local civic center.


 6th August 2002

Cases of Cumbrian Legionnaires' disease still increasing

More than 90 people are now receiving treatment for Legionnaires' disease.

A total of 123 people with links to the Barrow-in-Furness area in Cumbria have confirmed or suspected cases of the bug.

Patients are being looked after in hospitals or are being cared for at home by their GPs.

Eight of those who have the disease did not need to be hospitalised.

Health officials at Furness General Hospital confirm 93 people as having contracted the disease.

Some 19 patients are in intensive care units at six hospitals across the north west of England, four of whom are giving doctors cause for concern.

The number of hospital patients with confirmed cases of the bug had risen by 10 since Monday night - in line with doctors' expectations of how the outbreak will progress over the next few days.


The worst of the Legionnaires' disease outbreak in Cumbria may be over, health officials have said.

A total of 64 cases of the potentially fatal disease, which has been linked to one death so far, have been confirmed in what is the biggest outbreak in Britain for 10 years.

Two intensive care patients remain critically ill but others in the unit are said to be making good progress.

Investigations into the outbreak have centred on the council-run arts and civic centre in Barrow-in-Furness.
 

A council official has been suspended and police have been questioning other staff about maintenance at the centre.

Eighteen people are in intensive care units in five hospitals across north west England.

Total Cases

64 cases
18 in intensive care - two critical
30 suspected cases

Source BBC London
5th August 2002

 


 
6 August 2002

More than 80 people are now confirmed to have developed Legionnaires' disease in the outbreak in Cumbria - with the total number affected thought to have reached three figures.

Four patients, among 19 in intensive care, are giving doctors cause for concern.

Three hospitals treating cases; Furness General Hospital, Lancaster Royal Infirmary and Westmorland General Hospital, have cancelled all non-urgent surgery this week to help cope with the biggest outbreak of Legionnaires' disease in Britain for 10 years.

Ten ambulance crews and an air ambulance has also been brought in from other regions.

Eighty-two people are confirmed as having Legionnaires' disease, with 32 more suspected cases.

Eight of those confirmed as having the disease, which has been linked to one death, are amongst those being treated by their GPs at home.

Source BBC News London


06 August 2002

Police investigating the fatal outbreak of legionnaires' disease in Cumbria could bring charges of corporate manslaughter against any organisation found responsible.

A spokesman for the Cumbrian force declined yesterday to rule out such a prosecution, which carries maximum penalties of life imprisonment and unlimited fines. Inquiries in Barrow-in-Furness have centred on the maintenance of an air conditioning unit at the council-run Forum 28 leisure complex, almost certainly responsible for the outbreak.

One of the first police tasks will be to interview Barrow council's technical manager Kevin Borthwick, who has been suspended on full pay pending the investigation.

Mr Borthwick declined to comment yesterday. But Dr Nick Gent, local consultant in health protection, said a "very poor state of maintenance" had been found in the unit's cooling ponds, and Legionella bacteria had been detected in it. Five days will be needed to establish any match with the bacteria that has infected 54 people.

Police named the man who died from the disease as Richard Macaulay, an 88-year-old great-grandfather.

Neighbours said Mr Macaulay, known as Gerry, had failing health and needed a stair-lift at home. Described in a death notice as a "very dear granddad" and "a much-loved great-granddad", he had survived his wife, Cecilia, and their two children, Alec and Brenda.

But his frailty and weak immune system left him an easy prey to the disease. He had been cared for by friends and an elderly relative after falling ill and died soon after his immediate family arrived in Barrow on Friday. "He was a nice old bloke who always said hello to me if I saw him in the street," a neighbour said. "He rarely left his home because he was so frail but I would see him popping out his front door for a bit of fresh air."

An inquest into Mr Macaulay's death will be opened and adjourned today.

Eighteen people remained in intensive care yesterday, 15 said to be "poorly but stable" and the rest comfortable. Doctors said a total of 64 people had been confirmed as having legionnaires' disease and another 30 were suspected of having it, in Britain`s biggest outbreak in 17 years.


The only fatality of the Barrow outbreak of legionnaire's disease was named yesterday as the number of confirmed cases reached 64.

He was Richard Macaulay, who was 88 and lived in the town where a faulty air conditioning system at the council's main leisure centre has been blamed for the infections.

Four patients are still giving doctors cause for concern in hospital intensive care units in the north-west, after complications in their lungs and kidneys. A further 11 are also in intensive care and 30 people suspected of having the disease are receiving treatment.

An inquest into Mr Macaulay's death will investigate whether he had been near the vent in a town centre alley, which has been described by local people as spewing water droplets and steam.

It was suggested by Mr Macaulay's family that he might not have been into Barrow's town centre recently because of failing health, and pathologists are checking his strain of the disease.

Ian Cumming, chief executive of Morecambe Bay NHS Trust, said local hospitals were coping well with the crisis and still had intensive care beds available. Other hospitals are on standby, but doctors are increasingly confident the outbreak has peaked.


August 6 2002 
    
      There was barely a shopper in sight yesterday at the indoor market in Barrow-in-Furness, where traders say customers have stayed away since the outbreak of legionnaires' disease last week.

      "I don't think people are panic-stricken, but they are worried," said Gill Bateson, 34. "I'm going to my GP now to have a check. I'm going on holiday this week and I'm worried I won't be able to get travel insurance without a doctor's note."

      Alongside the market, police have cordoned off the Forum 28 civic centre, where the legionella bacteria were found in a 30-year-old air conditioning unit. The unit billowed out steam into a passageway into Barrow's main shopping precinct.

      "I have to walk through here virtually every day because it's the main route from the buses to the shops," said Harry Richardson, a pensioner. "There is something lacking here for this to happen. Someone, somewhere has been negligent. But it's the whole system, not an individual." Mr Richardson's 63-year-old neighbour was diagnosed with the disease last week. At Wilkinson supermarket, next door to the source of the outbreak, information notices have been put up to reassure shoppers that "there is no ongoing risk in the store".

      Trade was down over the weekend, the store said, although it picked up yesterday. "We are now looking forward to working with other traders to rebuild confidence."

      At Furness General Hospital, officials said 18 people were in intensive care in five hospitals in the north-west. Ian Cumming, chief executive of Morecambe Bay Hospitals NHS Trust, said he believed the epidemic had plateaued. The hospital's accident and emergency unit had been busy "but not overwhelmed, and the pressure seems now to be off".

      The hospital was still working on the assumption that 100 to 130 people might contract the disease. The mortality rate for legionnaires' is generally 10 to 15 per cent - although Mr Cumming said that patients were recovering well. One man, aged 88, has died, and five people in intensive care were giving cause for concern.

      Last night a hospital spokesman said nearly 100 people were receiving treatment for the disease. He said 94 had been admitted, with 64 confirmed cases. About 30 people suspected of having the disease were also in hospital.

      Police said they were investigating the death on behalf of the Barrow coroner. They will examine the maintenance record of the air conditioning unit thought responsible for the outbreak. "It will be a long investigation and we are only into day three. We are not ruling anything out," police said.

      Barrow borough council has suspended a worker responsible for the unit's maintenance.  


Aug 4 2002
 

 70 in hospitals in Legionnaires' disease outbreak

Nearly 70 people are in hospitals across the north west of England following a massive outbreak of Legionnaires' disease.
Ten people who are thought to be suffering from the disease were admitted to hospital in Barrow-in-Furness overnight.

Some 39 patients are currently receiving treatment having been confirmed to have contracted the disease, while a further 30 men and women are awaiting test results.

Twelve patients are in intensive care units in Barrow, Lancaster, Blackpool and Chorley - and four of them are giving doctors cause for concern after developing complications.

An 89-year-old man died on Friday afternoon after contracting the disease.

Meanwhile, people across Barrow are expected to pray for those affected by the disease.

Ministers in churches across the town are also expected to lead prayers for the dozens of others who might become ill in the coming week and for the hundreds who are working day and night to care for them.

Canon Peter Mann, the Rural Dean of Barrow, says the town is slowly coming to terms with the fact it had become the centre of one of the biggest outbreaks of Legionnaires' disease in the UK in recent years.

"In churches across the town, we will be saying prayers for everyone and we hope and pray it does not get too much worse and there are no more victims," he said.

Public health officials say they are "confident" they have traced the source of the outbreak. Forum 28, a council-run arts and civic centre had been closed and investigations are being carried out to see whether poor maintenance is part of the cause.

 

 
1,000 PEOPLE A DAY STROLLED PAST A VENT LEAKING LEGIONNAIRE'S BUG.. AND THE COUNCIL KNEW IT WAS FAULTY
 
THE faulty air conditioning unit blamed for Britain's biggest outbreak of Legionnaire's disease had been left unrepaired for a month - despite the council being aware of the problem.

Shoddy maintenance probably led to steam carrying the deadly disease being pumped into a public alleyway used by more than 1,000 people a day, it emerged last night.

The news came as the outbreak left one 89-year-old man dead, five people fighting for their lives and four giving cause for concern."

Yesterday Cumbrian health chiefs made an international appeal to anyone who may have walked down the alley next to the Forum 28 arts centre in Barrow-in-Furness to seek urgent medical attention.

Medics are already handling 58 suspected or confirmed cases of the pneumonia-like disease.

The 10-day incubation period of Legionnaire's means the estimated total number of infections now stands at 130 people and medical experts fear up to 20 more could die.

Morecambe NHS Trust chief executive Ian Cumming said around 15 per cent of those infected would "not pull through".

Last night Barrow's regional director of public health Prof John Ashton confirmed basic failings by Barrow council's environmental health department had left the broken air conditioning unit a bacterial breeding ground.

He said: "It's been an open secret that for the past 20 years the environmental health has had a shortage of resources."

The area last night remained a sterile zone, cordoned off and barred to the public, despite experts' belief that the risk of infection is now over.

Prof Ashton said: "Control measures have been taken so it doesn't pose a further threat to public health."

Barrow Borough Council Leader Terry Waiting said the air conditioning was still operating up to an hour before the first cases were confirmed on Thursday.

He added: "The system has been broken since July 1.

"Several people knew about it including myself. I am a trained engineer and I knew there was a fault - there was steam coming out and water running down the side of the building.

"But of course I never thought of Legionnaire's."

A spokesman for Barrow Borough Council said it was working urgently with the Health and Safety Executive to find out what happened.

The families of nine people in intensive care - four in Furness General Hospital and five in the Royal Lancaster Infirmary - were last night anxiously awaited developments. A further 10 patients are described as "poorly".

Of the 32 confirmed cases and 26 suspected the youngest is aged 22 the oldest was the 89-year-old man who died.

The seriously ill are receiving artificial respiration and kidney dialysis as the infection spreads.

One relative, Susan White, revealed her mother Myra Gawron, 71, had the disease.

She said; "She has been really bad since Monday. She could not breathe."

North West region consultant epidemiologist Dr Qutub Syed said the extent of the outbreak continued to be a source of concern.

He said: "We expect the majority of people will come in within the next two to five days."

 

 
 4 August 2002
 

The number of suspected cases in a massive outbreak of Legionnaires' disease in Cumbria has reached 59.

There are 36 confirmed cases.

One man has died and a further 12 adults are in intensive care in hospitals across the north west of England.

Tests on three children, a girl of five, a boy of eight and a boy in his early teens, have proved negative.

The outbreak in Barrow-in-Furness is believed to have been traced to a suspected faulty air-conditioning plant in a council-run arts centre.

Public health experts believe poor maintenance of the plant could have been a factor in the outbreak.

Officials at Furness General Hospital said they still anticipated the number of patients receiving hospital treatment over the next two weeks to double.

Speaking at a news conference at the hospital, Ian Cumming, chief executive of Morecambe Bay NHS Trust, said: "The hospital continues to cope well with the large number of patients admitted from this outbreak."

Two patients requiring intensive care treatment were transferred from Barrow to hospitals in Blackpool and Chorley, Lancs.

Four of those in intensive care are giving doctors "cause for concern" after developing lung or kidney complications as a result of the disease


‘Twenty could die’ in Legionnaire’s crisis

A HOSPITAL treating victims of Legionnaire’s disease last night warned that up to 20 people could die in the UK’s worst-ever outbreak. An 89-year-old man has already died in Barrow-in-Furness, Cumbria, and there are 18 more confirmed and 11 suspected cases. Five patients are in intensive care.

A spokesman for Furness General Hospital said it was expecting up to 130 people to be admitted over the coming fortnight, of which between 15 and 20 could die.

Last night Forum 28, a council-run leisure facility opposite the Town Hall in Barrow town centre, was closed as a precautionary measure.

Water samples have been taken from the centre and the site has been cordoned off by police.

Dr Nigel Calvert, a consultant in communicable disease control, said: "This is the largest outbreak I am aware of."

Dr Calvert, who is in charge of the investigation into the outbreak, said patients were being interviewed in an attempt to determine where they caught the disease.

Asked if people should avoid the centre of Barrow, Dr Calvert said: "It is difficult to give cast-iron advice. We are doing our best to find a solution."



Legionnaires' source isolated

Officials believe they have isolated the source of the Legionnaires' disease outbreak in Barrow-in-Furness amid fears that it could have been caused by a council blunder.
 
Police cordon off Barrow's leisure centre
Forum 28, a leisure and civic centre opposite the town hall, was closed and cordoned off by police yesterday after a large air-conditioning unit on the roof was found to be expelling steam.

Water samples have been taken from the unit and officials believe it is the source of the water-borne bacteria.

So far an 89-year-old man has died in the outbreak with another five people remaining critically ill and four others being treated in intensive care at Furness General Hospital.

Thirty-two cases have been confirmed and dozens more are being treated for symptoms of the disease. The youngest person being treated is 22-years-old with the oldest victim being the man who died yesterday.

Prof John Ashton, the Regional Director of Public Health, said the air conditioning system could have been infected by the bacteria because of poor maintenance.

He said: "Looking at the maintenance and servicing of the plant it identifies the fact that for a long time the environmental health side of things has not tended to be as strong as it should be."

He added: "It is a fairly open secret that over the past 20 years or so Environmental Health has had a shortage of resources."

Cllr Terry Waiting said there had been no danger to 1,000 people who use the civic centre each day. But people walking through an alley alongside the building towards the town square could have been infected by inhaling steam leaking from the air conditioning unit, he said.

Cllr Waiting said: "There's no danger to anybody in the town at the moment. There has been a fault on the [air conditioning] plant but just about where it was, I could not say. Obviously there's something wrong."

Ian Cumming, chief executive of Morecambe Bay NHS Trust, said that doctors are expecting to treat up to 130 people for the disease over the next two weeks, of whom between 15 and 20 might "not pull through".

However, he claimed that the outbreak was under control. He said: "In terms of hospital perspective, we are coping well. We still have 20 beds. We have cancelled all elective surgery through to the middle of next week"

Hospitals across Cumbria and Lancashire have been put on stand-by and the NHS could cope with the outbreak, Mr Cummings added


 
An 89-year-old man has become the first to die in a major Legionnaires' disease outbreak in north-west England.

Doctors say dozens more people may have the illness, which kills up to one in seven of those who fall sick.

The outbreak, in Barrow-in-Furness, Cumbria, is the largest in the UK for a decade, and is potentially one of the biggest ever recorded world-wide.

The search is on to find the source of the infection before dozens more fall ill. Anybody who visited the Barrow area from 1 July onwards could be at risk

At present, 19 cases have been confirmed and another 36 are suspected.

However, the five to 10 day incubation period of the disease means that experts estimate as many as another 100 cases could arise over the next one to two weeks.

The source of the outbreak has not yet been determined. However, police cornered off a council-run leisure facility in the centre of the town on Friday evening. So far they have identified six possible sources.

Most of those who have so far contracted the disease come from Barrow and all had recently been in the centre of the town. This includes one person from Burnley who had been visiting.

Major incident

A major incident team has been set up to handle the outbreak, with Morecambe Bay NHS Trust on alert to deal with more cases.

Most of the patients are being treated at Furness General Hospital. Four patients are in intensive care. All non-urgent operations have been cancelled.

Ian Cumming, chief executive of Morecambe Bay Trust, said the hospital was expecting more patients.

"We have been seeing people coming through at the rate of six to 10 a day, so projecting that over 10 days we are expecting another hundred."

Mr Cumming said more deaths from the disease were very likely. Experts fear the final toll could reach 20.

Rushed to A&E

The father of one 18-year-old girl spoke on Friday of how he had rushed his daughter to hospital on hearing of the outbreak.

Speaking outside Furness Hospital, Bernard Hannaway from Barrow said: "She's been feeling ill for two or three days. She has been burning up and feeling sick and with this news today we thought we had better come and get it checked out."

Laura Hannaway is believed to have been in Barrow town centre throughout the week for interviews to join the RAF.

Initially, patients at the hospital had been diagnosed with pneumonia but when the number of cases rose signficantly above normal levels medical staff became suspicious. Test results received on Friday morning confirmed Legionnaires'.

Dr John MacFarlane, a respiratory infections expert, said: that if medical staff in Cumbria had caught the disease early, then the death rate could be minimised.

He said: "It's an infection you can acquire if you are in the vicinity of an affected water system but it is not an infection that you can pass on from one person to another.

If people think they have got a simple summer cold, then it probably is just a cough and a sniffle, but if the symptoms are clearly worsening, then in the current climate they probably should get checked out by their doctor."

Dr John Lee, of the Central Public Health Laboratory, said males over 50 who smoke or those with existing health problems were most at risk of the contracting the disease.

"People who have sudden onset of acute respiratory symptoms should attend their doctor and ask to be investigated if they are seriously ill."

"The most likely scenario is it has been caused by a cooling tower," he said.

"Depending on the site of the source, a very large proportion of the population in the town could have been exposed. It is very difficult to know how many people will be affected."


 3 August, 2002
Legionnaires' experts 'trace source'
Health experts are confident they have tracked down the source of the Legionnaires' disease outbreak in Cumbria but fears remain that up to 130 people could be infected.

With 55 people in hospital either suspected or confirmed with the disease and one man dead, officials are urging residents of Barrow-in-Furness not to panic.
 

Although other sources are being investigated, the finger of blame is pointing to an air conditioning system at a council-run civic centre in the town called Forum 28.

The plant was closed down at 1630BST on Thursday, hours after fears of a Legionnaires' outbreak first emerged, when it was found to be expelling steam.

At a news conference in Barrow on Saturday Professor John Ashton, regional director of public health, said: "It is a fairly big outbreak, but I am fairly confident that we will have this thing sorted out in the near future."

He said that there might be an "issue" with the maintenance of Forum 28's air conditioning unit.

"Looking at the maintenance and servicing of the plant it identifies the fact that for a long time the environmental health side of things has tended not to be as strong as it should be," he said.

Disease confirmed

Public health officials fear 130 or more cases of Legionnaires' disease will be diagnosed in the outbreak.

It has been positively confirmed in 24 people so far, of whom 10 are classified as poorly and nine are in intensive care, with five giving medical staff cause for concern.

The one death so far was an 89-year-old man on Friday.

Numbers of patients remained almost constant overnight, but the 10-day incubation period for the bacterium means officials cannot say the outbreak will not be as bad as first anticipated.

Anybody who visited the Barrow area from 1 July onwards could be at risk, although Legionnaires' cannot be passed on from one person to another.

The risk to people on board ships that have passed through Barrow is among the areas being looked at by the outbreak control team.

Death toll 'will rise'

There had been no danger to people inside the council-run civic centre but instead the steam - which is thought to have carried the bug - was being expelled into the street, council leader Terry Waiting has said.

Those walking through an alleyway alongside the building towards Barrow Town Square could therefore have become infected from inhaling the steam, he added.

At Furness General Hospital extra medical supplies are being brought in to deal with the rising number of cases and as intensive care beds fill up other patients could be transferred to other hospitals in Cumbria.

Ian Cumming, chief executive of Morecambe Bay Trust, said routine operations had been cancelled because of the outbreak, but the hospital was coping.

Those confirmed with Legionnaires' disease vary in age from 47 years old to 89. A number of those affected could have now left Cumbria.

Mr Cumming said more deaths from the disease were "likely" - it is thought around 15% of cases could prove fatal.
 

"If the source is a leisure centre, there will be lots of people coming and going, lots of people infected.

The outbreak is the largest in the UK for a decade.

A spokesman for the Public Health Laboratory Service, a public body which offers advice to health authorities, said this was a "significant outbreak."

But he said it needed to be kept in perspective given that the largest known outbreak was in Spain last year where nearly 800 people contracted the disease.

Most of those who have so far contracted the disease in Cumbria come from Barrow and all had recently been in the centre of the town. This includes one person from Burnley who had been visiting.

A major incident team has been set up to handle the outbreak, with Morecambe Bay NHS Trust on alert to deal with more cases.

Initially, patients at the hospital had been diagnosed with pneumonia but when the number of cases rose significantly above normal levels medical staff became suspicious.

Test results received on Friday morning confirmed Legionnaires'

"If the source is a leisure centre, there will be lots of people coming and going, lots of people infected.

The outbreak is the largest in the UK for a decade.

A spokesman for the Public Health Laboratory Service, a public body which offers advice to health authorities, said this was a "significant outbreak."

But he said it needed to be kept in perspective given that the largest known outbreak was in Spain last year where nearly 800 people contracted the disease.

Most of those who have so far contracted the disease in Cumbria come from Barrow and all had recently been in the centre of the town. This includes one person from Burnley who had been visiting.

A major incident team has been set up to handle the outbreak, with Morecambe Bay NHS Trust on alert to deal with more cases.

Initially, patients at the hospital had been diagnosed with pneumonia but when the number of cases rose significantly above normal levels medical staff became suspicious.

Test results received on Friday morning confirmed Legionnaires' Disease

 

Disease experts will be racing to identify the source of a Legionnaires' disease outbreak that has already infected at least 19 people.

All those affected come from the town of Barrow-in-Furness in Cumbria - meaning the source is most likely somewhere in the town.

With only a small proportion of those exposed actually falling ill, it is probable that very large numbers of townsfolk have come into contact with the Legionnaires' bug.

However, the teams scouring the town have the benefit of the failures endured and successes achieved during previous outbreaks.

And the most helpful aspect of Legionnaires' is that everyone has to have caught the disease in the same place - it cannot be spread from person to person.

The culprit is the Legionella bacterium, which lives in water - and needs to reach the lungs of its next potential victim.

This limits the areas in which it can thrive and spread to humans.

Lung entry

Water droplets carrying the bacteria have to be carried in an aerosol form into the lungs.

The finger of blame generally points at industrial water cooling systems in factories, air conditioning units that serve office buildings, or perhaps communal spa baths.

One of the first to identify water cooling towers as a potential Legionnaires' threat in the UK was Professor Raj Bhopal, now at Edinburgh University.

He investigated a major outbreak in Glasgow in 1984.

He said: "The investigators will be looking for links between the patients to lead them to the source.

"It might be a cooling tower in an industrial estate, a whirlpool bath or maybe even a fountain.

"There is a tendency when these things happen to panic and start looking everywhere, but you don't need to do that."

"It's standard epidemiology - there are techniques to link the sources of outbreaks."

Illness hope

He did, however, offer some reassurance to the people of Barrow.

He said: "If you are of general good health and fitness, even if you have been exposed you are unlikely to fall ill.

"Those who fall ill are generally those in whom there are other factors, or who are older or in poorer health.

"If it is picked up in reasonable time there are some very good treatments."

And he said that fears that domestic water supplies could be contaminated were likely to prove unfounded.

He said: "Big outbreaks such as this do not tend to be traced back to water systems in the home, but to those in big buildings."

Even if the source of the outbreak is never found, he said, it was probable that the number of infections would drop away on their own.

He said: "There tends to be a particular set of circumstances, perhaps involving weather conditions, that leads to an outbreak at a particular moment."

Dozens of people may have potentially lethal Legionnaires' disease, a Cumbrian hospital has confirmed.

And the search is on to find the source of the infection before dozens more fall ill.

At present, 19 cases have been confirmed and another 11 are suspected in Barrow-in-Furness.

However, the incubation period of the disease means that experts estimate as many as another 100 cases could arise over the next two to three weeks.

The infection is fatal in up to 15% of cases.

The source of the infection has not yet been determined. All the patients come from Barrow.

A major incident team has been set up in Barrow to handle the outbreak, with Morecambe Bay NHS Trust on alert to deal with more cases.

Air conditioning

The disease is caused by the Legionella bacterium, and is often spread through colonised air conditioning units.

This is why outbreaks often happen in the summer months.

There is an incubation period of several days between infection and the onset of symptoms.

At first, these are flu-like, followed by fever and chills, then a dry cough develops.

The worst-affected patients often have great difficulty in breathing, and hospitalisation is always required.

Antibiotics are used to treat it, and this can take several weeks.

Major outbreaks

The disease was first identified following an outbreak at a hotel hosting a conference of the American Legion organisation in 1976 - this gave the illness its name.

The first cases of Legionnaires' in this country were spotted in 1977 - but this was followed by a serious of major outbreaks in the UK linked to infected water cooling systems.

An outbreak in Stafford in 1985 affected 101 people - of whom 28 died.

Two outbreaks in central London in 1988 - centered on the BBC - affected 79 people, with three deaths.

To date, the world's largest outbreak was in Murcia, Spain, with over 650 confirmed cases.

However, scientists warn that climate change could lead to a higher rate of outbreaks in future.



Man dies in legionnaires` outbreak

Twenty hit by disease in town as hunt begins for cause

August 3, 2002

One man has died and at least 100 people are believed to have been infected in the worst outbreak of legionnaire's disease in Britain for a decade.

The man, 89, died last night and 19 other people in Barrow-in-Furness, Cumbria, were confirmed as suffering from the illness. A further 36 had developed similar symptoms.

Of the cases confirmed at Furness general hospital, nine were in intensive care last night and a the remainder were described as "poorly".

The only factor linking the patients is that they have all recently visited Barrow town centre.

Nigel Calvert, a consultant in communicable disease control who is leading the investigation into the source of the outbreak, said patients were being interviewed in an attempt to determine where they caught the disease.

Early indications suggested that they had all been within 500 yards of Barrow town hall. Anyone who had visited Barrow since July 1 could have contracted the disease and should contact their GP if they displayed any pneumonia-like symptoms, he said.

Up to 130 people are expected to be identified as having been infected over the coming fortnight, of whom 15 to 20 could die, said health officials.

Dr Calvert said if, as predicted, a further 100 patients were affected during the outbreak, it could be one of the biggest cases in the world.

Asked if people should avoid the centre of Barrow, he said: "It's difficult to give cast iron advice. We are doing our best to find a solution."

A council-run leisure facility, Forum 28, opposite the town hall was closed yesterday afternoon as a precautionary measure. Water samples were taken from the centre and the site was cordoned off by police.

One of those infected was confirmed as 71-year-old Myra Gawron, who fell ill earlier this week but was only admitted to hospital on Thursday.

Her daughter, Susan White, said her mother had been delirious at times since falling ill on Monday. "She got worse then I got a phone call to say she could not breathe," Mrs White said. "I went there straight away and I got her straight to bed. She couldn't walk and I had to carry her."

Furness general hospital has been put on full alert to deal with cases emerging in the next few days.

All elective surgery has been cancelled on Monday and Tuesday and other hospitals in the area are preparing to treat at least 10 people a day over the next 10 days.

Ian Cumming, chief executive of the Morecambe Bay hospitals trust, said: "People should try not to be concerned - I know that is easier said than done. We believe we can cope with people coming through the doors at Furness general hospital."

Mr Cumming advised people to contact their GPs if they had any concerns.

Initially some of the patients were diagnosed with pneumonia - but when numbers rose significantly above normal levels for the time of year, medical staff became suspicious.

"Over the last few days we have been seeing a number of people presenting at the hospital with a diagnosis of pneumonia - much more than we would expect to see," Mr Cumming said.

Legionnaire's disease is fatal in 10%-15% of cases, although younger people usually make a full recovery. It can be spread through air conditioning units, which is why outbreaks often occur during summer months.

It took its name from the first identified outbreak in 1976, at a Philadelphia hotel hosting the American Legion organisation.

In October 1998 the bacterium was found in part of the water supply at Buckingham Palace after routine tests were carried out. That year there were 226 cases of the disease in England and Wales and 25 people died.

Provisional figures from the office of national statistics showed there were 14 deaths from legionnaire's disease last year.

Increased vigilance and safety checks on water cooling and air conditioning systems have reduced the number of outbreaks.

John Lee of the Central Public Health Laboratory said the most likely scenario was that the Cumbrian outbreak had been caused by a cooling tower.

He said people who had a sudden onset of acute respiratory problems should contact their doctor.

Mark Britton, chairman of the British Lung Foundation, said: "Legionella is the most severe organism that causes pneumonia, and pneumonia can lead to death if not treated properly."

Friday August 2

Health officials investigate Legionnaires' outbreak

Nineteen people are suffering from Legionnaires' Disease in Cumbria.

A further 11 people in Barrow-in-Furness are suspected of having the disease, Morecambe Bay Health Authority says.
A team has been set up to investigate the cause of the outbreak.
It is looking at whether a contaminated air-conditioning unit is to blame.
Legionnaires' Disease, which can be fatal, got its name in 1976 when there was an outbreak of pneumonia among people attending an American Legion Convention in Philadelphia


Man dies in legionnaires' outbreak

3rd August 2002

A man aged 89 has died of legionnaires' disease and at least 19 people have been infected in an outbreak that has led to part of Barrow-in-Furness, Cumbria, being sealed off.

Nine of those diagnosed were in intensive care last night and 10 were described as poorly. A further 36 were suspected of having contracted the illness.

A search was under way to find the source and doctors warned that more people could be at risk. The outbreak of the disease, which kills up to 20 per cent of its victims, is one of the biggest recorded.

Some of the centre of the former shipbuilding town was closed to the public last night. A council-run leisure facility opposite the town hall was cordoned off by police, and water samples taken. Air conditioning units, in which the legionnaires' bacterium breeds, were shut down in eight buildings.

Asked if the disease was likely to claim more lives, Ian Cumming, the chief executive of the Morecambe Bay NHS Hospitals Trust, said: "Unfortunately, that is probably going to be the case."

The potential threat will only be known when the source is found. Hospitals ­ a common source of the bacteria ­ have been ruled out, so the signs point to the town centre, where all 20 people confirmed with the disease had been recently.

The infected patients had been arriving at hospital with a diagnosis of pneumonia but medical staff became suspicious when the number rose significantly above normal levels


 
Legionnaires' disease claims first victim

 2nd Aug 2002

An elderly man has died and nine people are in intensive care in what could be one of the worst outbreaks of Legionnaires' disease the world has ever seen.

Nineteen people have been confirmed as being infected with the disease, and a further 36 are showing "strong clinical suspicion", health officials said.

A council-run leisure centre in Barrow-in-Furness, Cumbria, has been closed as a precaution while tests are being carried out to identify the source of the outbreak.

Ian Cumming, chief executive of the Morecambe Bay Hospitals Trust, said up to 100 more people may have been infected with the disease.

All elective surgery at the hospital has been cancelled, and nearby hospitals are preparing to help treat as many as 10 new cases a day for the next 10 days, Mr Cumming said.

"The disease has an incubation period of between five and 10 days. We are looking at something in the region of another 10 people a day for the next 10 days.

"We are gearing up to be able to deal with another 100 cases," he said.

A spokeswoman for the Public Health Laboratory Service said there were up to 200 cases of Legionnaires' disease each year.

Between 10 and 15 per cent of patients in good health die from the disease.


Legionnaires' outbreak spreads

 3 Aug 2002

More than 50 people have been hospitalized with suspected Legionnaires' disease, following what could be the largest outbreak of its kind in the world.

One man has died, while another 19 people are confirmed to be suffering from the disease.

A further 36 patients are showing "strong clinical suspicion" of having the disease following the outbreak, which is thought to be centered around Barrow-in-Furness town centre in Cumbria.

A council-run civic centre opposite Barrow town hall has been closed as a precaution while tests are carried out to identify the source of the outbreak.

Yesterday, an 89-year-old local man became the first victim of the outbreak, which hospital officials said could claim up to 20 lives.

Ian Cumming, chief executive of Morecambe Bay NHS Trust, said around 15 per cent of those in hospital with Legionnaire's disease were unlikely to "pull through" - according to statistics based on previous outbreaks.

Predicting that around 130 patients would be admitted to hospital in the next fortnight, he said that between 15 and 20 patients might die from the current outbreak.

If those figures were borne out, the outbreak could be among the worst in the world, doctors said.

Dr Nigel Calvert, consultant in communicable diseases at the hospital, said if there were 100 cases it would be "one of the biggest outbreaks" he was aware of in the world.

His department is currently interviewing patients and relatives in a bid to determine similarities between cases.

"So far, the only thing that unites the cases is the fact they have all been in Barrow town centre in the two weeks before falling ill," he said.


Legionnaires` disease could hit 130 cases

One man dead in major outbreak of disease

A MAJOR outbreak of Legionnaires' disease could infect 130 people and has already killed an elderly man.

So far, 19 people have been struck down with the lethal disease, but there are 11 more suspected cases.
Experts are still searching for the source of the outbreak, but believe it is in the town centre of Barrow-in-Furnace, Cumbria.
Forum 28, a function suite and civic centre for the town was cordoned off by police last night.
The victim has not been named, but he is an 89-year-old local man.
Doctors say the outbreak could eventually kill between 10 and 15 of its victims.

Ian Cumming, chief executive of the Morecambe Bay Hospitals Trust, said: "We are gearing up to deal with another 100 cases. A team is investigating the outbreak." The disease is a form of pneumonia caused by bacteria which live in water droplets.

Young people generally make a full recovery, but elderly, unfit people can die from the illness.
Dr David Telford, medical director of the NHS Trust, said the mortality rate for the disease in hospital is 10-15 per cent.

Asked if this meant 10-15 people could die, he replied: "That's the logical conclusion."

The outbreak was noticed after large numbers of people came into Furness General Hospital.

A hospital spokesman said: "We are very busy indeed and we will be issuing guidance to the public."

All elective surgery at the hospital has been cancelled for Monday and Tuesday and other hospitals the area are preparing to help treat as many as 10 new cases a day for the next 10 days.

Dr Mark Britton, of the British Lung Foundation and a chest consultant, said: "If there are 19 confirmed cases and it is virulent, that is an extremely large outbreak."

 

3rd August 2002

Council building may be bug source

An outbreak of Legionnaires' disease could have been caused by poor maintenance of an air-conditioning plant in an arts centre.

The council-run Forum 28 arts and civic centre was closed on Thursday following reports that the air conditioning system had been pumping steam into the surrounding streets in Barrow-in-Furness town centre.
One elderly man has died and five more patients are fighting for their lives following the outbreak, which hospital says could kill as many as 20 people.
 


BRITAIN One dead, at least 18 infected in Legionnaires' disease outbreak

 August 3, 2002

 LONDON -- An outbreak of Legionnaires' disease in northwest England killed an 89-year-old man and infected at least 18 other people, an official said Friday.
Eleven other people were suspected of having the disease.
The cases were all reported in Barrow-in-Furness, Cumbria, in England's lake district. People hospitalized with symptoms of the disease told investigators they had been within 500 yards of City Hall, a health official said.


ONE person died and 18 more were being treated last night in what is feared will be Britain’s biggest outbreak of Legionnaires’ disease.

A further 21 suspected cases were undergoing tests in
Barrow-in-Furness, Cumbria.

Doctors fear the total number of victims could reach 130 — and that up to 20 of them are likely to die.

Nine patients were in intensive care last night and the other ten were "poorly". The dead patient, who was 89 was not named.

Communicable disease expert Dr Nigel Calvert said: “This is one of the largest outbreaks in the world.”

Experts were urgently trying to find the source of the outbreak.

The only common factor is that all patients had been in Barrow town centre within 500 yards of the town hall. It is thought the bacteria was spread by a contaminated air conditioning unit.

A council leisure centre near the town hall was cordoned off by police as scientists took water samples.

Laura Hannaway, 18, who had interviews to join the RAF at the centre, was taken to hospital feeling ill. Her dad Bernard said: “She’s been feeling sick and nauseous.”

One confirmed victim, Myra Gawron, 71, had not left her house for two years until last week. She went out to deal with local authorities after the death of her husband Edwin, 79.

Dr David Telford, medical director of the Morecambe Bay Hospitals NHS Trust, said the death rate from the disease was ten to 15 per cent.

Expert Dr John Kurtz said the death toll would depend on the age and health of the people affected.

He went on: “It is a form of pneumonia caused by bacteria inhaled on water droplets. It doesn’t spread from person to person.”

Operations at Furness General Hospital have been cancelled to cope with the outbreak and hospitals in Kendal and Lancaster are on standby.

Hospital trust chief executive Ian Cumming warned: “The incubation period is between five and ten days.

“We are looking at another ten people a day for ten days. We are gearing up to deal with another 100 cases.

“Incident teams believe the disease broke out in a public place.”

Legionnaires’ disease is named after an outbreak at an American Legion convention in Philadelphia in 1976.

Anyone who has visited Barrow since July 1 and has pneumonia-like symptoms should contact their GP.


3 August 2002

Bug leaves 1 dead, 5 critical

Five people are fighting for their lives in hospital following an outbreak of legionnaire's disease that doctors fear could claim up to 20 lives.

One man has died and nineteen people have been confirmed with the disease, nine of whom are in intensive care, while the remaining ten are in a poorly but stable condition.

Five of those are giving doctors "cause for concern", a hospital spokesman said. A further 35 men and women are suspected to have the disease following the outbreak in the Cumbrian town of Barrow-in-Furness.

A council-run civic centre opposite Barrow town hall has been closed as a precaution while tests are carried out to identify the source of the outbreak.

On Friday, an 89-year-old local man became the first victim of the outbreak, which hospital officials said could claim up to 20 lives.

Legionnaires' disease got its name in 1976 when there was an outbreak of pneumonia among people attending an American Legion Convention in Philadelphia. A total of 29 legionnaires died.

The disease is a form of pneumonia caused by bacteria which live in water droplets.

Ian Cumming, chief executive of Morecambe Bay NHS Trust, said that, historically, about 15% of those hospitalised with Legionnaire's Disease "would not pull through".

Predicting that about 130 patients would be admitted to hospital in the next fortnight, he said that between 15 and 20 patients might die from the current outbreak.

If those figures were borne out, the outbreak could be among the worst in the world, doctors said.
 


August 03, 2002

Killer bug strikes fear into thousands
 
  • Britain's worst outbreak of legionnaires' disease grips town
     
  • AN OUTBREAK of legionnaires’ disease has killed an elderly man and infected 18 others in what could be the UK’s worst ever case.

    A further 11 people in Barrow-in-Furness, Cumbria, are suspected to have the disease and according to experts as many as 130 more cases could emerge in the next week or so, of which up to 20 could die.

    Tens of thousands of people who have walked though the heart of the town in recent weeks could also be at risk of contracting the disease.

    A public health team has been set up to search for the source. The only common feature is that all those with the disease had been in Barrow town centre recently. The man who died was 89 and lived locally. He has not been named.

    One of the 18 confirmed as being infected with the disease was named last night as Myra Gawron, 71, who contracted it when she left her house for the first time in two years. Her husband, Edwin, 79, died two months ago and she had visited the council offices to organise changes to tax and benefits.

    Suspicion is focusing on an air-conditioning unit housed on the roof of the council-owned civic centre in the heart of the town near the main shopping street. Last night health officials closed the building and cordoned off the area.

    The unit was shut down on Thursday afternoon amid fears that it was pumping out contaminated water droplets over a walkway leading to the town’s main shopping parade.

    The cooling system is fitted 40ft up on the roof of the two-storey complex, next to its rooftop car park. Each day thousands of people walk past the centre, called Forum 28, which houses a 550-seat theatre, a restaurant, bar and 280-seat concert hall.

    The outbreak is highly unusual because the bacterium does not easily survive in the open air. It is thought that the recent humid weather may have helped it to flourish.

    Legionnaires’ disease is caused by a bacterium, Legionella pneumophila, which can survive in the water in air-conditioning units. The bacteria are inhaled but are not passed on from patient to patient.

    It is a serious disease that can lead to respiratory and liver failure. In the most severe cases it can prove fatal. “Legionella is the most severe organism that causes pneumonia, and pneumonia can lead to death if not treated properly,” Mark Britton, chairman of the British Lung Foundation, said.

    Public health officials targeted the air-conditioning unit on the civic centre, opened in 1972, because it was the only one in the town centre that used a water-cooling system.

    Ian Cumming, chief executive of the Morecambe Bay Hospitals Trust, said that health officials were preparing to treat as many as 100 more cases of the disease over the next ten days. All elective surgery at Furness General Hospital has been cancelled for Monday and Tuesday and other hospitals in Kendal and Lancaster are preparing to help.

    “The disease has an incubation period of between five and ten days. We are looking at something in the region of another ten people a day for the next ten days,” Mr Cumming said.

    Dr Frank Atherton, director of public health for Morecambe Bay Primary Care Trust, said: “People could still be exposed to the infection. There’s going to be a great deal of public concern. Anyone who has visited the area of Barrow since July 1 is potentially at risk from the disease.”

    Legionnaires generally strikes in the summer or early autumn, seasons when pneumonia is not common. Dr Atherton said that suspicion was aroused when more than the expected number of pneumonia cases were diagnosed at the hospital.

    Figures from the Public Health Laboratory Service show that there are up to to 200 cases of legionnaires’ disease in Britain each year. Provisional figures from the Office for National Statistics show there were 14 deaths from legionnaires in 2001.

    Mr Cumming said he believed the hospitals in the area could cope with the outbreak and urged residents not to be alarmed but to see a doctor if they became worried.

    Dr Britton said that 19 confirmed cases represented an extremely large and significant outbreak.

    Dr David Telford, medical director of Morecambe Bay’s Hospitals NHS Trust, said the mortality rate for patients in hospital suffering from legionnaires’ disease was in the region of 10 to 15 per cent.

     


    THOUSANDS of people in Barrow-in-Furness, many of them frail and elderly, are this morning waking up to the possibility that they may be incubating an illness that in previous outbreaks has killed victims by the dozen.

    Anyone who in the past month has wandered past the suspected source of the outbreak — the town’s civic centre — knows that they are potentially at risk. The weak are especially vulnerable to legionnaires’ disease and, because of its long incubation period, many will not know for some time if they have the infection.

    “It looks pretty bad,” said George Park, 56, a school caretaker, who lives 200 yards from the suspected contamination. “I am quite healthy so it may not affect me, but my friend’s mother goes in there for lunch. They do lunch for the elderly. These old ladies are going to be worried.”

    Cliff Brockbank, 63, who also lives in the town, said: “It is frightening to think of this kind of thing in your own town. It will be devastating for those who have been into the Forum recently. They will be left wondering, what if?” It is impossible to calculate just how many thousands of people have visited the council-run centre, which doubles as a theatre, a meeting place for groups and societies, and a tourist office.

    Last night the centre of town, usually thronging with Friday night revellers and late-night shoppers, was deserted as news of the first death spread. A few pedestrians who ventured past the town hall steered a path well clear of the modern Forum centre, whose water-cooled air-conditioning system has been identified as a possible source of the infection.

    Police officers have closed down the building and wrapped blue and white scene-of-crime tape around the doors.

    Elenor Ayres, 74, who has lived in Barrow all her life, said: “Why have they only just told us about this outbreak now? Why was there no warning to people like me?”

    At Furness General Hospital, a father of a teenage girl explained how he had rushed his daughter in after hearing of the outbreak.

    Bernard Hannaway, from Barrow, said that his 18-year-old daughter, Laura, had been feeling unwell for several days, but that the family became worried only after hearing about the outbreak of legionnaires’ disease. However, Nigel Calvert, a specialist in communicable diseases, urged residents not to panic.

    He said that a huge number of people had visited the town centre and the “vast majority” would not contract the infection, which is treatable if caught early.

     


     

     

     

     

     


    Email Denis

    legion@q-net.net.au