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Final Issue: Volume 16 Number 51
Published on: 21 December 2006
Final Issue in PDF
Published: 21 September 2006 Volume 16, No.38 (PDF file, 211 KB)
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The rise in the number of recent cases of legionnaires’ disease reported to the Health Protection Agency is continuing. By 20 September, 162 cases had been reported to the National Surveillance Scheme for Legionnaires’ Disease in residents of England and Wales with onset of illness since 1 August. One hundred and thirteen of these cases are known to have become ill in August and 27 (so far) in September. In addition, a further 15 cases are assumed to have become ill in August and a further seven cases in September on the basis of the date of microbiological specimens. August and September are usually the months when most cases are reported each year. In August 2005, however, 63 cases were reported and in September 2005, 65 cases were reported. Thus, the number of cases reported for August this year is more than double that for the same time one year ago
Figure 1 Legionnaires' disease in residents of England and Wales, cases by month of onset 2004 to 2006
Cases have been reported from all Regions but there is no suggestion of a national outbreak occurring. Local clusters continue to be investigated for common sources of infection. Of the 113 cases with known onset in August, 21(18%) are associated with travel abroad and 17 (15%) with travel in the UK. The remaining cases are assumed to be community acquired.
Overall, the peak dates for onset of illness, excluding cases linked to travel abroad and those with unknown day of onset in August and September, range from 24 to 29 August (figure 2). It is not apparent yet whether any similar peaks or trends will be observed for the cases occurring in September.
Figure 2 All legionnaires' disease cases with known dates of onset, reported since 1 August (with travel abroad removed)
The HPA Centre for Infections (CfI), through its Respiratory Diseases Department, Respiratory and Systemic Infection Laboratory (RSIL) and Water and Environmental Microbiology Reference Unit (WEMRU) in collaboration with Local and Regional Services, has continued to convene a series of national teleconferences to ensure effective investigation of all cases and to collate and share information on the cases and clusters. Further cases, updated information on previously reported cases and reports of cluster investigations should be sent to the Respiratory Diseases Department at CfI. RSIL is undertaking confirmatory testing on all positive urine antigen samples submitted and requests clinical material (for example sputum or other respiratory tract samples) for culture, PCR and epidemiological typing. In addition, WEMRU is available to provide advice and assistance on environmental investigations and control of legionella.