Date: Fri 22 Dec 2000
From: ProMED-mail <promed@promedmail.org>
Source: The Age, 23 Dec 2000 [edited]
>

Legionella Death Hits the Royal Melbourne Hospital
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Hundreds of people may have been exposed to legionnaires' disease from
contaminated air-conditioning cooling towers at the Royal Melbourne
Hospital. Health authorities yesterday confirmed that a patient who died
on 12 Dec almost certainly contracted the disease at the hospital. He had
been there for more than 2 weeks and the maximum incubation period is
usually 10 days.

Legionellosis is a rare form of pneumonia which has a death rate of up to
20 per cent. While 3 other male patients have also tested positive, it is
not known whether they contracted the disease at the hospital.

John Carnie, head of the Department of Human Services' communicable
diseases division, said yesterday the hospital towers were made safe as of
15 Dec, but urged anyone who visited the hospital in the past month and was
having respiratory problems to see their doctor.

Dr. Carnie said people in hospital may be more vulnerable to infection,
especially if their immune systems were already compromised. He said
legionellosis could be diagnosed by a simple urine test so no one should be
deterred from being tested during the holiday period.

Graham Brown, the head of the Victorian Infectious Diseases Service,
located at the hospital, said the patient who died would most likely have
been infected by airborne particles of legionella bacteria sprayed from the
cooling towers when he went out on a balcony or outside the hospital.
Professor Brown emphasized that the bacteria were not in the
air-conditioning system inside the hospital. He said there was no
conclusive evidence to link all four cases to the hospital's towers, but
all the cases were being investigated.

The patient who died was confirmed as having legionella on 15 Dec and the
Department of Human Services was called in the same day. Its officers took
samples and dosed all the towers with chlorine that day to prevent any
ongoing infection. The results from the samples taken then came back on
Thursday and revealed that 2 of the hospital's 12 cooling towers had low
levels of the bacteria.

Of the remaining 3 patients confirmed as having legionellosis, 2 were
admitted with flu-like symptoms, suggesting they may have already been
infected when admitted. The hospital discharged 2 of the patients; the
third remains in hospital but is improving.

The patient who died was admitted in late November with an unrelated
illness. His condition deteriorated, he developed a fever and was tested
for a variety of conditions, including legionella. Despite treatment, he
died on 12 Dec.

Victoria has had a record number of legionellosis cases this year, with 244
notifications, including 9 deaths. This includes the 113 Victorians (2
of whom died) who caught legionella at the Melbourne Aquarium.

Professor Brown said infection occurred by inhaling aerosols containing the
bacteria and could not be contacted through human-to-human transmission.
The aquarium victims were most likely infected when they inhaled infected
spray from the building's cooling towers as they queued outside.

The incubation period for the disease is 2 to 10 days and can only be
diagnosed once flu-like symptoms appear.

[Byline: Mary-Anne Toy]