Update on Legionnaires’ Cluster Associated with a Hotel in Spain

3 February 2012

As soon as an association between the hotel and the UK cases was made, the tour operator and British Consulate offered all British guests at the hotel alternative accommodation and advised them to be aware of the signs and symptoms of Legionnaires’ Disease.

The Spanish health authorities assessed the hotel and implemented control measures, including disinfection of the water system, which can harbour the legionella bacteria that causes legionnaires’.

The Spanish health authorities and an independent consultant commissioned by the tour operator have carried out investigations at the hotel and the water system is considered to be the most likely source of the infection. The tour companies suspended bookings at the hotel while investigations are being carried out.

The HPA is working closely with the tour operator, colleagues in the European Centre for Communicable Disease Control (ECDC), the Association of British Travel Agents (ABTA) and the Spanish public health authorities in Madrid and Valencia to collect and share any further information which may assist in the investigation.

GPs in England and Wales have been alerted to the incident and encouraged to look for Legionnaires’ disease in any travellers with symptoms of the disease. The Department of Health (DH) has issued an alert to NHS health professionals and A&E departments to ensure they are alert to the signs and symptoms.

Professor Nick Phin, head of Legionnaires’ surveillance at the HPA said: “Legionnaires’ disease is a rare cause of pneumonia. It is not contagious so can’t be spread from person to person. However, it can cause a serious pneumonia particularly in vulnerable people, such as the elderly or people with pre-existing health conditions. We are reassured that the water system in the hotel is the most likely source of this outbreak and that the appropriate public health action has been taken by the tour operators to move guests and alert them to the signs and symptoms of Legionnaires’ Disease.

“The HPA will continue to assist the tour operators, ECDC, ABTA and the Spanish public health authorities who are leading on investigating this outbreak.”

Legionnaires' disease is a serious pneumonia caused by a bacterium called Legionella pneumophila. This bacterium lives naturally in water such as rivers and lakes. It is caught by breathing in small droplets of water contaminated by the bacterium. Legionnaires’ disease generally affects older people and those with other underlying illnesses. People in these groups can also have more severe symptoms and complications, which can be fatal. The infection usually responds to treatment with the appropriate antibiotics.

Early symptoms are flu-like with muscle aches, tiredness, headaches, dry cough, breathlessness and fever that can lead to pneumonia. As with any pneumonia, the patient can become very unwell. Diarrhoea and confusion may occur in addition to chest and breathing problems. It is usually six or seven days after exposure that the individual would begin to show symptoms.

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Notes to editors:

1. For further information about Legionnaires’ disease please visit http://www.hpa.org.uk/Topics/InfectiousDiseases/InfectionsAZ/LegionnairesDisease/ or NHS Choices: http://www.nhs.uk/conditions/legionnaires-disease/Pages/Introduction.aspx
2. For general travel health advise please visit the National Travel Health Network and Centre at http://www.nathnac.org/  
3. The Health Protection Agency is an independent UK organisation that was set up by the government in 2003 to protect the public from threats to their health from infectious diseases and environmental hazards. In April 2013, subject to the usual approvals procedures for establishing new bodies, the Health Protection Agency will become part of a new organisation called Public Health England, an executive agency of the Department of Health. To find out more, visit our website: www.hpa.org.uk  or follow us on Twitter @HPAuk .
4. For more information please contact the national HPA press office at Colindale on 0208 327 7901 or email colindale-pressoffice@hpa.org.uk . Out of hours the duty press officer can be contacted on 0208 200 4400.

Last reviewed: 1 May 2012