Legionnaires cases linked to a hotel in Ludlow

News from Public Health England and Shropshire Council

The Feathers Hotel in Ludlow has announced that it is temporarily closing to the public as a precautionary measure on the advice of health professionals from Public Health England (PHE) in the West Midlands and Shropshire Council.

The voluntary move follows laboratory test results establishing links between Legionella bacteria found in water samples from the hotel plumbing and two separate, confirmed cases of Legionnaires disease in guests (both from Merseyside) who stayed at the hotel. The first case was diagnosed in April 2017 and has recovered. Sadly, the most recently diagnosed individual, who stayed at the hotel in July, has died.

Dr David Kirrage, consultant with PHE West Midlands Health Protection Team, said:

“Firstly, my heartfelt condolences go out to those affected by this incident. On the discovery of the presence of Legionella at the hotel, the management implemented public health advice in order to minimise exposure to guests and staff. It closed the affected rooms, disinfected the water system and employed heating contractors to investigate the boilers and pipework.

“Isolated cases of Legionella infection are reported to us on a regular basis and investigated as a matter of routine. However, results from PHE laboratories on Monday 11 September 2017 confirmed that the strain of Legionella located in the hotel is indistinguishable from the samples taken from the two cases. Extensive work is now needed to overhaul and treat the plumbing in such an old building, so that guests can fully enjoy the facilities. The hotel has decided that with such a complex building it is easier and minimises risks to the public to close the hotel temporarily to conduct remedial works. Environmental health officers at Shropshire Council will continue to take water samples from the hotel during this time to test for the bacteria.”

Lee Chapman, Shropshire Council’s Cabinet member for health, adult social care and housing, said:

“I would like to offer my sincere condolences to the families affected by this very unfortunate incident. The health and safety of our residents and visitors in Shropshire is a key priority and Shropshire Council will always strongly encourage employers to make health and safety improvements that protect their customers and staff.

“Our health protection team provides advice on health and safety in the workplace including the control of Legionella bacteria in a wide range of water systems. The teams has been working closely with the proprietor of the hotel and under the direction of Public Health England to investigate the incident and ensure the right measures are in place to resolve this issue.

“Businesses have a clear responsibility to ensure that customers, staff and other visitors are safe on their premises and protected from any health hazards. It is reassuring to know that the proprietor is taking the necessary steps and arrangement to do this.”

Following consultation with PHE, the hotel is writing to guests who stayed at the hotel in the last two weeks to advise them to make contact if they have experienced any symptoms of Legionnaires disease. It is important to note that Legionnaires disease cannot be passed from person to person.

Legionnaires disease is a rare but potentially life threatening illness. Early symptoms include a ‘flu-like’ illness with muscle aches, tiredness, headaches, dry cough and fever which can then lead to pneumonia. As with any pneumonia, the patient can become very unwell. Diarrhoea and/or confusion may occur, as well as chest and breathing symptoms. It is effectively treated with a course of antibiotics.

Legionella bacteria are widely distributed in the environment. They have been found in hot and cold water systems and in some forms of industrial and commercial water cooling systems. Infection can be spread through aerosols from such water sources.

Further information

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About Legionnaires disease  

Legionella is a type of commonly occurring bacteria and can be found in around 10-20% of domestic hot water systems. Legionnaires’ disease is a severe and uncommon form of pneumonia caused by Legionella bacteria.

The majority of cases are reported as single (isolated) cases but outbreaks can occur. There are 350-400 cases a year reported in England and Wales, mainly in older adults. More information about Legionnaires’ disease is available on NHS Choices.

Who is affected?

All ages can be affected but the disease mainly affects people over 50 years of age, and generally men more than women. Smokers and those with compromised immune systems are at a higher risk.

What are the symptoms?

The early symptoms of Legionnaires disease include a ‘flu-like’ illness with muscle aches, tiredness, headaches, dry cough and fever. Sometimes diarrhoea occurs and confusion may develop. The incubation period normally ranges from 2 to 10 days. In rare cases some people may develop symptoms as late as three weeks after exposure.

Can you die from it?

Deaths occur in 10 to 15% of the general population and may be higher in some groups of patients.

How do you get it?

People become infected when they inhale Legionella bacteria which have been released into the air in aerosolised form from a contaminated source. Once in the lungs the bacteria multiply and cause either pneumonia or a less serious flu like illness (known as Pontiac fever).

Where do the bacteria live?

The bacteria are widely distributed in the environment. They can live in all types of water including both natural sources such as rivers and streams, and artificial water sources such as water towers associated with cooling systems, hot and cold water systems and spa pools.

They only become a risk to health when the temperature allows the legionellae to grow rapidly, such as in water systems which are not properly designed, installed and/or maintained.

Can the bacteria be prevented?

Control and prevention of the disease is through treatment of the source of the infection, ie by treating the contaminated water systems, and good design and maintenance to prevent growth in the first place. 

Why is it called Legionnaires disease?

An outbreak of this disease occurred in Philadelphia in 1976, among Legionnaires attending a state convention of the American Legion and led to naming the disease after this group. Subsequently, the bacterium causing the illness was identified and named Legionella pneumophila.

Is this a new disease?

No. Although the Legionella bacterium which causes the disease was identified in 1976, cases have been confirmed as far back as 1947 and some probably also occurred before then. However since 1976 further species of Legionella have been identified in the environment such as Legionella longbeachae, Legionella micdadei or Legionella bozemanii. A number of these species can occasionally cause Legionnaires disease.

How many cases are there in the West Midlands?

Number and population rate per million of confirmed cases of Legionnaires’ disease in residents of the West Midlands region by year of onset; 2012 – 2014

Information from Legionnaires disease: local summaries for England and Wales, 2014

https://www.gov.uk/government/publications/legionnaires-disease-local-summaries-for-england-and-wales-2014