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Piccadilly Circus legionnaires' disease outbreak

J M Watson¹, E Mitchell, J Gabbay

¹PHLS Communicable Disease Surveillance Centre, London.

Journal of Public Health Medicine

|September 1, 1994

Summary

Legionnaires' disease outbreaks in London were linked to contaminated cooling towers. Proper maintenance of these systems is crucial to prevent future Legionella pneumophila infections.

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Area of Science:

Epidemiology
Infectious Disease Control
Environmental Health

Background:

An outbreak of legionnaires' disease occurred in central London in January and February 1989.
An Infection Control Committee was established to investigate and implement control measures.

Purpose of the Study:

To describe the investigation and control of a legionnaires' disease outbreak.
To identify the source and implement control measures for Legionella pneumophila.

Main Methods:

Epidemiological survey and case-control study of community-acquired pneumonia cases in central London.
Identification of causative organism, Legionella pneumophila serogroup 1, in patients and environmental samples.

Main Results:

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Thirty-three confirmed cases (five deaths) and ten suspected cases (three deaths) were identified.

A strong association was found between illness and visits to the Piccadilly Circus area.

Legionella pneumophila serogroup 1 was isolated from patients and inadequately maintained cooling towers in the vicinity.

Conclusions:

Wet cooling systems, including cooling towers, pose a continuing risk for legionnaires' disease.
Adequate maintenance and risk assessment of cooling towers are essential.
New regulations require notification of wet cooling systems to facilitate outbreak investigations.