Legionnaires' disease struck 50% of homecoming holidaymakers in 2011

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According to the Health Protection Agency (HPA), about half of last year's reported cases of Legionnaires' disease in England and Wales were returning holidaymakers.

Holidaymakers suffering Legionnaires Disease

Of the 235 cases in 2011 of the respiratory disease, 116 concerned people returning from holiday. In the year before, 355 cases were reported, with 114 relating to returning travellers.

Legionnaires' disease normally affects vulnerable people, such as the elderly and those in already questionable health. Higher risk groups also include smokers, diabetics and people with weakened immune systems. Some 70% of the 2011 cases related to people suffering underlying health conditions, including around a 3rd related to heart patients.

The disease is normally caused by inhaling water droplets or the contents of aerosols contaminated with legionella bacteria, with taps, spa pools and shower heads common sources of outbreaks. Such water sources might have had temperature problems, or could have stored stagnant water for some time.

However, the HPA points out that Legionnaires' disease cannot be spread from person to person, but can only be contracted by breathing in contaminated water.

Early recognition of the infection is vital to ensuring that antibiotic treatment can be quickly administered. The first symptoms resemble flu, with fever, muscle aches, tiredness, headaches and a dry cough; all signs suggesting the eventual development of pneumonia. As well as the breathing issues related to pneumonia, diarrhoea and confusion can occur, with symptoms of Legionnaires' showing 6 or 7 days after exposure.

Prof Nick Phin, the HPA's head of Legionnaires' disease surveillance, said that while the risk of the disease is very low for most people, it can become severe pneumonia. "People who are more at risk of the infection should be aware of the signs and symptoms," Prof Phin said. "Health professionals should also remember to consider Legionnaires' disease as a possible diagnosis in individuals over the age of 50 with underlying health conditions and presenting with pneumonia-like symptoms, particularly if they are returning holidaymakers."

"Every effort is made to identify where a patient is likely to have acquired the infection so that once a likely source is identified, action can be taken immediately, such as disinfection of any suspected water systems, to reduce the risk of further cases."

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