Cooling towers blamed for outbreak of deadly Legionnaires' disease that has killed one man and claimed 40 victims – and the toll will getter higher
Bacteria thought to have been transmitted via droplets of infected water from cloud of gas rising into the air
Man in his 50s dies from deadly bug in Edinburgh Royal InfirmaryTens of thousands at risk as epidemic could spread 44 square miles from source
Scotland's health secretary expects the number of cases to peak over the weekendSymptoms include coughing, chest pains, fever and chills

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UPDATED:

07:20 GMT, 7 June 2012

A man has died and another 12 patients are critically ill in intensive care following an outbreak of Legionnaires’ Disease.

In total at least 40 people in Scotland are thought to have been struck down by the infection.

Health officials admit the number of victims will continue to rise as it can take up to two weeks for people to present symptoms after being infected with the disease.

Checks: An Edinburgh distillery yesterday, one of the possible sources of the Legionnaires disease outbreak

Checks: An Edinburgh distillery yesterday, one of the possible sources of the Legionnaires disease outbreak

But the country's health secretary Nicola Sturgeion said she expects the number of cases to peak over the weekend.

Legionnaires’ is a potentially fatal lung infection caused by the Legionella bacteria. It is caught by breathing in contaminated water droplets and cannot be spread from person to person.

In this instance, the Scottish health authorities believe that the bacteria found their way into one of several cooling towers in the south-west of Edinburgh.

The tower then emitted a cloud of vapour with the bacteria in the tiny water droplets.

It is believed to be the worst outbreak of its kind to hit Scotland for 30 years. Most of the victims are thought to be men, aged from their mid-thirties to mid-eighties.

They were mainly living in the Dalry, Gorgie and Saughton areas in the south-west of the city. The patient who died was in his 50s and had another health condition.

Ms Sturgeon said that 16 cooling towers that have been identified as possible sources of the outbreak were chemically treated on Sunday night and Monday morning.

She said: ‘Given the incubation period for Legionnaires’ disease, we would expect to see further cases emerge over the next few days.

‘As you would appreciate, that’s a complex process because it involves, in many cases, dealing with critically ill patients.

‘This is the most significant Legionnaires’ outbreak we have had in Scotland since the early 1980s.

‘NHS Lothian have brought additional public health staff to bear to make sure that as much information about the behaviours, patterns and the recent histories of these patients is being gathered.

Outbreak: A man in his 50s has died and 15 people are in a critical condition after an outbreak of Legionnaires' at the Edinburgh Royal Infirmary

Outbreak: A man in his 50s has died and 15 people are in a critical condition after an outbreak of Legionnaires' at the Edinburgh Royal Infirmary

‘No link has been identified
between these patients other than a general association with the
affected area in the south-west of Edinburgh.

'What
that does is underline the view that the source of this infection is an
outdoor community source and not an indoor-specific source, such as … a
spa in a hotel.

‘Samples
have been taken from all of those towers and all of them have been
subject to what is called shock treatment which is effectively chemical
treatment to deal with the risk of infection, and there will be sampling
over the course of today around these towers.’

Dr
Duncan McCormick, chairman of NHS Lothian’s incident management team
said that although he was ‘confident’ they had identified the source,
more cases of Legionnaires’ disease were expected as it takes several
days to develop.

‘The
incubation period of the disease is between two and 14 days but the
average is five or six days, so we’re expecting to have more cases over
the next few days.’

Legionnaires’
is three times more common in men than women and mostly affects the
over 50s. The elderly, smokers, and those with cancer, diabetes and
kidney disease are also at higher risk.

Initial
symptoms include muscle pain, a fever, a persistent cough, chest pains
and sometimes vomiting and diarrhoea. Although it can be treated by
antibiotics, about one in ten patients will die.

Deadly: A conceptual image of Legionella Pneumophila bacteria, which causes Legionnaires' Disease

Deadly: A conceptual image of Legionella Pneumophila bacteria, which causes Legionnaires' Disease

It
is so called because it was identified at a hotel hosting a convention
of the American Legion veterans organisation in Philadelphia in 1976.

Chair of the incident management team Dr
Duncan McCormick said today that the cases were yet to peak, although he said he hoped the source of
the outbreak 'had been dealt with'.

All those affected are men and women aged between 33 and 74. The
first case was diagnosed just over a week ago, but last night panic
spread through the city as it become clear the area was in the grip of a major epidemic after a man died at the Royal Infirmary.

NHS Lothian said that the scale of the outbreak had escalated dramatically in the last 24 hours.

The potentially fatal infection is breathed in through droplets of contaminated water and could spread up to 44 square
miles from the source, affecting tens of thousands of people, and symptoms can
begin anytime from between two to 14 days after exposure to the
bacteria.

An urgent investigation has been launched into the cause of the outbreak, with industrial cooling towers in the south west of the city thought a possible source.

Samples have been taken from four
facilities, but legionella is a difficult bacteria to culture and
it could take up to ten days before results of the samples are
available.

Panicked locals last night took to Twitter to express their fears over the dangerous disease.

One wrote: 'Legionnaires outbreak !! Next to my house, scared of going out.'

Another added: 'Having had pneumonia in the last year or so, I'm a tad worried about this.'

A map showing the location of the Legionnaires' disease outbreak

A map showing the location of the Legionnaires' disease outbreak

Dr McCormick warned those at
greater risk from contracting the disease were 'older people,
particularly men, heavy smokers and those with other health conditions'.

KILLER BUG SPREADS LIKE WILDFIRE THROUGH WATER SUPPLY

Legionnaires' disease is a potentially fatal lung infection caused by the bacteria legionella.

The bacteria is commonly found in any freshwater areas but can sometimes find its way into artificial water supply systems.

It is contracted when small droplets of contaminated water in the air are breathed in, but is not spread from person to person.

The elderly, smokers, diabetes sufferers, those with kidney disease and cancer patients are most at risk, and men are three times more likely to contract the disease than women.

Symptoms
of the disease include headaches, muscle pain, high fever, chills, a
persistent cough, shortness of breath, chest pains and sometimes
vomiting and diarrhoea.

About half of those who contract the disease experience changes to their mental state, such as confusion.

Symptoms can start between two and 14 days after exposure.

The disease is treated by intravenous antibiotics.

Around 10% of people victims will die from arising complications.

Large
buildings such as hotels, hospitals and museums are more vulnerable to
contamination because they have larger, more complex water supply
systems, which can let the contamination spread quickly.

'I would like to express my sincere condolences to the family of the patient who died,' said Dr McCormick.

'I would urge anyone who develops symptoms of Legionnaires' disease to contact NHS 24 or their GP.

'People who fall into certain risk groups, these are males who are adults, who have an alcohol, drinking habit and have an underlying illness such as diabetes, or heart disease or lung disease – these people are at greater risk.

'These people should be very much aware that if they start feeling symptoms of flu-like illness, together with diarrhoea, cough and confusion, they should be consulting their GP or NHS 24 as soon as possible.'

The first case was identified on Monday May 28, and since then the numbers have grown steadily.

Dr McCormick said there was no threat to the city's public water supply.

'The public water supply in Edinburgh is extremely closely monitored and in addition it's not possible to contract Legionnaires' disease through drinking water.

'It's contracted through the inhalation of water vapour in the form of an aerosol and that doesn't and that doesn't happen through drinking water supplies.'

Once it has infected your lungs,
Legionnaires' causes a persistent cough and the coughing up of mucus
or possibly blood followed by chest pains, and sometimes vomiting and diarrhoea.

Around half of those with the disease risk changes to their mental state, and may find themselves confused.

The
source of the outbreak continues to be examined by officials from the
City of Edinburgh Council’s Environmental Health Service and Scientific
Service and the Health and Safety Executive.

Further
inspections will be carried out by the
Environmental Health Service, Scientific Service and the Health and
Safety Executive over the coming days to ensure control measures
continue to be effective.

A spokesman from the North British Distillery in Edinburgh, one of the possible sources of the bug, said: 'Our thoughts are clearly with the families of those affected by this situation.

'The North British Distillery is actively working with the relevant authorities on the matter and supporting their ongoing inquiries to ascertain the source of the Legionella bacteria.

'Industrial cooling towers are only one potential source of infection, and the North British Distillery is one of a number of sites in the area with industrial cooling towers.

'The site has been inspected and nothing of concern was found. However, we are awaiting the results of the analysis of the samples taken by Edinburgh City Council Environmental Health Department.

'We wish to reassure the local community that we will comply fully with any guidance issued by the relevant agencies.'