Outbreak of deadly Legionnaires' disease that has killed a man and claimed 74 victims 'could get worse' as finger of blame pointed at distillery
Health chiefs questioned over delay in investigating all possible avenuesLabourer Robert Air, 56, died from deadly bug in Edinburgh Royal InfirmaryBacteria thought to have been transmitted via droplets of infected water from cloud of gas rising into the airTens of thousands at risk as epidemic could spread 44 square miles from source
Scotland's health secretary hopes cases peak over the weekendSymptoms include coughing, chest pains, fever and chills

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UPDATED:

22:01 GMT, 8 June 2012

A whisky distillery last night found itself at the centre of the Legionnaires’ disease outbreak after failing safety checks on a cooling tower.

The North British Distillery Company was yesterday served with an Improvement Notice by the Health and Safety Executive (HSE).

The watchdog found the firm’s tower had not been properly treated with chemicals to kill bacteria, including legionella.

Scotland's health secretary said the number of cases could still rise, despite a chemical clean-up of the industrial site thought to be responsible.

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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

An HSE statement said the improvement notice does not mean the tower concerned is where the outbreak originated.

The firm has already taken all three of its cooling towers at the site out of operation.

Scottish Health Secretary Nicola Sturgeon has said it is 'not always possible to conclusively determine the precise source of an outbreak'.

The dead man has been named locally as
Robert Air, 56, from the Seafield area of Edinburgh, who had reportedly
been working as a labourer on a building site in Gorgie before becoming
unwell.

Another
14 patients are critically ill in intensive care following the
outbreak, with 28 cases confirmed and 46 suspected. Ten people have now been discharged from hospital.

It can take up to two weeks for people to show symptoms after being infected with the disease. The potentially fatal infection could spread up to 44 square
miles from the source, affecting tens of thousands of people.

Two patients are being treated outside of the NHS Lothian area – in the Highlands and in the North of England.

Ms Sturgeon said: 'I want to stress that, although these patients are being treated elsewhere, they are considered part of the south-west Edinburgh outbreak. They have had association with the affected area.

'I would hope that over the next few days those investigations will start to deliver more specific answers on where the source of the outbreak might be.'

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

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

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.

Scottish health authorities believe the bacteria may have 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.

The outbreak is believed to be the worst of its kind to hit Scotland for 30 years. Most of the victims diagnosed so far are men aged from their mid-thirties to mid-eighties, mainly living in the Dalry, Gorgie and Saughton areas in the south-west of the city.

All those affected are men and women aged between 33 and 74.

A spokesman from the North British Distillery in Edinburgh 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.

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

'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.'

Ms Sturgeon said 16 cooling towers
identified as possible sources of the outbreak were chemically treated
last week and a fresh round of chemical treatment is under way in the
capital.

She said: ‘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.

A map showing the location of the Legionnaires' disease outbreak

A map showing the location of the Legionnaires' disease outbreak

Dr
Duncan McCormick, chairman of NHS Lothian’s incident management team
said: 'We’re doing everything we can in terms of early diagnosis,
appropriate treatment and intensive care, but I think we can’t rule out
any further deaths at this stage.'

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.

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.

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.

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.

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

'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 soared.

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.'

VIDEO: Latest update from Scottish Health Secretary Nicola Sturgeon

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