Status:
Active
Health alert:
AL200324
Date Issued:
24 Mar 2020
Issued by:
Dr Angie Bone, Deputy Chief Health Officer (Environment)
Issued to:
Health professionals and laboratories

Key messages

  • The department is investigating an outbreak of cases of Legionnaires’ disease (Legionella pneumophila, serogroup 1) in the suburb of Brunswick, Melbourne. As of midday on 23 March 2020, there have been four confirmed cases.
  • All affected individuals either reside in or have spent significant periods of time in Brunswick.
  • Be alert for Legionnaires’ disease in patients with influenza-like symptoms, particularly those with severe pneumonia, who have been around the Brunswick area since February 2020.
  • If you suspect Legionnaires’ disease, request urinary antigen testing through your normal pathology provider. As a priority, order Legionella culture on sputum, and undertake serology on blood at symptom onset and 4-8 weeks later (as paired sera).
  • The Department has identified a general increase in legionellosis in the first quarter of 2020. Consider alternative diagnoses to COVID-19 for respiratory infections and undertake appropriate investigations.
  • Legionnaires’ disease is an urgent notifiable condition which requires notification upon initial diagnosis or clinical suspicion (presumptive or confirmed) as soon as practicable and within 24 hours on 1300 651 160.

What is the issue?

The Department of Health and Human Services has now identified four confirmed cases of Legionnaires’ disease involving individuals who have spent time in the Brunswick area, including Sydney Road. All cases have required treatment in hospital. All had symptoms commencing in February and March 2020.

The department is continuing to investigate notified cases of Legionella infection to identify the possible source of their illness. Identified cooling towers in Brunswick have already been sampled and disinfected and further investigations will continue.

There have been no positive results for Legionella bacteria in the tested towers to date.
It is important that all suspected cases of Legionella infection are immediately notified to the department to ensure that appropriate control measures are in place.

Who is at risk?

People aged over 50 years, smokers, heavy drinkers, people with diabetes or chronic lung disease and those with an impaired immune system are most at risk. However, we have seen cases in individuals less than 50 years of age.

While those involved in this outbreak have spent significant time in the Brunswick area, it is important that clinicians continue to consider testing for Legionella pneumophila in any patient with a compatible illness.

Symptoms and transmission

Legionnaires’ disease often presents with initial influenza-like symptoms such as myalgia, headache, fever and cough, and may progress to atypical pneumonia, sometimes with confusion.

Rapid confirmation of the diagnosis of Legionella pneumophila serogroup 1, which makes up the majority of Victorian cases, can be obtained by urinary antigen testing. Sputum for culture should be sought in all cases if possible. A four-fold rise in titre between acute and convalescent sera is also diagnostic, however, this may take two to four weeks to develop.

Prevention and treatment

Early diagnosis and treatment with appropriate antibiotics is important in reducing the severity of illness and the risk of severe complications. Referral to hospital is often required for confirmed cases. Empirical treatment of moderate or severe community-acquired pneumonia (as per the current edition of the Therapeutic Guidelines) is recommended to cover Legionella bacteria.

More information

Clinical information

  • Legionnaires’ disease is an urgent notifiable condition which requires notification upon initial diagnosis or clinical suspicion (presumptive or confirmed) as soon as practicable and within 24 hours.
  • For further information or to notify a case please contact the Communicable Disease Prevention and Control Unit at the Department of Health and Human Services on 1300 651 160 or visit Legionellosis (Legionnaires’ disease)

Consumer information

Contacts

For more information please contact the Communicable Disease Prevention and Control section at the Department of Health and Human Services on 1300 651 160 (24 hours).


Learn more about the Chief Health Officer

Follow the Chief Health Officer on Twitter