Status:
Resolved
Health alert:
130004
Date Issued:
19 Apr 2013
Issued by:
Dr Rosemary Lester, Chief Health Officer, Victoria
Issued to:
Emergency Departments, General Practitioners and other health professionals

Key messages

  • Four cases of Legionnaires' disease have been identified in the last month who have travelled overseas or interstate and returned through Melbourne Airport Tullamarine. The airport may not have been the source of the illness; this alert is being issued as a precaution.
  • Consider Legionnaires’ disease in patients presenting with an influenza-like illness or pneumonia who have travelled through Melbourne Airport Tullamarine between 1 March 2013 and 12 April 2013.
  • Rapid confirmation for Legionnaires’ disease can be obtained by urinary antigen testing. Sputum for legionella PCR and culture should be sought in all cases if possible.
  • Legionnaires’ disease is a Group A notifiable condition which requires immediate notification to the Department of Health.

What is the issue?

The Department of Health has recently identified four cases of Legionnaires' disease in individuals travelling  overseas or interstate through Melbourne Airport Tullamarine. As part of the routine response to these cases, all cooling towers at the airport have been treated and sampled. No evidence of legionella bacteria has been detected. These actions have been taken as a precaution.

Who is at risk?

People who have travelled overseas or interstate through Melbourne Airport Tullamarine between 1 March 2013 and 12 April 2013. Those at greatest risk of Legionnaires’ disease are people aged over 50, smokers or those with a chronic medical condition and/or suppressed immunity.

Symptoms and transmission

Cases typically present with influenza-like illness progressing to atypical pneumonia. Symptoms can include fever, cough, shortness of breath, headache, rigors, confusion, myalgia and vomiting/diarrhoea. Rapid confirmation of the diagnosis ofLegionella pneumophila serogroup 1 (which makes up the majority of Victorian cases) can be obtained by urinary antigen testing. Sputum for legionella PCR and 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 confirm.

Prevention/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 Therapeutic Guidelines) is recommended to cover Legionella bacteria.

Notification

Legionnaires’ disease is a Group A notifiable condition which requires immediate notification to the Department by telephone on initial diagnosis (presumptive or confirmed) with written notification to follow within five days.

For further information or to notify a case please contact the Communicable Disease Prevention and Control Unit at the Department of Health on 1300 651 160 (business hours) or 1300 790 733 (after hours) or go to: http://ideas.health.vic.gov.au/bluebook/legionellosis.asp