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Cases of Legionnaires’ disease in England and

Wales to the end of June 2017

Knowledge

2017 Mid-year Legionnaires’ disease numbers in England and Wales.

An analysis of Public Health England’s (PHE) monthly Legionella report which provides a summary of data extracted from the national Legionella database for confirmed cases of Legionellosis in residents of England and Wales, as reported to the national surveillance scheme, shows the following summary. Whilst the report states “The report may not provide an accurate representation of Legionella activity in England and Wales during this time period due to delays in reporting. This means that the data for this month may not be comparable with data for the same period in previous years.” An email correspondence with the PHE confirms the 2017 numbers are accurate at the end of June 2017. * cases confirmed to have pneumonia and laboratory confirmation of Legionella infection; includes some with incomplete data. The chart shows some interesting figures with an overall increase of 26.5% increase in numbers in 2017 over 2016, however this hides the fact that if overseas travel is excluded, leaving only England and Wales, then the numbers show a reduction of 7.1% June year to date in 2017 compared to 2016 (65 vs. 70). For comparison, the annual numbers for 2016 as a whole year showed a total of 345 cases with 146 being Travel abroad, leaving 199 as England and Wales only cases. In 2015 the numbers were 371 in total and 197 as England and Wales only cases. The “domestic only” numbers show a continued good control as the 2015 number for June year to date was 66 cases, 2016 was 70 cases and 2017 is 65 cases. If the travel abroad numbers show the same “seasonality” as previous years then there will be about 247 (based on 2016 seasonality) to 226 travel abroad cases (based on 2015 seasonality) which will likely show an increase in 2017 total cases over 2016 assuming the England and Wales “domestic” numbers remain stable. What might account for these numbers? The static level of the England and Wales “domestic” numbers are encouraging and in my experience, this is, in part, due to sites becoming more experienced in managing the requirements of L8 4th Edition and HSG 274 which were released at the end of 2013 and beginning of 2014. Increased awareness of the requirements of these documents is helped by the numbers of companies offering services and training regarding managing Legionella on site. ECDC monitors European levels of Legionnaires' disease and their analyses shows the following trend. Numerous other countries have shown increases recently in the number of cases with the USA expressing a four-fold increase over the last 15 years (see graph below) and the high-profile cases in Dubai recently. Some of these increases will be due to an increased awareness of the illness leading to clinicians testing more frequently for the differences between pneumonia and Legionnaires' disease however the lack of strong legislation requiring end users to manage Legionella on site may have an input also. The UK has been at the forefront of managing Legionella since its first guidance document, the first in the world, back in 1987, thereafter the level of management has increased in the UK over time which unfortunately cannot be said for other countries. A review of European countries and US laws shows a surprising lack of detail and enforcement suggesting that the UK’s L8 and HSG 274 along with the Healthcare sector’s versions (HTM0401) has led to a level of control over Legionella that is not seen in other countries. Collaton Consultancy Limited helps both end users and water hygiene companies alike comply with L8, HSG 274 and HTM0401 ensuring sites successfully manage Legionella. Acting as an Expert Witness in cases of Legionnaires' disease gives Collaton Consultancy Limited a unique perspective of how companies get it wrong and hence can use these experiences to ensure our clients don’t end up the wrong side of the law. For more details about the services Collaton Consultancy Offer contact via email or by phone on +44 (0)7958 124563. References: 1. https://www.gov.uk/government/publications/legionnaires-disease-monthly-surveillance-reports-2017 2. https://ecdc.europa.eu/en 3. https://www.cdc.gov/legionella/surv-reporting.html 4. https://ecdc.europa.eu/en/news-events/increase-legionnaires-disease-cases-associated-travel-dubai

Consultancy that helps

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© 2016-2019 Collaton Consultancy Limited, 8 Grampian Close,

Collaton St Mary, Paignton Devon, TQ4 7GD, United Kingdom. UK

Company Registration number 9930189

Site Map

Cases of Legionnaires’ disease in England and

Wales to the end of June 2017

Knowledge

2017 Mid-year Legionnaires’ disease numbers in

England and Wales.

An analysis of Public Health England’s (PHE) monthly Legionella report which provides a summary of data extracted from the national Legionella database for confirmed cases of Legionellosis in residents of England and Wales, as reported to the national surveillance scheme, shows the following summary. Whilst the report states “The report may not provide an accurate representation of Legionella activity in England and Wales during this time period due to delays in reporting. This means that the data for this month may not be comparable with data for the same period in previous years.” An email correspondence with the PHE confirms the 2017 numbers are accurate at the end of June 2017. * cases confirmed to have pneumonia and laboratory confirmation of Legionella infection; includes some with incomplete data. The chart shows some interesting figures with an overall increase of 26.5% increase in numbers in 2017 over 2016, however this hides the fact that if overseas travel is excluded, leaving only England and Wales, then the numbers show a reduction of 7.1% June year to date in 2017 compared to 2016 (65 vs. 70). For comparison, the annual numbers for 2016 as a whole year showed a total of 345 cases with 146 being Travel abroad, leaving 199 as England and Wales only cases. In 2015 the numbers were 371 in total and 197 as England and Wales only cases. The “domestic only” numbers show a continued good control as the 2015 number for June year to date was 66 cases, 2016 was 70 cases and 2017 is 65 cases. If the travel abroad numbers show the same “seasonality” as previous years then there will be about 247 (based on 2016 seasonality) to 226 travel abroad cases (based on 2015 seasonality) which will likely show an increase in 2017 total cases over 2016 assuming the England and Wales “domestic” numbers remain stable. What might account for these numbers? The static level of the England and Wales “domestic” numbers are encouraging and in my experience, this is, in part, due to sites becoming more experienced in managing the requirements of L8 4th Edition and HSG 274 which were released at the end of 2013 and beginning of 2014. Increased awareness of the requirements of these documents is helped by the numbers of companies offering services and training regarding managing Legionella on site. ECDC monitors European levels of Legionnaires' disease and their analyses shows the following trend. Numerous other countries have shown increases recently in the number of cases with the USA expressing a four-fold increase over the last 15 years (see graph below) and the high-profile cases in Dubai recently. Some of these increases will be due to an increased awareness of the illness leading to clinicians testing more frequently for the differences between pneumonia and Legionnaires' disease however the lack of strong legislation requiring end users to manage Legionella on site may have an input also. The UK has been at the forefront of managing Legionella since its first guidance document, the first in the world, back in 1987, thereafter the level of management has increased in the UK over time which unfortunately cannot be said for other countries. A review of European countries and US laws shows a surprising lack of detail and enforcement suggesting that the UK’s L8 and HSG 274 along with the Healthcare sector’s versions (HTM0401) has led to a level of control over Legionella that is not seen in other countries. Collaton Consultancy Limited helps both end users and water hygiene companies alike comply with L8, HSG 274 and HTM0401 ensuring sites successfully manage Legionella. Acting as an Expert Witness in cases of Legionnaires' disease gives Collaton Consultancy Limited a unique perspective of how companies get it wrong and hence can use these experiences to ensure our clients don’t end up the wrong side of the law. For more details about the services Collaton Consultancy Offer contact via email or by phone on +44 (0)7958 124563. References: 1. https://www.gov.uk/government/publications/legionnaires- disease-monthly-surveillance-reports-2017 2. https://ecdc.europa.eu/en 3. https://www.cdc.gov/legionella/surv-reporting.html 4. https://ecdc.europa.eu/en/news-events/increase-legionnaires- disease-cases-associated-travel-dubai

Consultancy that helps

Knowledge

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