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 14
September 2004
UK - A Health Protection Agency study has highlighted serious problems
with spa pools being a cause of Legionnaires’ disease because
they are not managed or maintained properly. The study raises the
question of whether routine legionella testing should be included
within new Health and Safety Executive and HPA guidelines.
This research carried out in collaboration with local authority
environmental health officers will be presented to delegates on
the second day of the Agency’s scientific conference at Warwick
University. The year long study, surveyed over 100 spa pools, commonly
referred to as jacuzzis. Out of 88 premises, 23 spa pools were found
to contain legionella bacteria. Sixteen of these had passed current
accepted levels for routine microbiological parameters.
Speaking at the Agency’s annual conference, Dr Susanne Surman-Lee,
who led the research said, “In every spa pool related outbreak
that we have investigated the pool had not been managed or designed
according to guidelines or had poorly trained staff. In addition,
at present, testing for legionella is not mandatory for spa pools.
“Because spa pools are increasing in popularity we need greater
recognition and understanding of the risks associated with their
use and misuse. They have the potential to cause infection because
the water systems become contaminated with bacteria and the high
temperatures of the water make considerable demands upon the disinfection
and filtration systems making it easy for the bacteria to develop
and spread if not adequately maintained. The jets from spa pools
then produce aerosols containing legionella which can then be inhaled
and cause illness."
“It’s been assumed that if the pool water is satisfactory
for routine microbiological checks then growth and spread of legionella
would also be under control. But we discovered that the legionella
bacterium, may be present in high numbers in both privately owned
and public facilities even when routine microbiological and safety
checks appear satisfactory.”
During 2003, there were 27 cases of Legionnaires’ disease
in England where spa pools were identified as the source of infection,
with 3 deaths. So far this year there has been only one case of
Legionnaires’ reported to be associated with a spa pool.
The HPA has published spa pool guidelines since 1994 and a new
joint document with the Health and Safety Executive is being produced
which will update advice on risks and legislation associated with
spa pools.
Notes to Editors:
1. The Health Protection Agency’s Annual Conference takes
place at Warwick University from 13th to 15th September. Further
information can be found at the conference website at http://www.hpaconference.org.uk
2. Journalists are invited to attend the conference; to book your
place please call the Colindale press office on 0208 327 6647/7097.
3. Legionnaires' disease is pneumonia, caused by the bacterium
Legionella pneumophila. The majority of cases are reported as single
(isolated) cases but outbreaks can occur, currently around 300 cases
are reported annually. All ages can be affected but it mainly affects
people over 50 years of age, and generally men more than women.
4. The early symptoms of legionnaires’ disease include a
'flu-like' illness with muscle aches, tiredness, headaches, dry
cough and fever. Sometimes diarrhoea occurs and confusion may develop.
Deaths occur in 10-15% of the general population and may be higher
in some groups of patients.
5. The incubation period ranges from 2 to 10 days, sometimes up
to 14 days. In rare cases some people may develop symptoms as late
as three weeks after exposure.
6. Legionella infection can be treated with antibiotics and person-to-person
spread does not occur.
7. Legionellae are widely distributed in the environment. They
have been found in spa pools, hot and cold water systems, and water
in cooling towers.
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