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Recognising cases of Legionnaires' disease

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This summer has seen outbreaks of Legionnaire's disease in England and Scotland. More than 100 people caught the potentially fatal lung disease during an outbreak in Edinburgh in June, in which three people died.

Sixteen water cooling towers in the south-west of Edinburgh were treated with a range of chemicals, in order to kill any bacteria. The towers were identified as a potential source of the outbreak following the first reported cases. A further two people died in Stoke-on-Trent, following a Legionnaires' outbreak thought to be linked to a hot tub.

Although the Health Protection Agency (HPA) has now declared the outbreaks over, clinicians should be aware of this disease as a potential diagnosis for patients who have flu-like symptoms.

Reported incidence of Legionnaires' disease is rare, however many cases go unreported because its presentation is so similar to influenza. True figures are therefore difficult to estimate. Certainly, outbreaks have increased in the last decade and there has also been an increase in the number of isolated cases.

In 2009, there were 345 confirmed cases of Legionnaires' disease, leading to 43 deaths in England and Wales.1 It is thought that 163 of these cases occurred while the affected person was travelling, either abroad or in the UK.

Nurses working in primary care have a responsibility to patients to ensure accurate diagnosis and management of their conditions.

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