With any Legionnaires’ disease outbreak, the first order of business is to confirm the source of the outbreak to prevent further exposure to the legionella bacteria.
As of Friday, November 14, Portuguese news source iOnline is reporting:
Officials hope to have today until midnight test results that could confirm the source of the outbreak of Legionella[Translation by Google Translate]
The first analysis revealed Legionella in cooling towers of fertilizers Portugal, Central Beer and Solvay but experts Environmental Inspectorate point to a more significant problem in ADP. The analyses expected today should determine whether the samples collected in the factories are linked at the molecular level with the isolated bacteria in patients. The director general of health explained that it is not entirely certain that today’s analyses will be certain because the multiplication of bacteria in the laboratory is not fully controllable. Francis George said that there is a chance the results are not conclusive. Once the suspicious towers were closed on November 10th, there should no longer be new cases after 20 days, George said.
In this Portuguese article the reporter discusses that there were other findings consistent with Legionnaires in other sources: Portugal, Central Beer, and Solvay; but that the most significant samples were found in the ADP Fertilizer location. This is consistent with legionella and most water sources. Legionella will most likely be found in cooling towers or other water sources, but the question is not whether there is legionella – it is the levels or amount found in those sources. The duty of the water service or cooling tower maintenance persons is not to eradicate completely the legionella, it is to minimize the levels and maintain the water within safe levels. This is why almost all of the legionnaires disease cases are preventable – the water can be made safe with proper treatment and monitoring. Without the proper treatment and monitoring, the results can be catastrophic, as we are seeing in Portugal.
In the second part of the article the author, Marta F. Reis, explains that the health director will be analyzing the legionella samples at the cooling towers to make a match, and that since the towers have been shut down the number of new cases should drop. First, there may never be an exact match from the legionella samples found and that of the deceased or the ill patients. The expert analysis done by the agencies involved can never analyze every patient, and if they could the conclusions would likely vary. This is why the individual patients and families need to obtain their own trusted experts and physicians that can focus on the individual connections to the water source, and not be grouped into the larger generalized population.
It will also be interesting to find whether the number of cases drops because of the stoppage of the cooling towers. There will be drop of patients certainly, but there could be some under-reported patients that may have traveled away from the area, and unknowingly contracted legionnaires. Comparable to the pebble in the pond, the ease of movement of people in the present day may find a not so minor number of affected persons beyond the centralized area of Vila Franca de Gaia and Lisbon.
iOnline also reports:
According to Francis George, the outbreak – which caused seven deaths and 316 patients – was due to a “rare combination of environmental factors that explain the magnitude of the outbreak”
The Director General of Health announced today that some of the patients ‘legionella’ have the bacteria found in cooling towers factory in Vila Nova de Gaia, which is not identified by the case being “secret justice”.
Francis George spoke to journalists at the end of the presentation of the results of epidemiological studies carried out by ‘taskforce’ formed to monitor the outbreak of ‘legionella’ in Vila Franca de Gaia, which is attended by the Ministers of Health, Paulo Macedo, and the Environment , Spatial Planning and Energy, Jorge Moreira da Silva.
According George Francis, outbreaks – 316 causing dead-seven patients – due to a “rare combination of environmental factors that explain the magnitude of the outbreak” which includes “a high concentration of bacteria and aerosols cooling towers” and specific weather conditions.
“There analytical data establishing links between bacteria found in cooling towers and patients ‘legionella'” said Francis George.
Asked what the towers and that the companies were identified bacteria similar to those found in patients, Francis George said he could not disclose for the case to be in “secret justice” in the investigation of the prosecution.
According to the Inspector General of Agriculture, Sea, Environment and Spatial Planning, Nuno Banza, technical analyzes collected by this organism have been submitted and validated to prosecutors.
Legionnaires’ disease caused by the bacteria “Legionella pneumophila”, is contracted by inhalation of contaminated vapor droplets of water (aerosols) so small that carry the bacteria into the lungs, depositing in the pulmonary alveoli.[Translation by Google Translate]
Additionally, reports say the Health Minister announced that it was safe for the population to move about without fear, while keeping the identified company name secret.
These latest updates on the legionnaires outbreak in Portugal has taken on a very similar tone to that of legionnaires outbreaks in the United States. In the Portugal crisis, while over 300 people have been affected in what appears to be an identified water source, the government agencies have kept the information on the source of the legionella “secret.” This same approach was taken in a recent legionnaires case in Tampa, Florida.
While families are coming to grips with very serious illnesses and some deaths to their loved ones, and seeking answers to how this could have happened, the authorities actively keep valuable information from the victims. The most effective approach is to aggressively determine and disclose the source, and provide quality and accurate information to the public.