Outbreak of Legionnaires’ disease in a hotel in Calpe, Spain. December 2011 – January 2012

Risk assessment

Following notification of a cluster of cases of Legionnaires’ disease, all associated with the same hotel in Spain, ECDC has prepared an assessment of the risk to the EU.
It concludes that as the hotel has been closed, the residual risk is limited to recent hotel visitors and staff, as well as staff still working in the hotel; particularly those involved in the implementation of control measures.

Executive summary

Since 16 December 2011, 13 cases of travel-associated legionnaires’ disease (TALD) including three deaths have been notified to the ELDSNet Surveillance Network. All cases are associated with one hotel in the town of Calpe, in the province of Valencia, Spain, between 25 November 2011 (first arrival) and 31 January 2012 (last departure). In addition, three hotel staff presented Legionnaires’ disease.The TALD cases are mainly residents from the United Kingdom  (12 cases), and Spain (1 case). The average age of the cases is 74 years (min 44-max 89) and the gender distribution is 7 males/ 6 females.

The hotel was closed on 2 February; guests from the United Kingdom who stayed in the hotel prior to its closure have been informed about the symptoms of Legionnaires’ disease, and an alert was issued to clinicians in the UK asking them to consider Legionnaires’ disease in cases of pneumonia with recent travel to this area. Local hospitals and general practitioners in the area have also been alerted to support case-finding.Legionnaires’ disease is a potentially fatal infectious disease which tends to be under-diagnosed and under-reported. Early treatment of patients is important and health care providers should be reminded to consider this disease when ascertaining patients presenting with pneumonia, to enquire about recent travel, and to notify the relevant public health authorities of their country.