Outbreak of Legionnaires' Disease in Amsterdam


EWGLINET (The European Working Group for Legionella Infection) has alerted the Health Protection Surveillance Centre (HPSC) of an outbreak of Legionnaires' disease in Amsterdam.

As of July 14th 2006, 24 cases of legionnaires’ disease have been confirmed and one patient has died. The date of onset of symptoms ranges from 27th June to 9th July 2006.

All the cases either live or work in Amsterdam city centre and active case finding is underway. No cases have been reported so far from other countries. The most likely source of the outbreak is believed to be a cooling tower located in the central-eastern part of the city.

Legionnaires' Disease
Legionnaires' disease is a type of pneumonia caused by legionella bacteria. The early symptoms include a 'flu-like' illness with muscle aches, tiredness, headaches, dry cough and fever. Some people develop diarrhoea or may become confused. Deaths occur in 10-15% of otherwise healthy individuals and may be higher in some groups of patients. The incubation period ranges from 2 to 10 days but is usually 5 to 6 days. In rare cases some people may develop symptoms as late as three weeks after exposure.

It is advisable that any persons who visited Amsterdam from 8th June 2006 onwards who develop symptoms similar to those outlined above would seek medical advice and visit their GP. In particular they should inform him/her that they have visited Amsterdam and that an outbreak of legionnaires' disease has occurred there.

Clinicians should consider the possibility of legionnaires' disease in all patients with a diagnosis of community-acquired pneumonia and in those developing symptoms as outlined above within 14 days of returning from an area where legionnaires’ disease has been reported.

Further information on the outbreak (in Dutch) is available at http://www.rivm.nl/

More information on Legionellosis is available at http://www.hpsc.ie/hpsc/A-Z/Respiratory/Legionellosis/