65 cases of Legionnaires’ disease associated with travel to Dubai reported since October 2016
In recent months, there has been an increase in the number of cases of Legionnaires’ disease among European travellers returning from Dubai. One case has been reported by Ireland. As the source has not yet been identified, there could still be a risk for exposure to Legionella for persons visiting or living in Dubai.
What is Legionnaires’ disease?
Legionnaires’ disease is a type of pneumonia caused by the bacteria Legionella pneumophila and other Legionella species. The illness usually starts with flu-like symptoms including fever, tiredness, headache, and muscle pains. This is followed by a dry cough and breathing difficulties which may progress to a severe pneumonia. The disease is spread through the air from a water source. People become infected when they breathe in aerosols (tiny droplets of water) which have been contaminated with Legionella bacteria.
Further information on Legionnaires’ disease is available on the HPSC website.
An increase in cases of Legionnaires’ disease associated with travel to Dubai since October 2016 was observed by the European Centre for Disease Prevention and Control (ECDC). The most recent update is available on the ECDC website. Between 1 October 2016 and 20 June 2017, there have been 65 cases of Legionnaires’ disease reported to ECDC with a history of travel to Dubai. The majority of cases stayed in commercial accommodation sites (hotel or apartment). Two cases were reported as fatal. The most recent case became ill on 25 May 2017. These recent cases suggest there is still an ongoing exposure risk in Dubai.
Advice for travellers to Dubai or those recently returned
The WHO has not issued any advice against travel to Dubai. The risk of Legionnaires’ disease to travellers to Dubai is considered to be low. However, the risk may be increased for the following groups:
- Those aged over 50 years
- Those with underlying breathing problems/lung disorders
- Those who have weakened immune systems
If you are travelling to Dubai, be aware of the symptoms of Legionnaires’ disease. If symptoms develop while in Dubai you should seek medical care. If symptoms develop within two weeks of returning home you should seek medical care and inform your healthcare provider of your travel history.
Travellers to the United Arab Emirates (UAE) should also be aware of the symptoms and the advice on Middle East respiratory syndrome coronavirus (MERS), a different respiratory infection which is ongoing in the Arabian peninsula. Travel advice on MERS is available on the HPSC website.
Advice for healthcare providers
Healthcare providers should consider Legionnaires’ disease in patients presenting with pneumonia with a travel history to Dubai or the UAE in the two weeks prior to symptom onset.
Guidance information, on Legionnaires’ disease for healthcare providers is available on the HPSC website.
On diagnosis of a travel associated case of Legionnaires’ disease healthcare providers should inform the Department of Public Health in their area (contact details are available on the HPSC website).
Sporadic cases and outbreaks of MERS continue to occur in the Arabian peninsula, including the UAE. As symptoms of MERS and Legionnaires’ disease may be similar, MERS should also be considered in a person presenting with respiratory symptoms and a travel history to Dubai or the UAE in the two weeks prior to symptom onset. Guidance on the assessment and appropriate management of a possible case of MERS is available on the HPSC website.