Increase in cases of Legionnaires' disease in Palmanova, Mallorca
There has been a recent increase in the number of cases of Legionnaires’ disease in people who have travelled to Palmanova, in Mallorca, Spain.
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.
Since mid-September 2017, 18 cases of Legionnaires’ disease, one of which was fatal, have been reported in EU travellers returning from Palmanova, Mallorca. Fourteen cases have been reported by the UK, two by France, and one each from the Czech Republic and Denmark. No cases have been reported to date in Ireland. Legionnaires’ disease is an infection from the local environment and does not pass from person to person. The source of the outbreak has not yet been identified. The Spanish authorities are leading the response to this outbreak.
Advice for travellers to Palmanova, Mallorca or those recently returned from there
We are advising people who have travelled or are planning to travel to Palmanova in Mallorca to be aware of the signs and symptoms of Legionnaires’ disease, which are initially flu-like and include:
- mild headaches
- muscle pain
- high temperature (fever - usually 38C or above)
- chills tiredness and changes to your mental state, such as confusion
Once infection starts in the lungs, symptoms may become pneumonia-like, such as a persistent cough. This is usually dry at first, but as the infection develops, you may start coughing up phlegm, and develop shortness of breath and chest pains.
If you do experience symptoms, speak to your GP as soon as possible and inform them of your recent travel.
This is particularly important if you are in a group at increased risk of infection as follows:
- aged 50 or over
- have an underlying medical condition (such as diabetes, kidney disease, or a pre-existing lung condition)
- have a weakened immune systems (for example, if you are on certain types of cancer treatment)
- are a smoker or have smoked heavily in the past
- heavy alcohol drinker
Advice for healthcare providers
Healthcare providers should consider Legionnaires’ disease in patients presenting with pneumonia with a travel history to Palmanova, Mallorca in the two weeks prior to symptom onset.
Guidance and further 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 Medical Officer of Health in their local Department of Public Health.
ECDC Rapid Risk Assessment: Outbreak of travel-associated Legionnaires’ disease – Palmanova, Mallorca (Spain), September-October 2017