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Flu-like Landmark Hotel outbreak cases attributed to fever

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The Legionnaire’s outbreak at a Dundee hotel has taken a twist, with NHS Tayside confirming some of the flu-like illnesses had been caused by a condition called Pontiac fever.

It is a milder infection than Legionnaire’s, a form of pneumonia, but both are caused by the legionella bacteria. However, Pontiac fever often affects healthy young people and does not lead to pneumonia.

The NHS Tayside health protection team and Dundee City Council environmental health officers are continuing to investigate the large number of cases of flu-like illness, specifically a respiratory infection, in members of staff and visitors to the Landmark Hotel.

A single confirmed case of Legionnaire’s disease in a man who visited the hotel’s leisure club continues to be treated in Ninewells Hospital. There are no further confirmed cases of Legionnaire’s disease.

Public health medicine consultant, Dr Finn Romanes, said, “We are continuing our investigations and, to date, 96 people who work in or have visited Landmark Dundee are known to have had a flu-like illness with a respiratory infection.

“The investigation is considering all circumstances surrounding those people we know to have fallen ill. It now appears likely that, in a number of cases, illness could be caused by a condition called Pontiac fever.

“Pontiac fever is a short-lived, flu-like illness caused by exposure to legionella bacteria.

“Symptoms can include fever, headaches and muscle aches but, unlike Legionnaire’s disease, Pontiac fever does not cause pneumonia and the illness will usually clear up without treatment within two to three days.”Difficult diagnosisDr Romanes said no one has been confirmed as having Pontiac fever, which is difficult to diagnose and requires at least two blood tests over a period of two or more weeks. This underlines the importance of seeking medical attention and returning for a repeat blood test if advised by a doctor.He continued, “We are encouraging all those people who have come forward to inform us of their flu-like illness to keep in touch with their GP after they have had their initial set of tests so they can have follow-up blood tests if requested. “This will allow us to detect Pontiac fever but any positive diagnosis could take time due to the nature of the testing which is required for the illness.”Again I would ask that anyone who has experienced symptoms of Legionnaire’s disease, including high fever with sweating, severe headache, shortness of breath, pain in the side of the chest, a cough which is either dry or with greenish, thick mucus and muscle aches and pains, and who has visited the Landmark Dundee since the beginning of March, to contact their GP or NHS 24.”The hotel’s leisure facilities associated with the outbreak remain closed while the inquiry continues.

There are over 500 cases of Legionnaire’s reported in the UK each year, and one in 10 of them prove fatal.

Legionella bacteria are widely distributed in the environment. They have been found in ponds, hot and cold water systems, and water in air conditioning cooling systems. The disease is spread through the air from a water source. Person to person spread does not occur.

Breathing in aerosols from a contaminated water system such as spa pools is the most likely route of transmission.