What is Legionnaires’ Disease and how can I avoid it?

What is Legionnaires Disease?

Legionnaires' disease is a severe form of pneumonia — lung inflammation usually caused by a bacterium known as legionella. Most people catch Legionnaires' disease by inhaling the bacteria from water or soil. Signs and symptoms include cough, shortness of breath, high fever, muscle pains, and headaches. Nausea, vomiting, and diarrhoea may also occur. It can be very serious for those over 50, smokers or people with weakened immune systems.

How do you catch it?

It's usually caught in places like hotels, hospitals or offices where legionella bacteria have got into the water supply. It's less common to catch it at home.

You can get Legionnaires' disease from things like:

• air conditioning systems
• humidifiers
• spa pools and hot tubs
• taps and showers that are not used often

You cannot usually get it from: 

• drinking water that contains the bacteria
• other people with the infection
• places like ponds, lakes and rivers

How common is Legionnaires’ Disease?

After a string of outbreaks in the UK back in the 1980s, the Health & Safety Executive introduced rules and regulations to ensure water systems in public buildings were managed and maintained to control the growth of the bacteria and these have been largely effective. The last big outbreak was in 2002 at a leisure facility in Barrow-in-Furness. In 2023 there were a total of 604 cases across the UK although the medical view is that this was down to improved testing rather than an increase in the number of incidents.

Further afield, cases in Europe are highest in Netherlands, France, Germany and Spain, with Italy topping the charts – in 2023 there were 3874 cases in Italy alone.

How can I avoid Legionnaires Disease when I’m on holiday?

There are some simple steps you can take that can reduce the risks associated with exposure. For example, if you’re staying in a room or property with a shower or using campsite facilities, run the shower hot for a few minutes before using it – it’s best to minimise any spray, open any windows and leave the room while you wait. This flushes through the water pipes, any hoses and the showerhead itself, and helps to get rid of anything that might be in there before you use the shower. The same applies to any taps in the property, hot and cold, whether in a kitchen or bathroom. Flush the toilets with the lid down for the first few times. It’s simple, quick to do, and can help.

Any water source that could potentially put people in contact with aerosols and airborne droplets of water could lead to infection if it is not properly cleaned, maintained, and operated. For example, a hotel could have a stunning water feature in the foyer or outside. You may visit a spa that offers baths or whirlpool features that could pose a risk. Other potential issues may arise with fountains and even air conditioning, if the latter uses an evaporative condenser that could expose people to aerosols.

Very few people out of the millions who visit Europe each year will end up developing Legionnaires’ disease because of their holiday. However, being aware of the risks, where they are most likely to be, and of the simple steps you can take to reduce those risks, is a sensible approach. Legionnaires’ is rare, certainly, but given the fatality rate when someone does contract it, and the importance of seeking early medical advice, being more aware of your surroundings and flushing those taps and showers does make sense.

What if I’m high risk?

Realistically, the odds of contracting Legionnaires’ Disease while on holiday are incredibly slim; but there are other waterborne infections and viruses that are far more common and, while less serious, can result in some uncomfortable days, ruining an otherwise fabulous trip.

If you are high risk (and since Covid 19 we all know who fits that description) then there are some simple steps to avoid most nasties. Use bottled water for drinking (including ice), cleaning your teeth, washing your hands and face, and rinsing glasses, plates and cutlery. If you don’t like the idea of adding more single use plastic to the world’s landfill or litter epidemic, invest in a water bottle with a built-in purifier. The LifeSaver Liberty bottle is ideal for travel and can be filled from hotel taps, campsite standpipes or mountain lakes and streams – wherever you may be. The ultra filtration membranes remove 99.999% bacteria (including Legionella) and 99.99% viruses, leaving nothing but clean, safe water. It will filter up to 4,000 litres of water before the filter cartridge needs replacing which is plenty for even an extended holiday.

Remember – you're very unlikely to get Legionnaires from drinking contaminated water – it’s caught by breathing in water vapour or droplets; so make sure you run taps and showers before you use them and you should be fine. And of course, if you do start to feel unwell, always seek medical advice. 

Sources

https://legionellacontrol.com/legionella/travel-advice-how-to-avoid-legionnaires-disease-on-holiday
https://www.nhs.uk/conditions/legionnaires-disease/
https://www.hse.gov.uk/legionnaires/what-is.htm