Photo: Canada Press

The reported cases of Legionnaire’s disease are within the outbreak zone in the St. Roch and Old City area.

Shirley Nadeau
In a recent press release, Dr. François Desbiens, the Regional Director of Public Health of the Capitale-Nationale region (DRSP), assured the public about the efforts being made to control the outbreak of Legionnaires’ disease and to inform the public of the actions that have been taken since the beginning.

As of September 3, 2012, the DRSP has reported 173 cases of the disease caused by the legionella bacteria, including 11 deaths since the outbreak began on July 17. The average age of the victims is 79. The most recent cases are now appearing after a two-week incubation period. The source of the outbreak is thought be in the cooling systems of office building towers where the bacteria grow in stagnant water. On Friday, the public health board said it was seeing fewer cases of infections caused by the disease. According to authorities, the overall number of patients being admitted with the infection seems to be tapering off.

Monitoring interventions to Quebec City and the DRSP
In addition to the many measures already undertaken to identify the cooling towers, collect samples and disinfect the equipment, the Director of Public Health of the Capitale-Nationale region has ordered all owners or managers of buildings within the targeted perimeter with this type of equipment to clean out their systems and maintain a minimum level of chlorine in the water at all times to ensure that the legionella bacteria cannot grow.

Building owners who fail to provide written proof of a complete disinfection by Thursday, September 6, will be ordered to shut down their cooling towers.
Teams of inspectors have distributed to each building owner or manager a document which states what must be done to ensure a cooling tower maintains the best possible standards within a specified time. The joint team of municipal and provincial inspectors has expanded the contamination zone to include at least 100 cooling towers mainly located in the St. Roch and Old City area.

What is Legionnaires’ disease? Legionnaires’ disease, an infectious disease rare in Quebec, is caused by the legionella bacteria that grows in water at a temperature of 25 to 42℃, and is not transmitted from person to person.

These optimal growth conditions are found in devices with water in a closed circuit, such as cooling towers of large office buildings. DRSP does not recommend that citizens of Quebec City change their lifestyle. People in good health are usually not at risk and vulnerable people can refer to Info-Santé (811) in case of doubt about their health. If a person has symptoms of fever and breathing difficulties, they should immediately call 811 or consult a doctor promptly. An info-line has been created for people call and find out more information about legionnaires’ disease. The services are available from 8:00 a.m. to 8:00 p.m. at 1-877-644-4545.

What are the signs and symptoms of Legionnaires’ disease? Legionnaires’ disease usually begins with a headache, pain in the muscles and a general feeling of unwellness. These symptoms are followed by high fever (up to 40-40.5°C or about 104-105°F) and shaking chills. Nausea, vomiting, and diarrhea may occur. On the second or third day, dry coughing begins and chest pain might occur. Difficulty with breathing is often reported. Most patients develop pneumonia, a condition in which some of the lungs’ air sacs fill with fluid or pus, so air is excluded. The pneumonia might involve both lungs and become so severe that hospitalization is required. Pneumonia resulting from Legionnaires’ disease is similar to pneumonia from other causes. Laboratory tests are necessary for a confident diagnosis. Mental changes, such as confusion, disorientation, hallucination and loss of memory, can occur to an extent that seems out of proportion to the seriousness of fever. Complete recovery can take several weeks. About 5-15% of known cases of Legionnaires’ disease have been fatal. (from the Canadian Centre for Occupational Health and Safety web site)