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A cluster of Legionnaires’ disease has been reported from the tourist resort of Alanya, Turkey. Since the beginning of April 2012, four Danish residents, who travelled to this area have been reported as having contracted the respiratory disease. The date of onset of the most recent case was 06/04/2012. So far, no cases from the UK have been identified. The Turkish authorities, as the responsible body, are investigating the accommodation site.
Alanya is a popular tourist destination for UK travellers. Therefore, it is possible that further cases may be identified and Legionnaires' disease should be suspected in any patients presenting with pneumonic illness after return from this area. Legionnaires' disease is often diagnosed by the detection of antigen in a urine sample and the treatment of choice is with macrolide antibiotics (e.g. clarithromycin). Further information and advice on diagnosis and management of Legionnaire's disease can be obtained from local microbiology services.
It is important that any travel-associated cases of Legionnaires’ disease who have stayed in this resort are notified to the appropriate national centre as soon as possible.
Scotland - please collect samples and test in the usual way for any newly suspected cases which may be part of this cluster. Samples should be sent to local labs or the Legionella Reference Laboratory at Stobhill Hospital Glasgow. In this instance, samples should include a sputum sample where possible. In addition please report suspected cases to Alison Potts at Health Protection Scotland by telephone (0141 282 2931) or email alison.potts@nhs.net
England and Wales – the Legionella Section at Colindale (HPA) either by telephone (020 8327 7056) or email (Legionella@hpa.org.uk). The national questionnaire should be completed as fully as possible. It is important that sputum samples are collected where possible.
Northern Ireland – HSC Public Health Agency Northern Ireland by telephone (028 9031 1611) or email Brian.Smyth@hscni.net
Advice for Travellers
Be aware of the risk, mode of infection and symptoms. Flushing through showers in hotels or institutions with hot water when they have not been used recently may help. Clinicians seeing returned travellers from this part of Turkey should be aware of the possibility of Legionnaires’ disease linked to this outbreak.
