Risk assessment: Outbreak of Legionnaires’ disease in a hotel in Calpe, Spain November 2011 – June 2012

Risk assessment

This is a further update of the risk assessment of 4 July 2012; it is in response to new information regarding the risk associated with an outbreak of Legionnaires’ disease in a hotel in Calpe, in the province of Alicante, Spain.
New environmental investigations carried out in the hotel by regional public authorities, together with an external expert engaged by the hotel, identified the spa pool as the probable source of the outbreak. This conclusion is in line with the ECDC expert mission that joined the investigations team on Friday, 6 July. As the spa pool will be rebuilt and old pipes replaced, the intermittent source of contamination seems to be stopped and herewith also the risk for further extension of the outbreak. The hotel will remain closed until the Spanish health authorities will approve the reopening of the hotel.

Executive summary

In February 2012, ECDC issued a rapid risk assessment on the outbreak of travel-associated Legionnaires’ disease affecting in a hotel in Calpe, Spain. The risk assessment was updated in May, June and 4 July. In response to new investigations by the regional public health authorities, ECDC further updates its risk assessment. The affected hotel was closed on 2 July after new cases of Legionnaires’ disease had been reported in late June. It will remain closed until the Spanish health authorities will approve the re-opening of the hotel.New environmental investigations carried out from 3 to 5 July 2012 by the regional public health authorities, together with an external expert engaged by the hotel management, identified the hotel’s spa pool as the probable source of the outbreak. This conclusion is in line with the ECDC expert mission that joined the investigations team on 6 July 2012.

In particular, the origin of water contamination might have been related to construction aspects of the spa pool. The hotel is currently taking extensive measures to prevent further cases, including rebuilding of the spa pool and changing its pipes.

Further laboratory results are awaited to confirm that the source of water contamination has been found. If this is indeed the case, the risk for further infection is considered to be very low.