European Parliament president knocked down by Legionnaires’ disease

Legionnaires’ disease occurs by inhaling aerosols carrying the Legionella bacteria – which develop primarily in warm, stagnant water – with an infection that might lead to a deadly form of pneumonia. [EPA-EFE/HERTZOG]

What is legionellosis, the disease that took European Parliament’s President David Sassoli out of the parliamentary game for more than two months? And how has the EU improved legislation to tackle the spread of the pneumonia-causing bacteria?

“In September, during the plenary session of the European Parliament, I came down with a bad case of pneumonia caused by Legionella,” the 65-year-old Italian said in a video message on his social media accounts.

On 15 September, Sassoli was taken to the Hôpital Civil in Strasbourg, treated, then hospitalised “in good condition”, according to a note released by his spokesperson, Roberto Cuillo.

The infection was diagnosed a few days before the yearly Commission president’s address to MEPs, the State of the Union, which was chaired instead by one of Parliament’s vice-presidents, Maltese Christian-democrat Roberta Metsola.

After returning to Italy to recover from the disease, he had a relapse, “and this episode prompted the doctors to recommend a series of tests and investigations, and that’s what I’m doing,” he added.

Doctors are now working to ensure that he can return to presidential duties as soon as possible, Sassoli concluded in his message.

The fact he was diagnosed with pneumonia led reporters to initially speculate on the Parliament’s president contracting COVID-19 which his spokespersons promptly denied.

“There is also a risk that legionellosis might be misinterpreted or misdiagnosed as being COVID, due to the fact that symptoms can be quite similar to early Legionnaire’s diseases,” said Susanne Lee, a microbiologist with many years of experience in British public health agencies, in a recent interview with EURACTIV.

She added that getting a diagnosis quickly for legionellosis and getting the right antibiotics early could significantly impact a successful outcome from the disease.

ECDC: Legionella outbreak may be reduced with appropriate controls

A new community outbreak of Legionella in Belgium’s Flanders region renewed public attention to the so-called Legionnaires’ disease, which is increasing in the EU, according to the EU agency for infectious diseases control.

What is Legionellosis?

Legionnaires’ disease occurs by inhaling aerosols carrying the Legionella bacteria, which develops primarily in warm, stagnant water. The subsequent infection can then lead to a deadly form of pneumonia.

Legionella bacteria spreads through vapour which can commonly come from air-conditioning units of large buildings. Adults over the age of 50 and people with weak immune systems, chronic lung disease, or heavy tobacco users are those most at risk.

Hot and cold water systems are the second most common source of infection

It is no surprise that Sassoli was infected in mid-September, as most outbreaks and cases of Legionnaires disease happen during the summer season.

With temperatures rising, water distribution systems are at risk of being colonised by legionella bacteria. For this reason, climate change is often considered one of the reasons behind the increase of observed cases of legionellosis, particularly since 2017.

There are more than 60 species of this bacteria known to date, but Legionella pneumophila serogroup 1, causes most Legionnaires disease infections and the deadliest form of pneumonia. According to the ECDC, Legionella pneumophila amounted to approximately 96% of confirmed cases in Europe.

Climate change leads to spread of Pneumonia-causing bacteria, expert says

A warmer climate and Europe’s ageing population create a favourable breeding ground for legionella bacteria, which cause a type of pneumonia known as Legionnaires’ disease, Professor Martin Exner said in an interview.

Recent developments at EU level

The extension of the Legionella bacteria monitoring to every potable water system in the EU is part of the new risk assessment analysis included in the revised EU’s Drinking Water Directive (DWD).

The revision updated parameters of water quality set more than 20 years ago to restore citizens’ trust in tap water and reduce plastic bottle usage.

Once in force, Legionella monitoring will be extended to every potable water system in the EU as part of a new risk assessment analysis. They are currently compulsory only for hotels and public offices.

However, Legionella monitoring was at the centre of a back-and-forth during the final negotiations between the European Parliament and the EU ministers to amend the initial Commission’s legislative proposal.

According to the scientific world, the inclusion of testing for all Legionella species in the DWD might lead to a large amount of work, time, and financial expense for many end-users and delay test results with immediate consequences for public health.

In its original proposal backed by the Council, the Commission asked water suppliers to check for legionella species first and then the most dangerous one – Legionella pneumophila.

In the final compromise reached by the EU lawmakers, member states were left free to determine their approach to testing, as they can choose the methods they find most appropriate for the purposes they specify in national guidelines.

In Annex III of the drinking water directive, EU countries will be provided with the option of using alternative Legionella pneumophila testing to achieve public health protection objectives and are also called upon to establish guidelines for sampling methods of legionella.

Ironically, the Commission’s approach on monitoring all Legionella species instead of focusing on the one leading to the deadly form of pneumonia that infected Sassoli was criticised by the former European Parliament negotiator Michel Dantin, who said it would be a waste of time and resources.

Scientists and Commission clash over detecting Legionella risk

Some researchers and scientists firmly criticised the European Commission’s approach on assessing the risk of Pneumonia-causing bacteria in the Drinking Water Directive (DWD) during an event organised at the European Parliament by EURACTIV.

[Edited by Alice Tayor]

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