Legionnaires’ disease in the Netherlands and Spain

Since 15 November 2021, local government in the Netherlands has reported 15 cases, including one death, of Legionnaires’ disease in Schijndel, Noord-Brabant, in the south of the country. An outdoor source of infection is suspected, with cooling towers and fountains being investigated.

Additionally, public health authorities in Barcelona are investigating an outbreak of Legionnaires’ disease in the municipalities of Montmeló and Montornès del Vallès. From 5 to 18 November 2021, 26 cases were detected, with 16 admissions to hospital. The source of the infection is unclear, but the possible involvement of industrial water cooling towers is being investigated.

Legionnaires’ disease is spread by inhalation of legionella bacteria in water spray or aerosols, with outbreaks having being linked to heating or cooling systems, hot tubs, fountains, and swimming pools. The risk of infection is greatest for smokers, the elderly, those with a chronic lung condition or a weakened immune system. There is no vaccine to protect against Legionnaires' disease.

Advice for travellers

Travellers to the Schijndel and Barcelona areas should be made aware of the current outbreak, how the infection is transmitted, and the symptoms of infection. 

• Showers in accommodation that have not been recently used should be flushed through with hot water before first use. 
• Travellers should seek prompt medical advice if they develop an influenza-like illness with fever, cough or shortness of breath during their stay, or for up to two weeks after return. They should inform their healthcare professional of possible exposure to Legionnaires' disease and mention the area visited.

Information and advice for travellers on legionellosis is available on the TRAVAX (for health professionals) and fitfortravel (for the general public) websites.

Sources: TRAVAX, 23 November 2021 and TRAVAX, 19 November 2021