Investigations on the industrial
sources the légionellose ones
The DRIRE required of all the
companies subjected to regulation ICPE (Installation Classified for the
Protection of Environment), having systems air coolers and located in the
communes of residence of the patients concerned or common the close
relations, to take measures intended to identify the possible presence of légionellose.
The turns aéroréfrigérantes
constitute indeed environments favourable with the proliferation the légionellose
ones. The DRIRE also required of these companies to implement measurements
to lower the concentration into légionellose, in preventive manner, and
this without awaiting the results of the led analyses (it is frequently
necessary one or two weeks to obtain a final result). Within this framework,
the majority of the companies concerned proceeded to shocks biocides in
their coolant circuits; a company stopped its installations to ensure the
complete cleaning of its circuits (it acts of company NOROXO in
Harnes).
The Prefect formalized by a
prefectoral decree these requests for inspection of the classified
installations. The decree was taken on December 30, 2003.
This decree was cancelled and
replaced by a new decree signed on 09 January 2004 widening the perimeter of
research and prolonging this research, then by a new decree on January 26
2004 which prolongs the application of the various regulations until
February 9, 2004 and extended the field of research again.
A similar decree was taken on
January 12, 2004 by the Prefect of North for the communes of Bauvin, Provin,
Ostricourt and Esquerchin. These provisions were renewed until February 9,
2004 by a decree of January 28, 2004.
The perimeter of research was
extended to the commune of Bassée by decree of January 28, 2004. In
geographical term of perimeter, the checks were done in the manner
following: progressive extension of the perimeter of research (progressively
with the information given by the DDASS and on the basis of place of
residence of the patients), to the zone of the 45 communes concerned with
the investigations (figure of the 09/01/04) effort related initially to the
establishments subjected to authorization already known for the use of turns
air coolers; then on all the establishments subjected to authorization; then
on the establishments subjected to declaration
2 December 2003
Two cases of légionellose were identified in
the town of Harnes in Pas-de-Calais, at people at the risk (old people).
A patient has died and the other patient is in
convalescence in residence. The regrouping of these cases in time and the
space led to interroger on a common environmental exposure. One is reminded
that the légionellose is an acute pneumopathy due to Legionella, bacterium of
the hydrous medium and whose growth is supported by a temperature varying of
25 with 50°C.
This infection can occur 2 to 10 days after the
inhalation of a contaminated water aerosol. There is no transmission inter
human of the disease.
The transmission of the bacterium to the man is thus
carried out by wet inhalation of aerosol.
The sources of contamination accused in the epidemics are the systems
distribution of domestic hot water (showers), the systems of air-conditioning
(turns air coolers), the thermal springs.
The survey carried out by the Departmental Management
of the Medical and Social Businesses of Pas-de-Calais, in bond with the
medical Institute of day before (InVS), directs research towards the possible,
deprived or industrial sources of contamination, located in a sector of 2 km
around the zones of residence of these two patients.
By measurement of precaution, it has ores and already
requested from all the installations subjected to authorization to reinforce
the control and the measurements of prevention put in uvre on their equipment.
enquête continues on the other installations not subjected to authorization.
In waiting une possible identification of the source of contamination, the
professionals of health of the sector were sensitized so that the patients
presenting of the evocative signs of légionellose can quickly be dealt with.
The services of Etat attracted attention of the
managers of the turns aéroréfrigérantes on the need for maintaining them in
good condition of maintenance and for carrying out a regular monitoring of the
quality of the water of these installations, in order to avoid the development
of legionellose.
Arras, December 3, 2003
2 new confirmed cases of légionellose this
morning
Two new cases of légionellose were confirmed this
morning by the hospital complex of Lens.
It agit of two patients, hospitalized in the
intensive care unit of this establishment.
one is 70 years old and remains in Vendin-le-Viel,
autre 44 years old is without true fixed residence but remains in an
episodical way with Fouquières-les-Lens. One is reminded that the form
engraves légionellose generally occurs at old subjects or subjects reached of
chronic and serious diseases.
It may has well any confirmation quil agit of
the same species of bacterium as that which struck the two cases previously
listed these last days with Harnes.
The investigations carried out by the services of
Etat to seek the source of the contamination continue. All the companies
subjected to authorization with the title of regulation ICPE (Installation
Classified for the Protection of Environnement), having systems air coolers
and located in a radius of 2 km around the residences of the first two cases,
took measures intended to identify the possible presence of legionellose or to
clean their circuits eau and of cooling. Thus, entreprise NOROXO, in
relation to the services of the DRIRE, stopped its installations to ensure the
complete cleaning of its circuits. In addition, the DDASS proceeded has checks
in a certain établissements number receiving of the public thus qu au
residence of the sick people.
The checks appeared for instant negative.
Taking into account the period incubation which
ranges between two and ten days, it cannot be excluded that new cases will appear.
Arras, December 4, 2003
Case of légionellose in arrondissement of Lens
Following apparition of two remaining cases of légionellose concerning
people with Harnes, of the investigations were carried out by the DDASS to
the Hospital complex of Lens.
They have allowed to identifier several patients
reached of légionellose present in the services of pneumology and rehabilitation
for several days, or already left hôpital. On the whole, there
are 9 cases of légionellose: eight men and a woman, old of 71, 79, 44, 70,
57, 53, 80, 82 and 77 years remaining with Harnes, Fouquières-les-Lens,
Vendin the Old one, Courrières, Lens, Wingles, Plane and Loison-under-Lens.
Among these people, one deplores 2 deaths, of which
that of a 53 years old man remaining in Lens. On the other hand, 3 people
regained their residence, their health not justifying one hospitalization
more. Several communities are concerned and the dates apparition of the disease
are spread out in time. However investigation is in hand, with research une possible source common exposition.
One is reminded that the form engraves légionellose
generally occurs at old subjects or subjects reached of chronic and serious
diseases and quaucune measurement of individual preventionest recommended by
the experts for the people living the sector.
Thorough investigations are in hand, une share
near each patient to identify his practices of life and, autre share, in
direction of the various possible environmental sources. To this end, samples
with the research of the bacterium are carried out on the patients and
these potential sources. These samples will be analyzed by Institut
Pasteur. To date on the environmental level:
- A the request of the DRIRE, all the companies
subjected to authorization with the title of regulation ICPE (Installation
Classified for the Protection of Environment), having systems air coolers
and located in the communities of residence of the patients concerned, took
measures intended to identify the possible presence of légionellose or to
clean their circuits of cooling.
- the DDASS continues to make carry out the checks
in a certain establishments number receiving of the public thus quau
residence of still hospitalized patients or who regained their residence.
The checks appeared for instant negative.
Taking into account the period incubation which
ranges between two and ten days, it cannot be excluded that new cases
appear. A cell of follow-up, made up of various services of Etat (Prefecture
- DDASS DRIRE Sub-prefecture) was installation on instruction of the Prefect
of Pas-de-Calais as of Monday.
Foot-note
One is reminded that the légionellose is an acute
pneumopathy due to Legionella, bacterium of the hydrous medium and whose
growth is supported by a temperature varying of 25 with 50°C.
This infection can occur 2 to 10 days after the
inhalation of a contaminated water aerosol. There is no transmission inter
human of the disease. The transmission of the bacterium to the man is thus
carried out by wet inhalation of aerosol. The sources of contamination
accused in the epidemics are the systems distribution of domestic hot water
(showers), the systems of air-conditioning (turns air coolers), the thermal
springs.
Arras, December 6, 2003
Légionellose in Pas-de-Calais:
This afternoon, the polyclinic of Riaumont with
Liévin, stated to have transferred this day towards the hospital complex will
Arras patient a 80 years old reached of the légionellose and domiciled with
Harnes, increasing the number of cases in the department to eleven.
Like all the preceding cases, this patient had the
first symptoms of affection between the 10 and on November 28 the last.
Arras, December 7, 2003
Légionellose in Pas-de-Calais:
Yesterday evening, the hospital complex of Lens
announced to have admitted in service of pneumology patient a 73 years old
reached of the légionellose and domiciled in Fouquières-les-Lens, increasing
the number of cases in the department with twelve.
This patient seems to be reached by the first
symptoms of affection on the 3rd December.
The cell of follow-up of the Prefecture est
joined together this morning to carry out an assessment of measurements taken
these last days and to determine the research orientations to deepen. The
investigations continue so much in the medical plan environmemental.
Thus, the DDASS continues its investigations in the
residence of the people reached, question the patients, or their entourage, in
order to know their practices and their displacements these last weeks and
continues to make carry out the checks in the Establishments Receiving of the
Public.
The DRIRE contacted, from the very start of last
week, all the establishments concerned with regulation ICPE (Installations
Classified for the Protection of Environment) located in the communities of
residence of the people reached.
Arras, December 8, 2003
Légionellose in Pas-de-Calais:
This day, five other cases of légionellose
were announced by the hospitals of Lensois.
According to the first elements enquête of the
doctors of the DDASS, first symptoms' of affection for ensemble of the cases
appeared before December 3.
It agit of 4 old men and one woman of 77, 75, 52, 71
and 77 years, resident with Harnes, Billy-Montigny, Noyelles-under-Lens and
Bully-the-Mines.
These new descriptions change the total number of
cases of légionellose in the department to 17. On the 17 cases listed since
last week, one deplores two deaths. Four patients are currently in rehabilitation
in the hospital complex of Lens in a stationary state, eight patients are
dealt with by the services of pneumology of the establishments of Lensois and
three could regain their residence.
The investigations continue so much in the medical
plan qu environmental. Thus, the DDASS continues its investigations in the
residence of the people reached, question the patients, or their entourage, in
order to know their practices and their displacements these last weeks.
Moreover, it continues to make carry out the checks
in the Establishments Receiving of the Public, in connection with the mayors
of the communities concerned. The DRIRE continues to control all the
establishments concerned with regulation ICPE (Installations Classified for
the Protection of Environment) located in the communities of residence of the
people reached and in the neighbouring communities, which represents a total of
eighteen communities.
The Prefect of Pas-de-Calais meets, tomorrow,
ensemble
elected officials of the communities concerned in order to review situation.
Arras, December 10, 2003
Légionellose in Pas-de-Calais:
This day, two cases of légionellose
were announced by the polyclinic Hénin-Beaumont, increasing the number of cases
detected with 19.un of the two patients, 80 years old, domiciled in Wingles.
The first elements of interrogatoire
medical reveal that the first symptoms declared the 1 December.
This person was thus contaminated about
November 21. autre, 71 years old, domiciled in Billy-Montigny. It would seem
that the first symptoms were detected at this patient about December 4; a
complete interrogation will be carried out this afternoon to confirm this date
The two patients are dealt with by the
service urgences of the polyclinic. The services of the DDASS continue the
investigations already put inuvre for the preceding cases: they carry out their
surveys to the residence of the people reached, question the patients, or their
entourage, in order to know their practices and their displacements these last
weeks. One is reminded that current apparition of case of légionellose in
Lensois nest related at all to epidemy infections nosocomiales which has
affected several establishments of health in the departments of the north and
the North-East of France these last months
December 12, 2003
Twenty
cases of légionellose were announced to Ddass of Pas-de-Calais since
November 28, 2003
.
All the patients were hospitalized. 75 % of them are of male sex. Their age lies
between 44 and 86 years (average 71 years). The date of beginning of the
clinical signs is between November 10 and
December 5, 2003
. Two people died, 14 patients are still hospitalized and 4 left.
The diagnosis of légionellose is confirmed for all the cases by the presence of
soluble antigen urinary. Bronchial samples for search for Legionella were
carried out among seven patients and are being analysed in the National Center
of Reference (CNR) of Legionella.
The epidemiologic investigation is carried out
by the Cell Inter Regional of Northern Epidemiology, and the DDASS, with the
support of InVS. All the patients were questioned to document their practices of
life and their displacements in the 10 days preceding which has occurred by the
disease, the maximum duration of incubation of the légionellose being 10 days.
According to information collected, the majority of the patients had attended a
zone in the east of the town of
Lens
: Harnes and its avoisinnantes communities. This information suggests the
assumption of a local common source of contamination, of type turn aéroréfrigérante
(TAR).
The investigation environmental is led by the
DRIRE and the DDASS. Measures were taken right now by the DRIRE and the
prefecture near the installations at the risk (disinfection of the systems of
cooling). A factory was suspected in Harnes, following samples having
revealed high rates of Legionella, and was closed on December 3 to allow the
disinfection of the system of cooling of its TAR. The other installations were
the subject of inspection, and the whole of sampling were transmitted to CNR for
analysis. In addition, the DDASS, in collaboration with the town halls
concerned, counts the installations not recorded with the DRIRE and being able
to be suspect.
If the suspected factory, closed the 3/12, is
at the origin of the contamination, other cases can still occur until December
13, taking into account the duration of incubation.
The insulation of clinical species and their
comparison with environmental species will make it possible to determine if one
of the identified sources at the risk is at the origin of the contamination.
Légionellose
- Pas de Calais
Dossier d'actualité de la Direction régionale de l'industrie, de la
recherche et de l'environnement Nord-Pas-de-Calais (Drire)
