How many cases of legionellosis are there in the Maldives?

None?

Are you sure?

NO we are not absolutely sure.

There is a huge lack of awareness of legionella in the Maldives, and there is almost no chance of a legionellosis patient being diagnosed accurately in this country.

Lets face it – if someone goes to the clinic with fever, muscle ache, headache and cough, he will be isolated immediately and tested for COVID only. What we don’t realise is that another deadly pathogen – one whose mortality rate is much higher, is lurking in all our water systems – there is a real risk of people getting sick from inhaling this bacteria, and to confuse it all, patients with legionellosis show very similar symptoms to COVID 19.

OK – I’ve mentioned legionellosis / legionella several times now…. But I bet most of you have never heard of it. To be honest, I did not hear of this till I was over 40years, and well into the safety industry. And to be even more honest, doctors and clinicians themselves are painfully unaware of this disease, so much that only 10% of legionellosis cases are actually reported and recorded in the world. Most of them in the US, Europe and Australia.

So have I piqued your curiosity now?

……..In simple terms, legionella is a bacteria which is found in water systems. In small numbers, they are harmless. However, if conditions in our man-made water systems (i.e. hot and cold water systems and cooling systems) are such that the bacteria is allowed to multiply, then they may grow to unacceptably large numbers – enough to make susceptible people very sick. The disease caused by legionella bacteria is called legionellosis.

So – what causes this pathogen to multiply? Basically, the same thing which enables people to multiply – warmth, food, shelter.

1.      Warmth – temperatures between 20 – 50ºCare good for legionella growth. The best temperature being the temperature of the human body, 37ºC.

2.      Food – slime, sludge, algae, sediment, iron, scale, etc in water are all fantastic food for legionella.

3.      Shelter – rust, scale, biofilms, amoeba in water. Basically, stuff in the water which should not be there.

4.      In addition, the bacteria thrives stagnant conditions – i.e. no movement.

Take away any of the above, and the bacteria cannot multiply.

Good news is that consuming them through the mouth and digesting them will not cause illness. Legionellosisis not a food borne illness. Nor can this bacteria spread from person to person– it is not infectious.

The pathogen normally enters our body as aerosols (sprays of water) through our nose and into our lungs.

Once there, the warm, moist conditions of our lungs enables them to multiply and the first symptoms may appear in a few days.

The crux of the problem is - the worldwide outbreak of covid19 has placed another added burden for Legionnaires’ disease prevention.

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‍As our hotels stood empty for several weeks or longer, unused by humans…. …..unseen and potentially forgotten in the drama of a pandemic, this lethal bacteria can take advantage of being left alone in a disused water system…….

Now that COVID is eventually coming under control, with national vaccination programmes in full swing, everyone is desperate for a holiday, and sure enough, they are flocking to “open” tourist destinations such as the Maldives.

All of our hotels and resorts in the Maldives have been welcoming tourists back for weeks, many checks and measures are in place to control the sars-cov2 virus, stringently applied by the HPA.

However, with additional measures required to deal with COVID-19 safety issues, are we also making sure that the risk of Legionnaires’ disease is not forgotten?

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