Legionnaires' disease outbreak investigation toolbox

Legal context for outbreaks

• Legionella is not transmitted from person-to-person.
• Legionella is spread by any mechanism/operation that can generate aerosols or water droplets. Therefore, cases are usually linked to manmade water/cooling systems.
• Poorly maintained/designed water/cooling systems are usually the sources of infection and because of this, there is usually a potential for legally-enforced remedy.
• Most countries have legislation governing the control of Legionella in water/cooling systems, e.g. health and safety legislation.
• Because of this, breaches of such legislation can lead to prosecution and, if cases can be linked to such breaches, then the patient has recourse to legal means to gain compensation.
• An outbreak may lead to a police investigation and a corporate manslaughter charge.
• As a consequence of possible breaches of legislation, the outbreak control team should arrange for careful registration of all actions taken (in large outbreaks a logger might be appointed, apart from the need for careful notetaking by each of the technical experts involved).
• The outbreak control team should take into account all applicable legal issues with data protection and data sharing and review regularly in preparation for future outbreak investigations.