13 de fev. de 2014

Gran’s Legionella hell linked to compost - Legionella longbeachae

Edinburgh News 13/02/2014

A GRANDMOTHER today told for the first time how she was left fighting for her life after falling victim to a deadly bug linked to humble potting compost.

At one point 72-year-old Margaret Malcolm deteriorated so badly that her family was warned she faced being placed on a life support system. She spent three weeks in hospital – mostly in intensive care – drifting in and out of consciousness as her lungs failed and concerns grew that she might not pull through.
Now home in Prestonpans, the frail grandmother-of-ten says she is still suffering lingering and debilitating after-effects of potentially deadly Legionella longbeachae, usually linked to inhaling dust from man-made potting compost.
She is now preparing to launch a legal fight for compensation and has appealed for warnings on compost bags to highlight the risks.
“I never knew that there was a chance of catching something like Legionella from a bag of compost and I don’t think many people do,” she said. “People need to know.
“It’s changed my life,” she added. “I get so breathless now. I used to be able to get about, walk to the bus stop and go to Tesco – now there’s no way I can do that. I have to rely on my daughters to do all my shopping for me.
“I even struggle to get up and down the stairs in my house. My confidence has been shattered by it. I’m constantly tired. I’ve been told I could be feeling like this for a year.”
Mrs Malcolm was one of six Scots to fall ill with potentially lethal Legionella longbeachae last September. Five cases were in Lothian and another one in Tayside. All needed hospital treatment and the cases were linked by health officials to gardening compost.
However, six months later, laboratory tests have only just been completed. And it will be a further two months before a report on the outbreak is likely to be published – raising concerns that others may have similar products and are unaware of the potential risks.
Today Mr and Mrs Malcolm’s lawyer Mark Gibson, a product liability law specialist based at Digby Brown solicitors, pointed out some other countries have put in place compulsory hygiene warnings and safety instructions to alert users to the Legionella threat posed by compost.
“The shocking part of this is that it involves such a 
mundane, everyday packaged product and users, quite rightly, do not expect to be exposed to potentially fatal strains of bacteria,” he added.
“The demographic of compost users includes many older people with underlying health issues which make them vulnerable. The dangers associated with the use of compost have been known to trade associations for some time and British standards ought to have been developed and followed. There were simple and cost-effective measures which could have prevented these very serious infections such as heat treatment of the product and the use of face masks.”
Mrs Malcolm had been working in her back garden in Northfield Gardens, Prestonpans, one day last summer. Within 24 hours her health had dramatically deteriorated.
“I had been repotting some plants,” she recalled. “Next day I was sitting with my neighbour having a wee blether when I got up and felt funny and a bit sick. I just flaked out.”
She was rushed to the Western General Hospital by ambulance with husband David, 78, by her side. “I didn’t know what was going on,” he said. “She was unconscious and the longer it went on, the worse I was starting to feel about what was happening. When the hospital staff said she was going into intensive care, I just thought ‘Oh my God’. Eventually we were told it was Legionella and it was like a pneumonia attacking her lungs.”
She was given antibiotics and oxygen but her condition failed to improve. “When they started to talk about her going on life support, our daughters were in tears. Thank goodness it didn’t come to that. When I heard there were other cases at the same time and that it was being linked to potting compost, I really couldn’t believe it. Who would think potting compost could do that?”
Mrs Malcolm had bought three 56-litre bags of J Arthur Bowers Multi-Purpose Compost from Strawberry Corner in Musselburgh and opened one to pot her plants. The only warning on the bag suggests users wear gloves.
A recent letter to the couple from Eleanor Smyth, Acting Principal Environmental Health Officer for East Lothian Council confirmed the Glasgow-based Legionella Reference laboratory was still testing the compost. However she confirmed: “The major source of human infection [from Legionella longbeachae] is considered to be commercial growing media and other composted materials such as bark and sawdust.
“As there has not been concerns from industry with regards the specific brand of compost associated with cases of Legionella, the product has not been withdrawn from market.”
Last October a Strathclyde University study into the 22 different compost brands sold in the UK revealed 14 contained a variety of Legionella species. Four were found to have L. longbeachae.
It is believed changes in how compost is manufactured, from being mostly peat to now including sawdust and bark, have created a breeding ground for the bug to thrive. When users open the bag and breathe in the spores – or inhale droplets of water dripping from hanging baskets – infection can occur.
It’s understood Mrs Malcolm’s compensation claim could focus both on the manufacturer of the compost and the Musselburgh garden centre which sold it.
Dr Syed Ahmed, Consultant in Public Health, Health Protection Scotland said a report on the outbreak is likely in the next few months: “It is important that all members of the National Incident Management Team have an opportunity to review the report before it is finalised.
“The risk of becoming unwell from gardening activities (such as working with compost) remains very low. However, we would recommend good hygiene in relation to gardening – wearing gloves, a mask, and washing hands immediately after use.”
J Arthur Bowers compost is made by Lincoln-based William Sinclair Horticulture Ltd. A spokesman for the company said: “William Sinclair has committed to ensuring advice with regard to good hygiene practice will be included on all labelling. We believe this response is proportionate to the very low level of risk involved.
We were sorry to hear of the illness that the lady from Edinburgh suffered, and we hope she has made a full recovery”.
Neil Duffield, a director at Strawberry Corner garden centre, said: “We take advice from our suppliers. There are warnings on the bags to wash your hands and I have seen some bags which give instructions on opening them in well ventilated places. We are guided by that.”

Number of cases is on the increase

Once unheard of in Britain, Legionella longbeachae cases have increased in recent years.
The main source of infection is commercially made compost. Between 2008 and 2012 there were nine cases of L.longbeachae notified to Health Protection Scotland. Two people died and all others were seriously ill. All had links with gardening.
In the same period there was only one case in England and Wales. Concern at Health Protection Scotland prompted an investigation last year by its National Incident Management Team. It probed similarities with high incidences of the illness in Australia – where compost is made using mostly sawdust and bark, materials which are being used to replace traditional peat in many UK manufactured composts.
Australian composts carry a manufacturer’s warning and advice to wear gloves and a facemask while handling. Heat treating the compost during production can kill the legionella bacteria. The HPS report concluded: “There is a definite but very small risk of L.longbeachae infection from using growing media in those undertaking gardening activities in Scotland.”
And it warned: “Given the increasing popularity of gardening as a hobby and the growing number of over-65s with a higher prevalence of at-risk conditions in the population likely to participate in it, further cases of Legionnaires’ disease due to this cause can be expected.”

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