WRITTEN QUESTION E-3233/00

by Elly Plooij-van Gorsel (ELDR) and Jules Maaten (ELDR) to the Commission

(17 October 2000)

Subject: Failure to publish information about cases of legionnaires' disease in European hotels

According to information received from the European Working Group for Legionella Infections (EWGLI), 12 000 tourists using holiday accommodation in Europe have apparently been affected by legionnaires' disease in the last five years. It is estimated that 1200 of that number have subsequently died from the disease.

1. Is the Commission aware that the national health inspectorates, which are members of EWGLI, frequently do not notify this information to the tour operators who organise tours using the hotels where outbreaks have occurred? Is it further aware that, in their turn, the tour operators do not always inform their clients about outbreaks of the disease and usually let the booking proceed?

2. Does the Commission deem it acceptable that information from EWGLI, a body funded by European money, does not reach the tourists for whom such information is literally a matter of life or death? If not, what does the Commission intend to do about it?

3. Does the Commission agree that information from EWGLI must be made public and accessible to all rather than being kept secret?

Joint answer to Written Questions P-3211/00, E-3233/00 and P-3239/00 given by Mr Byrne on behalf of the Commission

(30 November 2000)

The data attributed to the European working group for Legionella infections (EWGLI) surveillance scheme and mentioned in the Dutch paper were an incorrect extrapolation from information on the EWGLI website. The actual number of travel related cases of legionnaires' disease that the EWGLI surveillance scheme has ascertained is one tenth of that quoted. The correct information is available at http://www.ewgli.org/.

The clusters of travel associated legionnaires' disease reported in the progress report(1) on the Community network through Commission Decision 2000/57/EC of 22 December 1999 on the early warning and response system for the prevention and control of communicable diseases under Decision no 2119/98/EC of the Parliament and of the Council(2) in its first year of operation were not a reflection of increasing outbreaks of legionnaires' disease. The EWGLI surveillance scheme has been reporting clusters through its network since 1987 when it became operational. This surveillance shows that the number of cases involving European residents associated with clusters of travel associated legionnaires' disease has in fact been declining in recent years.

The main aim of the EWGLI Legionella surveillance scheme, which is funded by the Commission, is the surveillance of cases associated with travel. This enables the detection of clusters of disease that would not necessarily be detected by national surveillance alone, in order to allow investigation and preventive measures. The association of cases with a site identified through the surveillance scheme is a starting point for investigation by local authorities and not an identification of the site as the actual source of infection.

In order to ensure the availability of relevant information as rapidly as possible, the surveillance scheme provides that information is to be treated as confidential and used by the participants for the purpose of making risk assessments and prevention. Making the information available to the public could be misleading given the unavoidably ambiguous, non-validated nature of much of the data. Without the rules of confidentiality, less information is likely to be made available, limiting the surveillance networks' effectiveness in preventing disease. However, the Commission is sympathetic to improving the information available to the public.

In the future proposed Community public health programme, one of the main three strands aims to improve information and knowledge for the development of public health. That includes information to the general public on health risks. In this context, the Commission will consider how best to reconcile the two requirements of confidentiality and transparency.

The EWGLI surveillance scheme places summary information on the problem of legionnaires' disease and travel on its public website as well as information on prevention to both the public and hoteliers (http://www.ewgli.org).

Following the two outbreaks in 1999 at a Netherlands flower show and at a trade fair in Belgium, the Commission has been working with experts in Member States and the Community network established by Decision 2119/98/EC of the Parliament and of the Council of 24 September 1998 setting up a network for the epidemiological surveillance and control of communicable diseases in the Community(3) to identify the need for future preventive action for legionellosis at a European level. legionnaires' disease is already a priority under Commission Decision 2000/96/EC of 22 December 1999 on the communicable diseases to be progressively covered by the Community network under Decision no 2119/98/EC of the Parliament and of the Council(4) within the Community network for epidemiological surveillance. The Commission has supported improvements in European surveillance of legionnaires' disease by extending this to non-travel related Community outbreaks and has supported European initiatives to develop technical guidance on prevention and control of legionellosis. The Commission will discuss this further with the Community network committee in December 2000 and will propose any further action.

Concerning the Community's drinking water legislation, Council Directive 80/778/EEC of 15 July 1980 relating to the quality of water intended for human consumption(5) applies. This stipulates that water intended for human consumption should not contain pathogenic organisms. The new drinking water Council Directive 98/83/EC of 3 November 1998 on the quality of water intended for human consumption(6) has to be transposed into national laws by 25 December 2000 and has to be implemented by 25 December 2003. Article 4.1(a) of this Directive puts an obligation on Member States to ensure that water intended for human consumption is free from any micro-organisms and parasites and from any substances which, in numbers or concentrations, constitute a potential danger to human health. The Commission considers that the Community legislation on drinking water quality is sufficiently protective. It is recalled that the source of the Legionella outbreak in the Netherlands was not bad drinking water quality, but a contaminated fire hose used to transport the water for use by the exhibition displays.

As far as the draft best available techniques (BAT) reference document(7) is concerned, in the context of the Integrated Pollution Prevention and Control (IPPC) Council Directive 96/61/EC of 24 September 1996 concerning integrated pollution prevention and control(8), it identifies five measures that operators of industrial wet cooling systems should take in order to reduce biological growth in these systems. These measures are strongly recommended for the licensing authorities that issue permits for all installations falling within the scope of the IPPC Directive. However, no universally applicable treatment has as yet been identified that at the same time takes into account the environmental and health requirements, and more research is needed.

Nor is it currently possible to propose a specific level of colony forming units (the unit in which the quantity of bacteria is measured) associated with a certain risk level. In the light of this, the Commission considers that it should remain the responsibility of the competent authority to discuss this problem with the plant operator, and to specify in more detail how the above-mentioned measures should be implemented, taking into account local factors such as site location and climate conditions.

(1) Progress Report on the Network for the Epidemiological Surveillance and Control of Communicable Diseases in the Community. COM(2000) 471 final. http://europa.eu.int/comm/health/ph/others/network/net03_en.pdf.

(2) OJ L 21, 26.1.2000.

(3) OJ L 268, 3.10.1998.

(4) OJ L 28, 3.2.2000.

(5) OJ L 229, 30.8.1980.

(6) OJ L 330, 5.12.1998.

(7) http://eippcb.jrc.es/.

(8) OJ L 257, 10.10.1996.