WRITTEN QUESTION P-3239/00

by Dorette Corbey (PSE) to the Commission

(12 October 2000)

Subject: Legionnaires' disease

A Dutch newspaper recently reported that, for several years now, European health authorities had been aware of the identity of about 100 hotels and apartments which had been connected on a number of occasions with legionnaires' disease but that they would not divulge those names. On 7 September 2000, the Commission published its Progress report on the network for the epidemiological surveillance and control of communicable diseases in the Community (COM(2000) 471 final) in which it reported a large number of new cases of legionnaires' disease in, amongst other countries, Belgium, France, Spain and the United Kingdom.

1. Does the Commission take the view that the measures taken by the Member States' authorities to control legionnaires' disease are adequate?

2. Will the new outbreaks of the disease prompt the Commission to propose Community measures? If, so, what measures is the Commission considering?

3. Does the Commission take the view that the failure of the national authorities to publish the names and addresses of hotels and apartments which have, on several occasions, been connected with legionnaires' disease is in line with the European policy of seeking to increase consumer confidence by means of complete and conclusive information (see the mission statement of the Commission's DG for Consumer Health Protection).

4. Does it take the view that the names and addresses of hotels and other holiday accommodation which have been connected with legionnaires' disease must be published? If so, should this involve publication of the presence of legionella in a specific location or publication of possible cases of disease?

5. Is the Commission prepared to play a part in this matter and, for example, to use electronic means of communication?

6. What other measures is the Commission taking, and what measures will the Commission be recommending to the Member States in order to provide consumers with information about the threat posed by legionella to human health in the EU?

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.