Severe acute respiratory syndrome: Lessons may be learnt from the  outbreak of legionnaires' disease in Barrow in Furness

doi:10.1136/bmj.326.7403.1396-a

BMJ 2003;326:1396 (21 June), doi:10.1136/bmj.326.7403.1396-a

Letter

Severe acute respiratory syndrome

Lessons may be learnt from the outbreak of legionnaires' disease in Barrow in Furness

The first 150 words of the full text of this article appear below.

EDITOR—Zambon's editorial describes the challenge that outbreaks such as that of the severe acute respiratory syndrome(SARS) might pose for healthcare systems.¹ We have analysedthe local organisational response to the outbreak of legionnaires' disease in Barrow in Furness last summer. Some features maybe relevant to large scale "medical" incidents such as SARS,influenza epidemics, and the effects of biological terrorism.

Firstly, recognition of the outbreak may be delayed, especiallywhen symptoms are non-specific. Although Legionella was identified promptly, the lack of a single catastrophic trigger such asan explosion (as would be usual in a "typical" major incident)and the initial difficulty in predicting the scale of the outbreakled to some confusion as to quite whether, and when, a majorincident should be declared.

A further difference is the duration of the crisis, which necessitated careful planning to protect staff from overwork. This wouldbe . . . [Full text of this article]

Andrew F Smith, head of research and development

Andrew.Smith@rli.mbht.nhs.uk

Cathy Wild, researcher

Morecambe Bay Hospitals Trust, Royal Lancaster Infirmary, Lancaster LA1 4RP

John Law, professor

Department of Sociology, University of Lancaster, Lancaster LA1 4YT