Midlothian Health and Social Care Partnership

Why are some parts of Bonnyrigg Health centre being closed to patients and staff?

We have identified as part of our robust building management, monitoring and hygiene control measures, that there are bacteria affecting the water supplied in the health centre.  

This monitoring is carried out as routine activity in line with legislation and national guidance. It is not because of an ongoing problem with patient infection. We now need to take steps to clean and service the water system and carry out further testing.

Parts of the building are being closed to allow access for that work, and to minimise any potential risk to staff, patients or the general public.

We have active infection surveillance systems in place to identify any patient who may develop an infection with Legionella. We are reassured that there have been no human cases of this infection reported which could be linked to this building.

What is Legionella?

Legionella is a Gram-negative bacteria commonly found in soil, natural water sources (e.g. rivers, lakes) and artificial water supplies (e.g. in buildings, water fountains, spa baths)

There are 39 different species (types) of Legionella. One species, Legionella pneumophila, is responsible for around 90% of human infection.  We have not found this species in samples from Bonnyrigg.

Where Legionella in water becomes aerosolised (for example in showers, spa baths, sprinklers, air conditioning units) and inhaled by someone who is vulnerable to infection it can make them unwell.

These infections are rare in Scotland. Most cases are associated with recent foreign travel.

Is it harmful?

Legionella bacteria can cause illness ranging from mild infection requiring no treatment to severe or life-threatening pneumonia which requires hospital admission (often referred to as ‘Legionnaire’s disease’).

Legionella infections can be treated with antibiotics.

Legionella infections do not spread from person to person or from affected drinking water.

How do you prevent Legionella in healthcare buildings?

We can minimise the risk of Legionella infection by not allowing the bacteria to grow or multiply in water or allowing biofilm (a sort of bacterial slime) to form inside water tanks, pipes, or taps.

This is mainly achieved by:

• Movement of water: keeping enough water moving freely through the whole water system. Bacteria can multiply more easily where there is stagnation or reduced flow.
• Water temperature: water temperatures are maintained at below 20° c for cold water and above 55°c for hot water. Legionella bacteria find it difficult to grow in low or high temperatures.
• System Maintenance: regular checking, cleaning and repair of the whole plumbing system

Who has been involved in risk assessing this situation?

Prompt action is taken if laboratory results show there is Legionella in any sample. The actions required are guided by a number of things including the area that has been sampled, the type of services provided in the room, whether patients or others are ‘high risk’, how much has been found (the number of colony forming units or CFU in 1000mls of water sampled) and in how many places.

Results are shared with Estates, Microbiology, Infection Control Team, service managers and Health Protection Team who work together to agree the safest and most appropriate actions.

At low levels (low number of CFU) the only actions that may be required would include additional flushing through the system followed by repeat water testing to confirm this has worked.

At higher levels a more detailed risk assessment is carried out with input from Estates, IPCT, Health & Safety and Service managers.

Additional actions are sometime required to protect service users, staff and the wider public. Actions might include not using a tap/outlet until further work is completed.  Sometimes additional attachments are fitted to taps to filter out bacteria. These are called point of use filters. These cannot be used on all tap types.

Sometimes it may be necessary for service users and staff to stop using the room/area at all while sampling or other work is taking place.