Facilitator notes: Legionnaires’ disease: Risk assessment, outbreak investigation and control Session 12: Legionnaires disease – The importance of communication and the media ECDC, 2012

Why is LD of interest to the media? People - sick people in hospital, people who use commercial facilities i.e. potential negligence - Death – high fatality (around 10%) Scandal - ‘dirty’ hospitals (lack of maintenance), negligence, failure to act on advice

The importance of the location Rivers and streams = natural therefore any problem is a tragedy Hot and water cooling systems in the home – most likely domestic therefore tragedy Commercial/public premises – is maintenance adequate/have they had this problem before? Will there be compensation and fines e.g. corporate manslaughter?

How the media work News release - there were 345 cases of LD in 2009 - straight in the bin There were 345 cases of LD in 2009 and 80 per cent were in hospitals - keep reading There were 276 (80% of 345) cases of LD in 2009 in hospitals and this is a 90% increase on 2008 - reach for the phone There were 276 cases of LD in 2009 in hospitals, 90% increase on previous year and 70% of patients died - FRONT PAGE

The outbreak control team (OCT) Staff from the communications should be included on the OCT A reactive statement should be prepared detailing what the organisation is doing e.g. the National Institute is investigating and working with other relevant bodies (e.g. Environmental Health). The source of the outbreak/case is taking advice and remedial action etc. (if appropriate)

The outbreak control team contd. If it is a large outbreak, such as that seen in Wales in September 2010, then the public health agency should engage proactively with the media e.g. press conferences, daily or weekly updates, make spokespeople available etc.

The statement All press releases/statements have to have the Who, What, Where, When, Why and How? Who: e.g. the National Institute or your municipal public health department What: Is the issue? What are you trying to say? Where: Global, national or local? When: Has this happened? Published today? Why: Are you giving this information? How: Has this happened?

The statement contd. Proactive v reactive Proactive: Some information you want to release proactively to make people aware of a risk of something and to highlight the action you are taking – e.g. a cluster of cases of LD in an area Reactive: a single case in a hospital and a positive swab has been taken from a tap/the area closed and action taken

The statement contd. What is LD? Explain. It is not contagious! Identify a spokesperson and include a quote from your expert

Examples of what journalists ask I don't know if you can help me but we've heard about a man that has died after contracting Legionnaires disease just days after using a hotel jacuzzi. Have you heard of this before - someone contracting Legionnaires in this way and have you ever heard about any deaths? Also, please could you provide a comment about the potential dangers of jacuzzis and what people need to be aware of?

Examples contd. Another query regarding Army accommodation where LD had been found. There were no cases in patients. Angle - poor accommodation had led to the bacteria developing. A query from the Sunday Times - the National Institute produced a report in 2007 with recommendations to the hospital re their issues with Legionnaires’ disease. They’d like a comment from us on whether or not the hospital has complied with those recommendations. They’d also like a general comment of Legionnaires’ disease and want us to comment on whether the hospital is a particularly bad hospital for the disease…. 

You will have no control over the headline Different people on the newspaper write the headlines than write the article so you could see: Water cooling tower closed in Legionnaires’ scare Killer compost Disease danger in windscreen sprays

After all that what could go wrong?

Facilitator notes: Acknowledgements The creation of this training material was commissioned in 2010 by ECDC to Health Protection Agency (UK) and the University of Chester (UK) with the direct involvement of Louise Brown, Janice Gidman, Emma Gilgunn-Jones, Ian Hall (on behalf of the ECDC Legionnaires Disease Outbreak Toolbox Development Group), Tim Harrison, Rob Johnston, Carol Joseph, Sandra Lai, John Lee, Falguni Naik, Nick Phin, Michelle Rivett, and Susanne Surman-Lee. The revision and update of this training material was commissioned in 2017 by ECDC to Transmissible (NL) with the direct involvement of Arnold Bosman and Kassiani Mellou.