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14 maltatoday | WEDNESDAY • 10 NOVEMBER 2021 NEWS European Parliament president knocked down by Legionnaires' disease "IN September, during the ple- nary session of the European Parliament, I came down with a bad case of pneumonia caused by Legionella," the 65-year-old president of the European Par- liament, David Sassoli, said in a video message on his social me- dia accounts. On 15 September, Sassoli was taken to the Hôpital Civil in Strasbourg, treated, then hos- pitalised "in good condition", according to a note released by his spokesperson, Roberto Cuillo. The infection was diagnosed a few days before the yearly Commission president's ad- dress to MEPs, the State of the Union, which was chaired instead by one of Parliament's vice-presidents, Maltese Chris- tian-democrat Roberta Metso- la. After returning to Italy to re- cover from the disease, he had a relapse, "and this episode prompted the doctors to rec- ommend a series of tests and investigations, and that's what I'm doing," he added. Doctors are now working to ensure that he can return to presidential duties as soon as possible, Sassoli concluded in his message. The fact he was diagnosed with pneumonia led reporters to initially speculate on the Parliament's president con- tracting COVID-19 which his spokespersons promptly de- nied. "There is also a risk that le- gionellosis might be misin- terpreted or misdiagnosed as being COVID, due to the fact that symptoms can be quite similar to early Legionnaire's diseases," said Susanne Lee, a microbiologist with many years of experience in British public health agencies, in a recent in- terview with EURACTIV. She added that getting a diag- nosis quickly for legionellosis and getting the right antibiot- ics early could significantly im- pact a successful outcome from the disease. What is Legionellosis? Legionnaires' disease occurs by inhaling aerosols carrying the Legionella bacteria, which develops primarily in warm, stagnant water. The subse- quent infection can then lead to a deadly form of pneumonia. Legionella bacteria spreads through vapour which can commonly come from air-con- ditioning units of large build- ings. Adults over the age of 50 and people with weak immune systems, chronic lung disease, or heavy tobacco users are those most at risk. Hot and cold water systems are the second most common source of infection It is no surprise that Sassoli was infected in mid-Septem- ber, as most outbreaks and cas- es of Legionnaires disease hap- pen during the summer season. With temperatures rising, water distribution systems are at risk of being colonised by legionella bacteria. For this reason, climate change is of- ten considered one of the rea- sons behind the increase of observed cases of legionellosis, particularly since 2017. There are more than 60 spe- cies of this bacteria known to date, but Legionella pneumo- phila serogroup 1, causes most Legionnaires disease infec- tions and the deadliest form of pneumonia. According to the ECDC, Legionella pneumophi- la amounted to approximately 96% of confirmed cases in Eu- rope. Recent developments at EU level The extension of the Le- gionella bacteria monitoring to every potable water system in the EU is part of the new risk assessment analysis included in the revised EU's Drinking Wa- ter Directive (DWD). The revision updated param- eters of water quality set more than 20 years ago to restore citizens' trust in tap water and reduce plastic bottle usage. Once in force, Legionella monitoring will be extended to every potable water system in the EU as part of a new risk assessment analysis. They are currently compulsory only for hotels and public offices. However, Legionella moni- toring was at the centre of a back-and-forth during the final negotiations between the Eu- ropean Parliament and the EU ministers to amend the initial Commission's legislative pro- posal. According to the scientific world, the inclusion of test- ing for all Legionella species in the DWD might lead to a large amount of work, time, and financial expense for many end-users and delay test results with immediate consequences for public health. In its original proposal backed by the Council, the Commis- sion asked water suppliers to check for legionella species first and then the most danger- ous one – Legionella pneumo- phila. In the final compromise reached by the EU lawmakers, member states were left free to determine their approach to testing, as they can choose the methods they find most ap- propriate for the purposes they specify in national guidelines. In Annex III of the drinking water directive, EU countries will be provided with the op- tion of using alternative Le- gionella pneumophila testing to achieve public health pro- tection objectives and are also called upon to establish guide- lines for sampling methods of legionella. Ironically, the Commission's approach on monitoring all Legionella species instead of focusing on the one leading to the deadly form of pneumonia that infected Sassoli was criti- cised by the former European Parliament negotiator Michel Dantin, who said it would be a waste of time and resources. What is legionellosis, the disease that took European Parliament's President David Sassoli out of the parliamentary game for more than two months? And how has the EU improved legislation to tackle the spread of the pneumonia- causing bacteria?