NHS England issued a Patient Safety Alert yesterday (Tuesday, June 17) notifying all of its organisations providing midwifery, microbiological and neonatal services of the conditions which may put newborns at risk of the lung infection, which affects 350 to 400 people every year in England and Wales
It cautions against the use of a heated birthing pool 'which has been filled prior to the onset
of labour and where the temperature has been maintained by use of a heater and pump'.
The warning does not apply to heated birthing pools which are filled at the onset of labour, only those which are filled prior to labour and then maintained at the desired temperature, allowing bacteria to multiply.
The directive explains that 'if Legionella is present in the pool pump equipment or the domestic supply, the warm water in the heated pool provides ideal growth conditions, potentially over several weeks'.
It adds that: "Pumps of any type should be used solely for pool emptying and not for recirculation."
Legionnaires' disease, or legionella pneumophila, affects between 350 and 400 people every year in England and Wales. However, it is extremely rare in babies and children, so newborns are not routinely checked for symptoms.
The Patient Safety Alert reports that only one other case of Legionnaires' disease in a child under nine has been reported in the UK since 1990. There are two known cases of Legionnaires' being transmitted to newborns via birthing pools, both from the 1990s and neither occurring in the UK.
Meanwhile, the baby who became infected with Legionnaires' disease after a home birth in a heated birthing pool remains in intensive care. Public Health England says that the company who supplied the pool in question have recalled the model suspected of transmitting the infection.
A full assessment is under-way, and until it is completed, the NHS alert instructs birth and neonatal professionals to make sure that heated pools 'filled in advance of birth' are not used for labour in a home setting.