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Akihiko Okayama - One of the best experts on this subject based on the ideXlab platform.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological fi ndings of
2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires' disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investiga- tion of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires' disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the character- istic fi ndings of Legionnaires' disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological fi ndings of HRCT were analyzed in 35 patients. The radio- logical severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires' Disease of the Min- istry of Health, Labour and Welfare of the Japanese Gov- ernment. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires' disease. Typical HRCT fi ndings showed bilateral multilobar infi ltrates in the subpleural
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological findings of pneumonia
Journal of Infection and Chemotherapy, 2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires’ disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investigation of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires’ disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the characteristic findings of Legionnaires’ disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological findings of HRCT were analyzed in 35 patients. The radiological severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires’ Disease of the Ministry of Health, Labour and Welfare of the Japanese Government. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires’ disease. Typical HRCT findings showed bilateral multilobar infiltrates in the subpleural areas without centrilobular opacities. Multivariate logistic regression analysis identified male sex, short incubation period, high serum C-reactive protein, high serum alanine aminotransferase, hyponatremia, and positive Legionella urinary antigen test results as independent risk factors for high pneumonia scores. Patients with high pneumonia scores required significantly longer hospitalization and showed poor prognoses.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse i a clinical analysis
Journal of Infection and Chemotherapy, 2008Co-Authors: Takashi Sasaki, Nobuhiro Matsumoto, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:Few reports have analyzed the clinical manifestations of patients with Legionnaires’ disease in large outbreaks throughout the world. We retrospectively evaluated the clinical presentation and prognostic factors in 76 patients with Legionnaires’ disease, reported by local physicians, in a large outbreak resulting from contamination of the water in a public bathhouse in Miyazaki, Japan. Fever, gastrointestinal tract symptoms, and abnormal neurological findings were seen in 95%, 35%, and 21% of the 76 patients, respectively. Respiratory tract symptoms were seen in only 42% of the patients, although all of these patients revealed pneumonia on chest X-ray. Only 20 (31%) of the 64 patients who had microbiological tests were reported to have positive results for one of the three microbiological tests (sputum culture, serology, and urinary antigen) which are specific for Legionella infection. Based on univariate analysis, the existence of neurological symptoms, elevated levels of C-reactive protein and transaminases, hyponatremia, a positive urinary antigen test, and serological evidence of Legionella infection were independent risk factors for poor clinical courses in patients with Legionnaires’ disease. Patients treated with antimicrobial agents, such as macrolides, tetracyclines, and/or fluoroquinolones, within 3 days of onset of illness exhibited significantly better outcomes, when assessed by a multivariate logistic-regression model, after adjusting for the severity of pneumonia. Taking a careful history and documenting potential Legionella exposure, as well as microbiological testing, is important for an accurate diagnosis of Legionnaires’ disease. Antimicrobials effective against Legionella bacteria should be administered without delay in subjects with suspected Legionnaires’ disease.
Robert F. Breiman - One of the best experts on this subject based on the ideXlab platform.
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Risk Factors for Domestic Acquisition of Legionnaires Disease
JAMA Internal Medicine, 1996Co-Authors: Walter L. Straus, Joseph F. Plouffe, Thomas M. File, Harvey B. Lipman, Barbara H. Hackman, Sara-jane Salstrom, Robert F. Benson, Robert F. BreimanAbstract:Background: Legionnaires disease is a common cause of adult pneumonia. Outbreaks of Legionnaires disease have been well described, but little is known about sporadically occurring Legionnaires disease, which accounts for most infections. Exposure to contaminated residential water sources is 1 plausible means of disease acquisition. Methods: Employing a matched case-control study design in 15 hospitals in 2 Ohio counties, we prospectively enrolled 146 adults diagnosed as having nonepidemic, community-acquired Legionnaires disease and compared each with 2 hospital-based control patients, matched for age, sex, and underlying illness category. An interview regarding potential exposures was followed by a home survey that included sampling residential sources for Legionella . Interview and home survey data were analyzed to estimate the risk of acquiring Legionnaires disease associated with various exposures. Results: Multivariate analysis showed that a nonmunicipal water supply (odds ratio [OR], 2.26; 95% confidence interval [CI], 1.17-4.37), recent residential plumbing repair (OR, 2.39; 95% CI, 1.10-5.18), and smoking (OR, 3.48; 95% CI, 2.09-5.79) were independent risk factors for Legionnaires disease. Univariate analysis suggested that electric (vs gas) water heaters (OR, 1.97; 95% CI, 1.10-3.52), working more than 40 hours weekly (OR, 2.13; 95% CI, 1.12-4.07), and spending nights away from home before illness (OR, 1.68; 95% CI, 1.03-2.74) were additional possible risk factors. Lower chlorine concentrations in potable water and lower water heater temperatures were associated with residential Legionella colonization. Conclusions: A proportion of sporadic cases of Legionnaires disease may be residentially acquired and are associated with domestic potable water and disruptions in residential plumbing systems. Potential strategies to reduce Legionnaires disease risk include consistent chlorination of potable water, increasing water heater temperatures, and limiting exposure to aerosols after domestic plumbing repairs. Arch Intern Med. 1996;156:1685-1692
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outbreak of Legionnaires disease among cruise ship passengers exposed to a contaminated whirlpool spa
The Lancet, 1996Co-Authors: D B Jernigan, Robert F. Benson, Robert F. Breiman, Barry S. Fields, Jo Hofmann, Martin S Cetron, J P Nuorti, Harvey Lipman, R J Carter, C A GeneseAbstract:Abstract Summary Background Outbreaks of travel-related Legionnaires' disease present a public-health challenge since rapid, sensitive, and specific diagnostic tests are not widely used and because detection of clusters of disease among travellers is difficult. We report an outbreak of Legionnaires' disease among cruise ship passengers that occurred in April, 1994, but that went unrecognised until July, 1994. Methods After rapid diagnosis of Legionnaires' disease in three passengers by urine antigen testing, we searched for additional cases of either confirmed (laboratory evidence of infection) or probable Legionnaires' disease (pneumonia of undetermined cause). A case-control study was conducted to compare exposures and activities on the ship and in ports of call between each case-passenger and two or three matched control-passengers. Water samples from the ship, from sites on Bermuda, and from the ship's water source in New York City were cultured for legionellae and examined with PCR. Findings 50 passengers with Legionnaires' disease (16 confirmed, 34 probable) were identified from nine cruises embarking between April 30 and July 9, 1994. Exposure to whirlpool spas was strongly associated with disease (odds ratio 16·2, 95% Cl 2·8-351·7); risk of acquiring Legionnaires' disease increased by 64% (95% Cl 12-140) for every hour spent in the spa water. Passengers spending time around the whirlpool spas, but not in the water, were also significantly more likely to have acquired infection. Legionella pneumophila serogroup 1 was isolated only from the sand filter in the ship's whirlpool spa. This isolate matched a clinical isolate from the respiratory secretions of a case-passenger as judged by monoclonal antibody subtyping and by arbitrarily primed PCR. Interpretation This investigation shows the benefit of obtaining a recent travel history, the usefulness or urine antigen testing for rapid diagnosis of legionella infection, and the need for improved surveillance for travel-related Legionnaires' disease. New strategies for whirlpool spa maintenance and decontamination may help to minimise transmission of legionellae from these aerosol-producing devices.
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Reevaluation of the Definition of Legionnaires' Disease: Use of the Urinary Antigen Assay
Clinical Infectious Diseases, 1995Co-Authors: Joseph F. Plouffe, Thomas M. File, Sara-jane Salstrom, Robert F. Breiman, B. A. Hackman, Barbara J. Marston, Barry S. FieldsAbstract:: Cases of Legionnaires' disease have been categorized as definitive and presumptive. The sensitivity and specificity of antibody titers of > or = 256 and of urinary antigen ratios of > or = 3 were evaluated in 68 patients with "definitive" Legionnaires' disease and in 636 patients with pneumonia who had negative cultures and did not have fourfold rises in titers of antibody to Legionella pneumophila. An acute-phase antibody titer of > or = 256 did not discriminate between cases and noncases (10% vs. 6%; P = .29). The urinary antigen assay gave a positive result in fewer than 1% of noncases but was positive in 55.9% of all cases. This assay was most sensitive (80%) in cases in which L. pneumophila serogroup 1 was isolated. We propose that the case definition for definitive Legionnaires' disease be expanded to include positive urinary antigen assays and that the category of presumptive Legionnaires' disease--based on acute-phase or standing antibody titers of > or = 256 in the nonoutbreak setting--be discarded. The urinary antigen assay will be a valuable tool in the prompt diagnosis of Legionnaires' disease.
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Investigation of the risk factors for sporadically occurring Legionnaires` disease
1995Co-Authors: Joseph F. Plouffe, Robert F. Breiman, Thomas M. FileAbstract:The potential of acquiring Legionnaires` disease in the home environment was studied using a case-control design with 146 cases of Legionnaires` disease and 275 matched controls living in two counties in Ohio. By multivariate analysis, cases were more likely than controls to have Legionellae cultured from water sources in the home, to have non-municipal water supplied to their home, and to have had recent plumbing work on their home. Franklin county residents with underlying health conditions had strongest associations with domestic risk of acquiring Legionnaires` disease presence of Legionellae in home (p
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Surveillance for Legionnaires' Disease: Risk Factors for Morbidity and Mortality
JAMA Internal Medicine, 1994Co-Authors: Barbara J. Marston, Harvey B. Lipman, Robert F. BreimanAbstract:Background: To augment available information about the epidemiology of Legionnaires' disease, we analyzed data reported to the passive surveillance system at the Centers for Disease Control and Prevention, Atlanta, Ga, from 1980 through 1989. Methods: Risk of disease associated with specific demographic characteristics and health conditions was calculated by comparing the surveillance group with the US population. Risk of death was calculated using multivariate logistic regression models. Results: A diagnosis of Legionnaires' disease was confirmed on the basis of clinical and laboratory criteria for 3254 patients. Disease rates did not vary by year, but were higher in the northern states and during the summer.Legionella pneumophila, serogroup 1, constituted 71.5% of fully identified isolates. This study confirmed previously identified risk factors for Legionnaires' disease. In addition, a markedly elevated risk was identified for persons with acquired immunodeficiency syndrome (rate ratio, 41.9; 95% confidence interval, 12.9, 71.0), or hematologic malignancy (rate ratio, 22.4; 95% confidence interval, 19.0, 25.9). Likelihood of death was increased in patients who were elderly or male; those with hospital-acquired infection, renal disease, malignancy, or immunosuppression; and those from whomL pneumophila, serogroup 6, was isolated. Conclusions: Infection withLegionellaremains an important cause of disease and death in the United States. Diagnosis and treatment of Legionnaires' disease should be targeted at patients at increased risk for illness and complications due toLegionellainfection. Diagnostic tests for Legionnaires' disease based on species other thanL pneumophila, serogroup 1, should be developed and tested. Recommendations for prevention of Legionnaires' disease should be focused on settings where there are persons at greatest risk for illness or serious outcome. (Arch Intern Med. 1994;154:2417-2422)
Nobuhiro Matsumoto - One of the best experts on this subject based on the ideXlab platform.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological fi ndings of
2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires' disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investiga- tion of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires' disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the character- istic fi ndings of Legionnaires' disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological fi ndings of HRCT were analyzed in 35 patients. The radio- logical severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires' Disease of the Min- istry of Health, Labour and Welfare of the Japanese Gov- ernment. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires' disease. Typical HRCT fi ndings showed bilateral multilobar infi ltrates in the subpleural
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological findings of pneumonia
Journal of Infection and Chemotherapy, 2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires’ disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investigation of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires’ disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the characteristic findings of Legionnaires’ disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological findings of HRCT were analyzed in 35 patients. The radiological severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires’ Disease of the Ministry of Health, Labour and Welfare of the Japanese Government. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires’ disease. Typical HRCT findings showed bilateral multilobar infiltrates in the subpleural areas without centrilobular opacities. Multivariate logistic regression analysis identified male sex, short incubation period, high serum C-reactive protein, high serum alanine aminotransferase, hyponatremia, and positive Legionella urinary antigen test results as independent risk factors for high pneumonia scores. Patients with high pneumonia scores required significantly longer hospitalization and showed poor prognoses.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse i a clinical analysis
Journal of Infection and Chemotherapy, 2008Co-Authors: Takashi Sasaki, Nobuhiro Matsumoto, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:Few reports have analyzed the clinical manifestations of patients with Legionnaires’ disease in large outbreaks throughout the world. We retrospectively evaluated the clinical presentation and prognostic factors in 76 patients with Legionnaires’ disease, reported by local physicians, in a large outbreak resulting from contamination of the water in a public bathhouse in Miyazaki, Japan. Fever, gastrointestinal tract symptoms, and abnormal neurological findings were seen in 95%, 35%, and 21% of the 76 patients, respectively. Respiratory tract symptoms were seen in only 42% of the patients, although all of these patients revealed pneumonia on chest X-ray. Only 20 (31%) of the 64 patients who had microbiological tests were reported to have positive results for one of the three microbiological tests (sputum culture, serology, and urinary antigen) which are specific for Legionella infection. Based on univariate analysis, the existence of neurological symptoms, elevated levels of C-reactive protein and transaminases, hyponatremia, a positive urinary antigen test, and serological evidence of Legionella infection were independent risk factors for poor clinical courses in patients with Legionnaires’ disease. Patients treated with antimicrobial agents, such as macrolides, tetracyclines, and/or fluoroquinolones, within 3 days of onset of illness exhibited significantly better outcomes, when assessed by a multivariate logistic-regression model, after adjusting for the severity of pneumonia. Taking a careful history and documenting potential Legionella exposure, as well as microbiological testing, is important for an accurate diagnosis of Legionnaires’ disease. Antimicrobials effective against Legionella bacteria should be administered without delay in subjects with suspected Legionnaires’ disease.
Takashi Sasaki - One of the best experts on this subject based on the ideXlab platform.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological fi ndings of
2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires' disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investiga- tion of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires' disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the character- istic fi ndings of Legionnaires' disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological fi ndings of HRCT were analyzed in 35 patients. The radio- logical severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires' Disease of the Min- istry of Health, Labour and Welfare of the Japanese Gov- ernment. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires' disease. Typical HRCT fi ndings showed bilateral multilobar infi ltrates in the subpleural
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse ii radiological findings of pneumonia
Journal of Infection and Chemotherapy, 2008Co-Authors: Nobuhiro Matsumoto, Takashi Sasaki, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:In July 2002, one of the largest outbreaks of Legionnaires’ disease associated with a public bathhouse in Japan occurred in Miyazaki. The local government and the University of Miyazaki performed a retrospective investigation of those persons who were considered to have been exposed to Legionella. This investigation provided a unique opportunity to analyze the clinical presentation of patients with outbreak-associated Legionnaires’ disease. The purpose of the present study was to analyze high-resolution computerized tomography (HRCT) scans for the characteristic findings of Legionnaires’ disease and to evaluate the correlation between the radiological severity on the initial chest X-ray and the outcome of the patients. Radiological findings of HRCT were analyzed in 35 patients. The radiological severity on chest X-ray was evaluated in 69 patients, utilizing the pneumonia scoring system proposed by the Research Committee on Legionnaires’ Disease of the Ministry of Health, Labour and Welfare of the Japanese Government. Air-space consolidation, ground-glass opacity, and pleural effusion were common features on HRCT in patients with Legionnaires’ disease. Typical HRCT findings showed bilateral multilobar infiltrates in the subpleural areas without centrilobular opacities. Multivariate logistic regression analysis identified male sex, short incubation period, high serum C-reactive protein, high serum alanine aminotransferase, hyponatremia, and positive Legionella urinary antigen test results as independent risk factors for high pneumonia scores. Patients with high pneumonia scores required significantly longer hospitalization and showed poor prognoses.
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an outbreak of Legionnaires disease associated with a circulating bathwater system at a public bathhouse i a clinical analysis
Journal of Infection and Chemotherapy, 2008Co-Authors: Takashi Sasaki, Nobuhiro Matsumoto, Hiroyuki Nakao, Takahiko Katoh, Yusuke Fukuda, Masamitsu Nakazato, Akihiko OkayamaAbstract:Few reports have analyzed the clinical manifestations of patients with Legionnaires’ disease in large outbreaks throughout the world. We retrospectively evaluated the clinical presentation and prognostic factors in 76 patients with Legionnaires’ disease, reported by local physicians, in a large outbreak resulting from contamination of the water in a public bathhouse in Miyazaki, Japan. Fever, gastrointestinal tract symptoms, and abnormal neurological findings were seen in 95%, 35%, and 21% of the 76 patients, respectively. Respiratory tract symptoms were seen in only 42% of the patients, although all of these patients revealed pneumonia on chest X-ray. Only 20 (31%) of the 64 patients who had microbiological tests were reported to have positive results for one of the three microbiological tests (sputum culture, serology, and urinary antigen) which are specific for Legionella infection. Based on univariate analysis, the existence of neurological symptoms, elevated levels of C-reactive protein and transaminases, hyponatremia, a positive urinary antigen test, and serological evidence of Legionella infection were independent risk factors for poor clinical courses in patients with Legionnaires’ disease. Patients treated with antimicrobial agents, such as macrolides, tetracyclines, and/or fluoroquinolones, within 3 days of onset of illness exhibited significantly better outcomes, when assessed by a multivariate logistic-regression model, after adjusting for the severity of pneumonia. Taking a careful history and documenting potential Legionella exposure, as well as microbiological testing, is important for an accurate diagnosis of Legionnaires’ disease. Antimicrobials effective against Legionella bacteria should be administered without delay in subjects with suspected Legionnaires’ disease.
Sjoerd M. Euser - One of the best experts on this subject based on the ideXlab platform.
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Two Community Clusters of Legionnaires’ Disease Directly Linked to a Biologic Wastewater Treatment Plant, the Netherlands
Emerging Infectious Diseases, 2018Co-Authors: Anna D Loenenbach, Sjoerd M. Euser, Christian Beulens, Jeroen P. G. Van Leuken, Wim Van Der Hoek, Ana Maria De Roda Husman, Wilhelmina L M Ruijs, Alvin A Bartels, Ariene RietveldAbstract:A biologic wastewater treatment plant was identified as a common source for 2 consecutive Legionnaires' disease clusters in the Netherlands in 2016 and 2017. Sequence typing and transmission modeling indicated direct and long-distance transmission of Legionella, indicating this source type should also be investigated in sporadic Legionnaires' disease cases.
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Legionnaires' disease and Pontiac fever after using a private outdoor whirlpool spa
Scandinavian Journal of Infectious Diseases, 2010Co-Authors: Sjoerd M. Euser, Manon Pelgrim, Jeroen W. Den BoerAbstract:AbstractPontiac fever and Legionnaires’ disease are regarded as clinically and epidemiologically distinct diseases, caused by bacteria of the genus Legionella. Although several outbreaks of either Pontiac fever or Legionnaires’ disease have been reported, they are rarely seen simultaneously. In this report we describe such a simultaneous outbreak of Pontiac fever and Legionnaires’ disease that occurred in the Netherlands. In August 2009, 1 patient with Legionnaires’ disease and 3 patients with Pontiac fever, all from a single family, were reported to the Municipal Health Service. All family members had been exposed to the private whirlpool spa in the garden of their home. A sampling investigation by the Legionella Source Identification Unit (LSIU) showed that a sample from the whirlpool spa, as well as a sample from the garden shower and 2 samples from a garden hose were positive for Legionella pneumophila serogroup 1, and genotyping results indicated the AFLP-type 004 Lyon (ST47) to be present in these s...
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Legionnaires' disease and Pontiac fever after using a private outdoor whirlpool spa
Scandinavian journal of infectious diseases, 2010Co-Authors: Sjoerd M. Euser, Manon Pelgrim, Jeroen W. Den BoerAbstract:Pontiac fever and Legionnaires' disease are regarded as clinically and epidemiologically distinct diseases, caused by bacteria of the genus Legionella. Although several outbreaks of either Pontiac fever or Legionnaires' disease have been reported, they are rarely seen simultaneously. In this report we describe such a simultaneous outbreak of Pontiac fever and Legionnaires' disease that occurred in the Netherlands. In August 2009, 1 patient with Legionnaires' disease and 3 patients with Pontiac fever, all from a single family, were reported to the Municipal Health Service. All family members had been exposed to the private whirlpool spa in the garden of their home. A sampling investigation by the Legionella Source Identification Unit (LSIU) showed that a sample from the whirlpool spa, as well as a sample from the garden shower and 2 samples from a garden hose were positive for Legionella pneumophila serogroup 1, and genotyping results indicated the AFLP-type 004 Lyon (ST47) to be present in these samples.