Epidemic Legionnaires' Disease Two Decades Later: Old Sources, New Diagnostic Methods | Zendy

Anthony E. Fiore | Zendy; J. Pekka Nuorti | Zendy; Orin S. Levine | Zendy; Arthur Marx | Zendy; André Weltman | Zendy; Suzanne M. Yeager | Zendy; Robert F. Benson | Zendy; Janet Pruckler | Zendy; Paul H. Edelstein | Zendy; Patricia W. Greer | Zendy; Sherif R. Zaki | Zendy; Barry S. Fields | Zendy; Jay C. Butler | Zendy

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Epidemic Legionnaires' Disease Two Decades Later: Old Sources, New Diagnostic Methods

Author(s) -

Anthony E. Fiore,

J. Pekka Nuorti,

Orin S. Levine,

Arthur Marx,

André Weltman,

Suzanne M. Yeager,

Robert F. Benson,

Janet Pruckler,

Paul H. Edelstein,

Patricia W. Greer,

Sherif R. Zaki,

Barry S. Fields,

Jay C. Butler

Publication year - 1998

Publication title -

clinical infectious diseases

Language(s) - English

Resource type - Journals

SCImago Journal Rank - 3.44

H-Index - 336

eISSN - 1537-6591

pISSN - 1058-4838

DOI - 10.1086/516309

Subject(s) - medicine , outbreak , legionnaires' disease , pneumonia , odds ratio , epidemiology , transmission (telecommunications) , confidence interval , legionella , virology , legionella pneumophila , biology , bacteria , electrical engineering , genetics , engineering

In July 1995 we investigated a pneumonia outbreak in a Pennsylvania town. We conducted epidemiological and molecular microbiological studies to determine the outbreak source and interrupt transmission of disease. Legionnaires' disease (LD) was quickly identified by urine antigen testing, and a newly developed immunohistochemical stain confirmed nosocomial transmission to a hospital inpatient. LD was confirmed in 22 patients. Case-patients were more likely than controls to have been within 1,000 feet of the hospital (matched odds ratio, 21.0; 95% confidence interval, 2.9-368) during the 2 weeks prior to illness. Legionella pneumophila serogroup 1 (Lp-1) was isolated from hospital cooling towers (CTs) and rooftop air samples but not from hospital potable water or community CTs. Hospital CT and air Lp-1 isolates matched all five patient isolates by monoclonal antibody, arbitrarily primed polymerase chain reaction, and pulsed-field gel electrophoresis subtyping. Strategies to prevent LD must include minimizing transmission from CTs.

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