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Legionnaires’ disease outbreak in south western Sydney, 1992: Clinical aspects
Author(s) -
Kociuba Katherine R,
Munro Rosemary,
Buist Michael,
Lee Anna,
Cleland Bruce
Publication year - 1994
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1994.tb125831.x
Subject(s) - outbreak , medicine , serology , legionella pneumophila , legionnaires' disease , sputum , pneumonia , seroconversion , legionella , prospective cohort study , disease , sputum culture , pediatrics , immunology , tuberculosis , pathology , antibody , biology , bacteria , genetics
Objectives To document the clinical, laboratory and radiological features of patients with Legionella pneumophila serogroup 1 pneumonia during an outbreak, and probe for any relationship between clinical or laboratory features and outcome. Design and setting Prospective identification of patients with Legionnaires’ disease in an outbreak from 15‐26 April 1992 in the South Western Sydney Area Health Service, centred on the Fairfield area. Patients Twenty‐six patients (22 men, four women) were confirmed to have the disease, based on the presence of clinical features of pneumonia, with L. pneumophila serogroup 1 isolated on culture, or evidence of seroconversion. Results Seventeen patients (65.4%) were culture‐positive for L. pneumophila serogroup 1 and nine were diagnosed on serological criteria. A direct fluorescent antibody (DFA) test of sputum performed well as a rapid diagnostic method. Twenty‐three patients (89%) presented with hyponatremia, 14 (54%) with renal impairment and nine of 19 (47%) with elevated serum creatine Phosphokinase levels. Overall mortality was 23% (71% for patients requiring mechanical ventilation). Eleven of 119 patients (10.2%) who did not have Legionnaires’ disease showed serological evidence of previous exposure. Conclusions The duration of symptoms and severity of biochemical abnormalities at presentation were not related to outcome. The sputum DFA test is useful for rapid diagnosis during outbreaks.