Legionnaires'
Disease
Outbreaks in
1997 and
1998
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news briefs
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-
Madrid
hospital,
Nov
1998,
3
deaths
-
Seattle
hospital,
Nov
1998,
3
cases
-
Thomastown,
Melbourne,
Australia,
16
cases,
Oct
1998
-
Ellenville,
NY,
USA,
Oct
1998:
11
cases,
3
deaths
-
Somerset,
UK
Oct
1998:
10
cases,
3
deaths
-
Plastics
plant,
Baltimore,
USA,
Oct
1998
-
French
hospital,
2
deaths,
Oct
1998
-
London,
5
men,
27-45
years
of
age,
Aug
1998
-
Paris:
19
cases,
3
deaths,
July
1998
-
5
cases
of
Legionnaires',
one
death,
Victoria,
Australia,
June-July
1998
-
Legionella
on a
cruise
ship,
June
1998
-
Legionnaires'
outbreak
in
Southwest
PA,
USA,
June
1998
-
Prague
hospital,
June
1998,
8
cases,
7
deaths
-
32-year-old
Englishman
dies
from
Legionnaires',
July
1998
|
|
Madrid
hospital, Nov
1998, 3 deaths
Three
people died
from
Legionnaire's
disease in a
hospital in
Zaragoza in
northeastern
Spain--two in
November and
one in
September. All
suffering from
serious
illnesses that
had weakened
their immune
system. The
hospital is
disinfecting
the water and
air
conditioning
systems to
prevent
further
infection.
Source:
Reuters Return
to top
Seattle
hospital, Nov
1998, three
cases
A
Seattle
hospital is
working with
state health
officials to
try to
determine the
source of
infection of
three patients
who acquired
Legionnaire's
disease. Two
cases in July
involved a man
and woman in
their 40s,
both cancer
patients. The
woman died,
but it is
unclear
whether her
death stemmed
from the
Legionnaire's
infection,
hospital
officials
said. The man
survived. Late
October, a man
in his 40s, an
organ
transplant
patient, also
contracted
Legionnaires’
Disease but
recovered.
``On the first
two cases the
evidence is
pretty good
that
somewhere,
somehow these
individuals
acquired the
infection
here,'' state
senior
epidemiologist
Dr. John
Kobayashi said
at a news
conference.
Despite
extensive
tests of water
systems at the
hospital,
however, no
source of the
patients'
strain of
bacteria has
been found,
officials
said. Source:
Associated
Press Return
to top
Thomastown,
Melbourne,
Australia, 16
cases, Oct
1998
Three
businesses in
Thomastown
have been
identified as
possible
sources of
October's
Legionella
outbreak
involving 16
confirmed
cases and
another 10
suspected
cases. Testing
of 74 cooling
towers
revealed three
towers carried
Legionella
bacteria.
Victoria's
chief health
officer, Dr
Graham Rouch,
said samples
taken from
eight of the
17 people
infected
matched the
bacteria found
in a cooling
tower at an
industrial
facility. A
chicken-processing
company of
Thomastown is
also believed
to be a
potential
source after
testing proved
inconclusive.
The Thomastown-Reservoir
outbreak is
Victoria's
largest
occurrence of
Legionnaires
Disease. Nine
of the 16
confirmed
victims have
been
discharged
from hospital.
Four patients
remain in the
hospital, one
of them in
intensive
care.
Source: Herald
Sun, Victoria
Return
to top
Ellenville,
NY, USA, Oct
1998: 11
cases, three
deaths
Eleven
Ellenville
area residents
were diagnosed
with
Legionnaires'
disease. All
are among more
than 30 cases
of pneumonia
to hit the
Ellenville
area since
mid-September.
In addition,
30 to 40
Ellenville
Community
Hospital
workers were
diagnosed with
flu-like
symptoms that
health
investigators
said was
Pontiac Fever,
a type of
legionellosis
that is not as
severe as
Legionnaires’
Disease.
Three of the
Legionnaires’
victims died.
Water samples
from the
hospital's
cooling tower
tested
positive for Legionella.
"This is
likely to be
the
exposure,"
said Dr. Joel
Acklesberg, a
doctor with
the federal
Centers for
Disease
Control and
Prevention.
However, the
hospital's hot
water system
tested
negative. That
has led
investigators
to speculate
exposure could
have occurred
as people were
coming in and
out of the
hospital, for
anything from
lab tests to
visiting
hours. The
connection to
the hospital
was
strengthened
by interviews
of individuals
with the
illness. Seven
of the eight
people
investigators
interviewed
visited
Ellenville
Hospital the
week prior to
their
exposure.
Source: The
Times Herald
Record online
Return
to top
Somerset,
UK Oct 1998:
10 cases, 3
deaths
An
outbreak of
Legionnaire's
disease in
Glastonbury,
Somerset, U.K.
has claimed
three lives. A
total of 10
cases were
reported. A
major
investigation
is still under
way to trace
the source of
the outbreak.
Source: Press
Association
Newsfile (UK)
Return
to top
Plastics
plant,
Baltimore,
USA, Oct 1998
Part
of a plastics
plant in a
Baltimore
suburb was
shut down
after three
employees
contracted
Legionnaires'
disease. A
51-year-old
male died
after several
days in the
hospital. The
two other
employees
diagnosed with
the disease
have been
discharged
from the
hospital and
are
recovering.
Health
officials are
testing hot
water and air
conditioning
systems and
other areas to
find the
source of the
Legionella
bacteria.
Source: The
Associated
Press. Return
to top
French
hospital, two
deaths, Oct
1998
Two
aged patients
have died and
three other
people became
ill following
an outbreak of
Legionaires
disease late
September in a
hospital in
this Tarbes,
France. 70
other people
who had been
treated in the
same hospital
were also
prescribed
antibiotic
treatments as
a precaution.
Hot water used
in treatments
was thought to
be the source
of
contamination.
Source:
Reuters Return
to top
London,
five men,
27-45 years of
age, Aug 1998
Five
men, aged 27
to 45 years,
who live or
work in London
developed
legionellosis
between 2
August and 14
September
1998. All have
recovered.
Source: CDR
WEEKLY, Volume
8 Number 41, 9
Oct 1998
Return
to top
Paris:
19 cases, 3
deaths, July
1998
Between
6 June and 3
July, 1998, 19
cases of
legionellosis
were
identified
among visitors
to Paris. Ten
of the cases
were French
nationals and
9 were
tourists from
other European
countries.
Three patients
died. Source:
The Weekly
Epidemiological
Record (WHO) Return
to top
Five
cases of
Legionnaires',
one death,
Victoria,
Australia,
June-July 1998
A
73-year-old
woman died
from
Legionnaires'
disease and
four other
people were
identified as
carrying the
illness late
June and early
July. One of
the infected
women worked
at the Moonee
Ponds
Australian Tax
Office, while
another was a
contract
worker at the
city tax
office, but
lived in
Moonee Ponds.
The three
other victims
contracted the
disease after
shopping in
the area. An
Essendon man,
79, was
battling for
his life in
the John
Fawkner
Hospital,
while a
49-year-old
woman at the
same hospital
was in a
stable
condition.
Legionellae
were found in
the cooling
towers of the
Australian
Taxation
Office
building in
Gladstone
Street and the
Caseready
Meats tower in
Young Street.
Victoria's
chief health
officer Dr
Graham Rouch
was cited as
saying that
laboratory
testing had
shown the
cluster of
Legionaires'
cases in the
Moonee Ponds
area, in
Melbourne's
north-west,
was "most
likely
linked"
to the cooling
tower of
Caseready
Meats. Dr
Rouch was
further cited
as saying in a
statement that
tests from two
of the five
people
infected had
shown the Legionella
type they were
carrying was
the same as
that
identified in
the meat
manufacturer's
tower. Cooling
towers at both
Caseready
Meats and the
Tax Office
were
disinfected.
Source: FSNET
and The
Australian
News Network
Return
to top
32-year-old
Englishman
dies from
Legionnaires',
July 1998
A
32-year-old
man from
Blackpool,
England died
of
Legionnaires'
disease after
travelling to
France for the
World Cup
Finals. Three
other fans -
two Scots and
another
Englishman -
also fell ill
with the
disease after
visiting
France. The
Department of
Health
reported that
three of the
men went to
the same
football match
in Paris. One
Scotsman in
his 50s was
treated in
hospital at
Livingston,
West Lothian,
but was later
allowed home.
The French
health
ministry said
the victims
all appeared
to have passed
at some point
through Paris,
but then
attended
matches in
different
cities.
According to a
Foreign Office
spokesman in
London,
"They had
been in Paris
during the
incubation
period."
French and
British health
authorities
were to
investigate
the cases to
see if there
was a common
link.
Source: BBC
and ITN
Online, 3 July
1998. Return
to top
Legionnaires'
outbreak in
Southwest PA,
USA, June 1998
Excerpts
from Press
Release, 10
July 1998: The
Pennsylvania
Health
Department
reported six
cases of
community-acquired
Legionnaires'
disease near
the
Southwestern
Pennsylvania
borough of
North Belle
Vernon,
Westmoreland
County. The
source of the
outbreak has
not yet been
identified;
epidemiologists
are testing
likely
sources. Each
of the six
cases occurred
between June
15 and June 30
and required
hospitalization.
All but one of
the patients,
the one most
recently
infected, have
been
discharged. Return
to top
Prague
hospital, June
1998, 8 cases,
7 deaths
Eight
cases of
Legionnaire's
disease
appeared among
kidney
transplants at
a leading
transplant
center in
Prague in
June. Seven
patients died.
The outbreak
was caused by L.pneumophila
sg.3,
revealed both
from lung
tissues and
from hot water
samples (about
1,000 cfu/ml).
Subtyping of
the strains
linked the
cases to the
the hot water
plumbing.
Heating the
water to 85
deg C and
flushing all
taps and
outlets
reduced
legionellae
counts
signicantly,
but some sites
still remained
positive (
1-10 cfu/50
ml).
Consequently
the Tarn-Pure
TP 30 was
installed. In
spite of all
remedial
measures
performed,
legionellae
have not been
completely
eradicated
from all
sampling
sites. Very
low
concentrations
persist. The
hospital is
regularly
monitored. The
outbreak made
competent
health
authorities
put
expeditiously
the National
Legionella
Surveillance
Scheme into
operation
service. All
hospitals
treating
debilitated
patients had
to be examined
for the
presence of
legionellae.
Source :
National
Legionella
Reference Lab
Vyskov, Czech
Republic. Return
to top
Legionella
on a cruise
ship, June
1998
A
woman aged 77
years and a
man of 71
years, both
from England,
developed
legionnaires’
disease after
taking
separate
cruises to the
southern
Mediterranean
aboard the SS
Edinburgh
Castle. Both
cases were
diagnosed
serologically.
Both cruises
sailed from
and returned
to Liverpool,
but their
itineraries
included calls
at different
ports. On
learning of
the first
case, samples
were obtained
from the
ship’s fresh
water supply
by Scottish
port health
and
environmental
health
officers when
it docked in
Greenock on 21
June. An
incident
control team
met on 24 June
in Liverpool
after the
second case
had been
reported and
advised the
ship’s
owners and the
tour operator
of the control
measures
required on
the basis of
information
then
available.
Initial
control
measures for
water
treatment were
carried out
before the
ship returned
to Greenock.
Legionella
pneumophila
serogroup 1
was cultured
by the
Scottish
Legionella
Reference
Laboratory on
24 June. A
separate
incident
control team
in Scotland
met on 28
June, when the
ship docked in
Greenock, to
review the
microbiological
results and a
proposed that
a thorough
supervised
water
treatment
program should
be implemented
in
consultation
with the
ship’s
owners and
engineers when
the ship
docked in
Greenock.
The tour
operators gave
passengers who
disembarked in
Scotland on 28
June a letter
that advised
them what to
do if they
developed
symptoms of
legionella
infection. The
ship is now
subject to
regular
monitoring and
water sampling
when docked in
Liverpool or
Greenock. Case
searching
among
passengers and
crew will
continue
through public
health
networks in
the United
Kingdom.
Source: Eurosurveillance
Weekly, 2
July 1998.
Reported by
Peter
Christie,
Scottish
Centre for
Infection and
Environmental
Health,
Glasgow and
Carol Joseph,
on behalf of
European
Working Group
for Legionella
Infections (EWGLI).
A separate
report stated
that the ship
was cleared by
health
officials on 2
July.Return
to top
Legionnaires’
disease in
British lorry
(truck)
drivers, Mar.
1998
Two
British long
distance lorry
drivers became
ill with
legionella
infections on
8 and 11 March
1998. The
drivers drove
in separate
lorries to
Dover and
travelled on
the same ferry
ship to France
before meeting
in northern
Spain. Both
took showers
at a lorry
park, where
they slept
overnight in
the cabins of
their lorries.
Legionella
pneumophila
serogroup 1
was cultured
from sputum of
one of the
cases, a 50
year old man
whose illness
was confirmed
as Legionaires’
disease. The
other case,
diagnosed
serologically
on the basis
of a single
high titre and
without
radiological
evidence of
pneumonia,
was 29 years
of age.
Regional
authorities in
northern Spain
are conducting
environmental
investigations.
The report
indicated that
the showers at
the lorry park
will be the
focus of the
investigation.
Source: Eurosurveillance
Weekly.
Reported by
Carol Joseph,
European
Surveillance
Scheme for
Travel
Associated
Legionnaires'
Disease, PHLS
Communicable
Disease
Surveillance
Centre. Return
to top
Three
cases of
Legionnaires'
in Pittsburgh
office
building - 5
Mar. 1998
Three
people who
worked in the
same office
building have
contracted
Legionnaire's
Disease--one
in February
and two last
October. The
downtown
Pittsburgh
building was
just opened in
1996.
Investigators
tested water
samples
collected from
the plumbing
system, coffee
makers, and a
cooling tower
but found no
legionellae,
according to
John Schombert,
chief of
public
drinking water
and waste
management for
the county
health
department.
The cases are
still under
investigation.
Source:
Associated
Press. Return
to top
Sauna
implicated in
Legionnaire's
cases
A
sauna has been
blamed for six
cases of
Legionnaire's
disease in the
Netherlands,
two of which
were fatal. A
female kidney
transplant
patient died
of the disease
10 days after
using the
sauna. The
other fatality
was a
59-year-old
immunosuppressed
man. Dr J.W.
Den Boer of
the Municipal
Health
Service, along
with other
colleagues
from Haarlem,
reported that
water from the
footbath in
the sauna
contained the
same strain of
Legionella
pneumophila
that was found
in the
victims. The
operators of
the sauna have
made changes
to prevent
water
stagnation and
are testing
the water
regularly.
These are the
first
documented
cases of
Legionnaire's
disease
associated
with a sauna.
Source: The
Lancet,
1998;351:114. Return
to top
Los
Angeles Health
Officials
investigating
increase in
Legionnaires'
cases
Reported
cases of
Legionnaire's
disease in Los
Angeles (USA)
doubled last
year’s
count,
according to
Dr. James
Haughton of
the Department
of Health
Services,
"But
there may be
more cases
that we don't
know
about,"
Haughton said.
Health
officials are
investigating
the increase.
Source: Los
Angeles Times,
13 Dec.1997. Return
to top
Legionnaire's
disease arises
near Ann
Arbor,
Michigan
(U.S.A.) - 5
Dec. 1997
Margo
Burrage, St.
Joseph Mercy
Hospital
spokeswoman,
said that a
68-year-old
woman with
Legionnaires
disease was in
serious
condition in
an intensive
care unit at
the hospital.
According to
Dr. Matthew
Boulton,
Livingston
County medical
director, this
case appears
to have no
connection
with the three
recent
Legionnaire's
cases at
Brighton High
School.
"She
appears not to
have had any
contact
whatsoever
with the
school,"
he said.
"We're
relatively
sure we have
no link."
Just weeks
earlier, three
Brighton High
School
students
contracted
what appeared
to be
Legionnaire's.
Two girls who
were diagnosed
with pneumonia
in October
tested
"borderline
positive"
for
Legionnaires
disease,
according
Boulton. 7 of
40 water
samples
collected by
health
officials
contained the
same strain of
Legionella
found in the
two girls.
Tests of
another
student with
pneumonia
indicated a
slightly
different
strain of the
bacteria.
Antibiotics
brought quick
recoveries in
all three
students,
Boulton said.
Health
officials
flushed the
plumbing
system with
hot water.
Locker room
showers were
ordered closed
by school
officials
until the
results of
health
department
follow-up
water sampling
indicated
safety.
Source:
Michigan Live
Inc. Return
to top
Two
cases of
Legionnaires'
in Columbus,
Ohio senior
center
Two
residents of
Lutheran
Village, a
senior center
in Columbus,
Ohio (USA),
were
hospitalized
and treated
for
Legionnaires
disease.
The center,
occupied by a
total of 270
residents, has
assisted
living,
private and
semiprivate
rooms. A woman
was diagnosed
with the
disease on 6
Nov. 1997,
which was
about 10 days
after moving
into a room
that had been
closed off and
unused for 18
months,
according to
Tom Widney,
the executive
director. The
woman has been
released from
the hospital.
The second
victim, a man,
remains
hospitalized
but is
expected to
recover.
Widney said
that each used
the same water
system, which
serves about
150 rooms. The
report
mentioned that
environmental
samples were
cultured, but
the results
were not
given. Bath
hoses and
shower heads
were
sterilized in
the building.
Source: The
Columbus Dispatch,
24 Nov. 1997. Return
to top
French
tourists
acquire
Legionnaires'
disease in
Turkey,
Sep-Oct 1997
Three
women and 14
men aged 49 to
82 developed
respiratory
symptoms after
staying at the
Hotel Festival
in Istanbul at
various times
during
September and
October.
Four have
died, six are
still in the
hospital, and
seven have
recovered.
Legionella
infection has
been confirmed
in 13 of the
victims.
Legionellosis
was
bacteriologically
confirmed in
three of the
four
individuals
who died.
Clinical
symptoms
suggested
legionellosis
in the fourth
fatal case but
laboratory
confirmation
could not be
obtained. No
cases have
been
identified
since 16
October, the
date when the
hotel was
identified as
the probable
source of the
infection. but
forthcoming
serological
test results
may indicated
additional
cases. A tour
operator
estimated that
the hotel
could have
accommodated
3300 people
between the 1
September and
22 October
1997,
indicating an
attack rate of
approximately
1 percent.
Source:
Eurosurveillance
Weekly,
reported by
Carol Joseph
on behalf of
the European
Working Group
on Legionella
Infections (EWGLI).
Also reported
by the Centre
de Référence
des
Legionella,
Lyon, France.
This report is
also available
in French at
the Réseau
National de
Santé
Publique
(http://www.b3e.jussieu.fr:80/rnsp/).
Return
to top
British
tourists get
Legionnaires’
on Rhine
cruise
Six
cases of
Legionaires
in British
tourists (four
men, two
women, aged 72
to 78 years)
have been
linked to a
ship used for
cruises on the
Rhine. The
cases occurred
between July
and October
1997.
None has died.
The
Dutch-owned
ship is being
investigated
by Dutch
health
authorities.
There are no
reports of
illness among
members of the
crew. The
European
Working Group
on Legionella
(EWGLI)
collaborators
in Germany and
the
Netherlands
are working
closely with
EWGLI’s
coordinators
in London to
measure the
extent of the
outbreak and
identify the
source of
infection.
Source:
Eurosurveillance
Weekly,
reported by
Carol Joseph
on behalf of
the European
Working Group
on Legionella
Infections (EWGLI).
Return
to top
Outbreak
of
Legionnaires’
among European
tourists
visiting
Portugal,
May-Oct. 1997
Five
cases of
Legionnaires
(three men and
two women aged
30 to 67 years
) have been
associated
with an
apartment
hotel in
Albufeira,
Portugal. No
deaths have
been reported.
One case was
reported from
the
Netherlands,
two from
Scotland, and
two from
England.
Source:
Eurosurveillance
Weekly,
reported by
Carol Joseph
on behalf of
the European
Working Group
on Legionella
Infections (EWGLI).
Return
to top
Four
cases of
Legionnaires’
reported in
the Chicago
suburb of
Woodstock,
Aug. 1997
An
outbreak of
Legionnaires'
disease in the
Chicago suburb
of Woodstock
was reported
in the Chicago
Sun Times, 15
August 1997.
According to
the Times
story, four
cases have
been confirmed
and three more
are suspected.
All seven live
in Woodstock
and range from
47 to 84 years
in age. The
first case was
confirmed 22
July and the
most recent on
1 Aug. The
news story is
posted at
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