Legionella E-news, December 2001
Matthew R. Freije, Editor
**IN THIS ISSUE**
1. Update on Norway Outbreak
2. Follow-up to Last Issue's Survivor Letter
3. 2002 Legionella Courses - 4 New Locations
4. The Role of Protozoa in Legionella Control
5. New Online Publications on Waterborne Disease
1. UPDATE ON NORWAY OUTBREAK
The September issue of E-news included information on an outbreak inStavanger, Norway. At that time 17 confirmed and 2 probable cases of Legionnaires' disease had been identified, with 2 deaths. A final reporton the outbreak, published in the 29 November 2001 issue of Eurosurveillance Weekly, states that 26 confirmed (by urinary antigen)and 2 probable cases were identified. 21 of the 28 patients were men. 7 of the 28 have died, one of which was one of the two probable cases. Theage range of the 28 cases was 16 to 94 years, with a mean age of 54. Theage range of those who died was 43 to 94 years, with a mean age of 81.All the patients had been in the same area in the city centre within the incubation period. Legionella pneumophila serogroup 1 was found in watersamples collected from the cooling tower of a hotel where three of the patients had been staying. The outlet of the cooling tower was situated five meters above ground, close to a bus terminal. Nine isolates from patients and five isolates from the cooling tower showed similaritiesand were different from other known Norwegian legionella isolates. [Thereport did not indicate that the isolates matched exactly.]
2. FOLLOW-UP TO LAST ISSUE'S SURVIVOR LETTER
I prefaced the story with a note that the writer of the letter did not mention whether Legionnaires' disease was confirmed by laboratory tests. I have since found out, from the hospital that treated the patient, thatLegionnaires' disease was indeed confirmed by sputum culture.
Many of you responded to the request for feedback as to whether weshould include Legionnaires' survivor letters in future issues of E-news, or focus strictly on technical content. Most thought the survivor letters were a good idea, but a few suggested technical content only. Iappreciated your suggestions. As a compromise, we will considerincluding letters from survivors of confirmed Legionnaires' diseaseevery 10 or 12 issues, but only those letters that indicate a lesson inprevention, diagnosis, or treatment.
3. 2002 LEGIONELLA COURSES - 4 NEW LOCATIONS
Here are locations for the Legionella Prevention Training Course in thefirst half to 2002:
* Dallas: 30-31 January
* Montreal: 7-8 March
* New York City: 21-22 March
* Chicago: 1-2 May
Hotel information should be available at http://hcinfo.com/legionellaseminar.htm within one or two weeks. To register for the seminars, or get more information, visit http://hcinfo.com/legionellaseminar.htm or e-mail
4. THE ROLE OF PROTOZOA IN LEGIONELLA CONTROL
Sharon G. Berk, Martha J.M. Wells, and Anthony L. Newsome of Tennessee Technological University, Middle Tennessee State University, conducted an EPA-funded study from 1 October 1996 to 30 September 2000 entitled"Protozoa in Risk Assessment of Legionellosis-Inadequacy of Guidelinesand Monitoring." The study examined several aspects of protozoa in actual cooling tower water. The project included a number of objectives, one of which was to evaluate the efficacy of commonly used biocides and combinations of biocides. The results indicate that protozoa may play important roles in maintaining Legionellae in cooling towers, that conditions of cooling towers may facilitate production and release of vesicles containing legionellae from protozoa, and that certain biocides may be more effective than others in inhibiting legionellae within vesicles. The researchers conclude that protozoa should be considered in monitoring and risk assessment of Legionella in cooling towers and that biocides should target protozoan hosts. The final report is posted at http://es.epa.gov/ncer/final/grants/96/envbio/berk.html
5. NEW ONLINE PUBLICATIONS ON WATERBORNE DISEASE
Because of a special licensing arrangement between HC Information Resources Inc. and the UK office of John Wiley & Sons, Inc., each chapter of Waterborne Disease: Epidemiology and Ecology (by Paul R. Hunter, Public Health Laboratory Service, Chester, UK) is now available online at hcinfo.com. The chapters can be purchased individually for $11 each. Each downloads in less than 30 seconds. Chapters 1-4 and 31-33 cover epidemiology, water supply and distribution, drinking water, illness associated with recreational water, chemical poisoning, cancer, and adverse pregnancy outcomes. The other chapters cover a specific water-related illness or pathogen, one per chapter, discussing, as applicable, clinical features, diagnosis, treatment, environmental detection, ecology, epidemiology, and microbiology.
References are included at the end of each chapter. To order or get moreinformation, visit http://hcinfo.com/waterbornedisease.htm.
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