Legionellosis historical perspective: Difference between revisions
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==Overview== | ==Overview== | ||
Legionnaires' disease acquired its name in 1976 when an outbreak of [[pneumonia]] occurred among people attending a convention of the American Legion in Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown [[bacterium]], subsequently named ''[[Legionella]]''. | Legionnaires' disease acquired its name in 1976 when an outbreak of [[pneumonia]] occurred among people attending a convention of the American Legion in Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown [[bacterium]], subsequently named ''[[Legionella]]''. There have been numerous outbreaks of Legionnaires since it was first discovered. Some of the outbreaks of Legionella are listed below in chronological order. | ||
== Historical Perspective == | == Historical Perspective == | ||
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===France, 2004=== | ===France, 2004=== | ||
Between November 2003 and January 2004, an outbreak of [[Legionnaires disease]] occurred in Pas-de-Calais, France. There were 18 fatalities out of the 86 laboratory-confirmed cases, giving the outbreak a mortality rate of about 21%. A Legionella pneumophila strain named Lens was isolated from samples of air, wastewater, and cooling towers from plant A. Researchers determined that the dispersion extended over a distance of at least 6 km (3.75 miles) from the plant. <ref name="pmid16323138">{{cite journal| author=Nguyen TM, Ilef D, Jarraud S, Rouil L, Campese C, Che D | display-authors=etal| title=A community-wide outbreak of legionnaires disease linked to industrial cooling towers--how far can contaminated aerosols spread? | journal=J Infect Dis | year= 2006 | volume= 193 | issue= 1 | pages= 102-11 | pmid=16323138 | doi=10.1086/498575 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=16323138 }} </ref> | |||
===Norway, 2005=== | ===Norway, 2005=== | ||
In May 2005 there was | In May 2005 there was another outbreak of [[Legionnaires disease]] in Norway, in the town of Fredrikstad. Initially, 56 patients were confirmed infected and ten people were dead. However, on serological testing of other patients with community acquired [[pneumonia]], another 47 patients were discovered to have the disease, bringing the total for the oubreak to at least 103, 16 of whom are probable cases. The source of the outbreak unexpectedly came from an air scrubber that disseminated that bacterium over a distance of about 10 km (6.25 miles). <ref name="pmid18171215">{{cite journal| author=Nygård K, Werner-Johansen Ø, Rønsen S, Caugant DA, Simonsen Ø, Kanestrøm A | display-authors=etal| title=An outbreak of legionnaires disease caused by long-distance spread from an industrial air scrubber in Sarpsborg, Norway. | journal=Clin Infect Dis | year= 2008 | volume= 46 | issue= 1 | pages= 61-9 | pmid=18171215 | doi=10.1086/524016 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=18171215 }} </ref> <ref name="pmid25887275">{{cite journal| author=Simonsen Ø, Wedege E, Kanestrøm A, Bolstad K, Aaberge IS, Ragnhildstveit E | display-authors=etal| title=Characterization of the extent of a large outbreak of Legionnaires' disease by serological assays. | journal=BMC Infect Dis | year= 2015 | volume= 15 | issue= | pages= 163 | pmid=25887275 | doi=10.1186/s12879-015-0903-2 | pmc=4383209 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25887275 }} </ref> | ||
===New Zealand, 2005=== | ===New Zealand, 2005=== | ||
In mid-2005, Christchurch, New Zealand experienced an outbreak of [[Legionnaires disease]]. There were 3 deaths out of the 19 confirmed cases. Legionella pneumophila serogroup 1 (Lpsg1) was identified as the causative agent for all cases. A water cooling tower located in the center of the clusters is believed to be the source of the outbreak<ref name="pmid22697112">{{cite journal| author=White PS, Graham FF, Harte DJ, Baker MG, Ambrose CD, Humphrey AR| title=Epidemiological investigation of a Legionnaires' disease outbreak in Christchurch, New Zealand: the value of spatial methods for practical public health. | journal=Epidemiol Infect | year= 2013 | volume= 141 | issue= 4 | pages= 789-99 | pmid=22697112 | doi=10.1017/S0950268812000994 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=22697112 }} </ref>. | |||
===Toronto, | ===Toronto, Ontario, Canada=== | ||
An outbreak of [[Legionnaires disease]] at the Seven Oaks Home for the Aged, a nursing home in Toronto, in the province of Ontario, Canada from September to October 2005 resulted in illness in 135 people, 23 (17%) of whom died. Researchers confirmed that a contaminated air conditioning cooling tower was the source of the outbreak. <ref name="pmid17314363">{{cite journal| author=Gilmour MW, Bernard K, Tracz DM, Olson AB, Corbett CR, Burdz T | display-authors=etal| title=Molecular typing of a Legionella pneumophila outbreak in Ontario, Canada. | journal=J Med Microbiol | year= 2007 | volume= 56 | issue= Pt 3 | pages= 336-341 | pmid=17314363 | doi=10.1099/jmm.0.46738-0 | pmc=2884934 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=17314363 }} </ref> | |||
== | |||
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===Michigan, 2014 - 2016=== | ===Michigan, 2014 - 2016=== | ||
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In June 2017, 2 people became ill after staying at a hotel in Las Vegas. This outbreak may be associated with contaminated air ducts in hotels. The patients have developed pneumonia and no deaths have been reported. | In June 2017, 2 people became ill after staying at a hotel in Las Vegas. This outbreak may be associated with contaminated air ducts in hotels. The patients have developed pneumonia and no deaths have been reported. | ||
==References== | ==References== | ||
{{reflist|2}} | {{reflist|2}} | ||
Revision as of 08:42, 2 March 2022
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ogechukwu Hannah Nnabude, MD Tarek Nafee, M.D. [2]
Overview
Legionnaires' disease acquired its name in 1976 when an outbreak of pneumonia occurred among people attending a convention of the American Legion in Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown bacterium, subsequently named Legionella. There have been numerous outbreaks of Legionnaires since it was first discovered. Some of the outbreaks of Legionella are listed below in chronological order.
Historical Perspective
Philadelphia, 1976
The first recognized legionella outbreak occurred in 1976 during a meeting of the American Legion in Philadelphia, Pennsylvania. About 29 of the 182 people that contracted the infection died [1]. It was after the bacterium had been successfully isolated that previous cases of Legionella were identified.
United Kingdom, 1985
In 1985, Stafford District General Hospital experienced a Legionella outbreak. A total of 68 confirmed cases were treated in hospital and 22 of these patients died. A further 35 patients were suspected cases of Legionnaires' disease, 14 of whom only required treatment at home. Legionella was found in the water within the cooling tower and a chiller unit which cooled the air entering the outpatient department. The chiller unit is believed to be the major source of the outbreak [2].
Netherlands, 1999
During a flower exhibition in Bovenkarspel, Netherlands, an outbreak of Legionella occurred. It is believed to have been caused by a contamination of the whirlpools in halls 3 and 4, and the sprinkler in hall 8, all of which tested culture positive for Legionella. There were 133 confirmed cases and 55 possible cases out of the 77061 visitors to the exhibition [3].
Spain, 2001
In Murcia, Spain, over 800 suspected cases of Legionnaires' disease were recorded. Of these cases, 449 were confirmed to be caused by Legionella. This is currently the largest outbreak of Legionella ever recorded. About 1% of affected patients died from the disease [4].
Norway, 2001
The first recognized outbreak of Legionella in Norway was in 2001 when 28 people were infected in the city of Stavanger, and seven died. Of the 28 patients, 21 were within the city of Stavanger, five were in other areas in Norway, and two were other countries, with one being in England and the other in Germany. This was initially a mystery to the investigators. However, it was discovered that a cooling unit from a nearby hotel was the source of the infection. The air outlet was found to be just over 16 feet above the ground and located close to a bus station. This was determined source of contact for the patient in Germany and the patient in England [5]
United Kingdom, 2002
In 2002, six women and one man in Barrow-In-Furness died as a result of the illness, another 172 people also contracted the disease. The outbreak was traced to a contaminated cooling tower at the town’s Forum 28 arts center.
France, 2004
Between November 2003 and January 2004, an outbreak of Legionnaires disease occurred in Pas-de-Calais, France. There were 18 fatalities out of the 86 laboratory-confirmed cases, giving the outbreak a mortality rate of about 21%. A Legionella pneumophila strain named Lens was isolated from samples of air, wastewater, and cooling towers from plant A. Researchers determined that the dispersion extended over a distance of at least 6 km (3.75 miles) from the plant. [6]
Norway, 2005
In May 2005 there was another outbreak of Legionnaires disease in Norway, in the town of Fredrikstad. Initially, 56 patients were confirmed infected and ten people were dead. However, on serological testing of other patients with community acquired pneumonia, another 47 patients were discovered to have the disease, bringing the total for the oubreak to at least 103, 16 of whom are probable cases. The source of the outbreak unexpectedly came from an air scrubber that disseminated that bacterium over a distance of about 10 km (6.25 miles). [7] [8]
New Zealand, 2005
In mid-2005, Christchurch, New Zealand experienced an outbreak of Legionnaires disease. There were 3 deaths out of the 19 confirmed cases. Legionella pneumophila serogroup 1 (Lpsg1) was identified as the causative agent for all cases. A water cooling tower located in the center of the clusters is believed to be the source of the outbreak[9].
Toronto, Ontario, Canada
An outbreak of Legionnaires disease at the Seven Oaks Home for the Aged, a nursing home in Toronto, in the province of Ontario, Canada from September to October 2005 resulted in illness in 135 people, 23 (17%) of whom died. Researchers confirmed that a contaminated air conditioning cooling tower was the source of the outbreak. [10]
Michigan, 2014 - 2016
An outbreak of Legionnaires' disease was reported in Flint, Michigan. The outbreak infected more than 87 individuals. Following investigations, it is thought that the outbreak may be associated with elevated lead concentrations in the watery supply.
Las Vegas 2017
In June 2017, 2 people became ill after staying at a hotel in Las Vegas. This outbreak may be associated with contaminated air ducts in hotels. The patients have developed pneumonia and no deaths have been reported.
References
- ↑ Fraser DW, Tsai TR, Orenstein W, et al. Legionnaires’ disease: description of an epidemic of pneumonia. N Engl J Med 1977; 297: 1189–97.
- ↑ O'Mahony MC, Stanwell-Smith RE, Tillett HE, Harper D, Hutchison JG, Farrell ID; et al. (1990). "The Stafford outbreak of Legionnaires' disease". Epidemiol Infect. 104 (3): 361–80. doi:10.1017/s0950268800047385. PMC 2271767. PMID 2347381.
- ↑ Cordasco G, Cicciù D, Lo Giudice G, Matarese G, Nucera R, Mazza M (1999). "Kinesiographic investigations in children with increased nasal airways resistance". Bull Group Int Rech Sci Stomatol Odontol. 41 (2–3): 67–72. doi:10.3201/eid0801.010176. PMC 2730281. PMID 11799746.
- ↑ García-Fulgueiras A, Navarro C, Fenoll D, García J, González-Diego P, Jiménez-Buñuales T; et al. (2003). "Legionnaires' disease outbreak in Murcia, Spain". Emerg Infect Dis. 9 (8): 915–21. doi:10.3201/eid0908.030337. PMC 3020623. PMID 12967487.
- ↑ Outbreak of legionellosis in Stavanger, Norway – final report Blystad, H and Bjorlow, E and Aavitsland, P and Holm, J, Weekly releases (1997–2007), 5, 2059 (2001), https://doi.org/10.2807/esw.05.47.02059-en.
- ↑ Nguyen TM, Ilef D, Jarraud S, Rouil L, Campese C, Che D; et al. (2006). "A community-wide outbreak of legionnaires disease linked to industrial cooling towers--how far can contaminated aerosols spread?". J Infect Dis. 193 (1): 102–11. doi:10.1086/498575. PMID 16323138.
- ↑ Nygård K, Werner-Johansen Ø, Rønsen S, Caugant DA, Simonsen Ø, Kanestrøm A; et al. (2008). "An outbreak of legionnaires disease caused by long-distance spread from an industrial air scrubber in Sarpsborg, Norway". Clin Infect Dis. 46 (1): 61–9. doi:10.1086/524016. PMID 18171215.
- ↑ Simonsen Ø, Wedege E, Kanestrøm A, Bolstad K, Aaberge IS, Ragnhildstveit E; et al. (2015). "Characterization of the extent of a large outbreak of Legionnaires' disease by serological assays". BMC Infect Dis. 15: 163. doi:10.1186/s12879-015-0903-2. PMC 4383209. PMID 25887275.
- ↑ White PS, Graham FF, Harte DJ, Baker MG, Ambrose CD, Humphrey AR (2013). "Epidemiological investigation of a Legionnaires' disease outbreak in Christchurch, New Zealand: the value of spatial methods for practical public health". Epidemiol Infect. 141 (4): 789–99. doi:10.1017/S0950268812000994. PMID 22697112.
- ↑ Gilmour MW, Bernard K, Tracz DM, Olson AB, Corbett CR, Burdz T; et al. (2007). "Molecular typing of a Legionella pneumophila outbreak in Ontario, Canada". J Med Microbiol. 56 (Pt 3): 336–341. doi:10.1099/jmm.0.46738-0. PMC 2884934. PMID 17314363.