An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation

Joseph M. Jansà; J. A. Caylà; D. Ferrer; J. Gracia; C. Pelaz; M. Salvador; A. Benavides; T. Pellicer; P. Rodriguez; J. Ma Garcés; A. Segura; J. Guix; A. Plasencia; J. Ma Armengou; A. Botia; B. Moreno; A. Ferrer; P. García de Olalla; J. Guix; H. Pañella; R. Pedro; M. Sanz; J. Villalbí Ramón; A. Díez; M. García-Carasusan; R. Manzanera; V. Beneyto; J. Masdéu; R. Garriga; A. Domínguez; L. Salleras; J. Alvarez; C. Bravo; J. Flores; F. Gudiol; R. Grau; L. Matia; R. Monterde; F. Morell; J. Oromí; M. Sabrià; A. Trilla; J. Vaqué

An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation

Joseph M. Jansà, J. A. Caylà, D. Ferrer, J. Gracia, C. Pelaz, M. Salvador, A. Benavides, T. Pellicer, P. Rodriguez, J. Ma Garcés, A. Segura, J. Guix, A. Plasencia, J. Ma Armengou, A. Botia, B. Moreno, A. Ferrer, P. García de Olalla, J. Guix, H. PañellaR. Pedro, M. Sanz, J. Villalbí Ramón, A. Díez, M. García-Carasusan, R. Manzanera, V. Beneyto, J. Masdéu, R. Garriga, A. Domínguez, L. Salleras, J. Alvarez, C. Bravo, J. Flores, F. Gudiol, R. Grau, L. Matia, R. Monterde, F. Morell, J. Oromí, M. Sabrià, A. Trilla, J. Vaqué

Research output: Contribution to journal › Article › peer-review

32 Scopus citations

Abstract

OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/ 1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

Original language	English (US)
Pages (from-to)	831-838
Number of pages	8
Journal	International Journal of Tuberculosis and Lung Disease
Volume	6
Issue number	9
State	Published - Sep 2002
Externally published	Yes

Keywords

Community outbreak
Legionella pneumophila
Typing methods

ASJC Scopus subject areas

Pulmonary and Respiratory Medicine
Infectious Diseases

Cite this

Jansà, J. M., Caylà, J. A., Ferrer, D., Gracia, J., Pelaz, C., Salvador, M., Benavides, A., Pellicer, T., Rodriguez, P., Garcés, J. M., Segura, A., Guix, J., Plasencia, A., Armengou, J. M., Botia, A., Moreno, B., Ferrer, A., García de Olalla, P., Guix, J., ... Vaqué, J. (2002). An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation. International Journal of Tuberculosis and Lung Disease, 6(9), 831-838.

Jansà, JM, Caylà, JA, Ferrer, D, Gracia, J, Pelaz, C, Salvador, M, Benavides, A, Pellicer, T, Rodriguez, P, Garcés, JM, Segura, A, Guix, J, Plasencia, A, Armengou, JM, Botia, A, Moreno, B, Ferrer, A, García de Olalla, P, Guix, J, Pañella, H, Pedro, R, Sanz, M, Villalbí Ramón, J, Díez, A, García-Carasusan, M, Manzanera, R, Beneyto, V, Masdéu, J, Garriga, R, Domínguez, A, Salleras, L, Alvarez, J, Bravo, C, Flores, J, Gudiol, F, Grau, R, Matia, L, Monterde, R, Morell, F, Oromí, J, Sabrià, M, Trilla, A & Vaqué, J 2002, 'An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation', International Journal of Tuberculosis and Lung Disease, vol. 6, no. 9, pp. 831-838.

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title = "An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation",

abstract = "OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/ 1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.",

keywords = "Community outbreak, Legionella pneumophila, Typing methods",

author = "Jans{\`a}, {Joseph M.} and Cayl{\`a}, {J. A.} and D. Ferrer and J. Gracia and C. Pelaz and M. Salvador and A. Benavides and T. Pellicer and P. Rodriguez and Garc{\'e}s, {J. Ma} and A. Segura and J. Guix and A. Plasencia and Armengou, {J. Ma} and A. Botia and B. Moreno and A. Ferrer and {Garc{\'i}a de Olalla}, P. and J. Guix and H. Pa{\~n}ella and R. Pedro and M. Sanz and {Villalb{\'i} Ram{\'o}n}, J. and A. D{\'i}ez and M. Garc{\'i}a-Carasusan and R. Manzanera and V. Beneyto and J. Masd{\'e}u and R. Garriga and A. Dom{\'i}nguez and L. Salleras and J. Alvarez and C. Bravo and J. Flores and F. Gudiol and R. Grau and L. Matia and R. Monterde and F. Morell and J. Orom{\'i} and M. Sabri{\`a} and A. Trilla and J. Vaqu{\'e}",

year = "2002",

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language = "English (US)",

volume = "6",

pages = "831--838",

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T1 - An outbreak of Legionnaires' disease in an inner city district

T2 - Importance of the first 24 hours in the investigation

AU - Jansà, Joseph M.

AU - Caylà, J. A.

AU - Ferrer, D.

AU - Gracia, J.

AU - Pelaz, C.

AU - Salvador, M.

AU - Benavides, A.

AU - Pellicer, T.

AU - Rodriguez, P.

AU - Garcés, J. Ma

AU - Segura, A.

AU - Guix, J.

AU - Plasencia, A.

AU - Armengou, J. Ma

AU - Botia, A.

AU - Moreno, B.

AU - Ferrer, A.

AU - García de Olalla, P.

AU - Guix, J.

AU - Pañella, H.

AU - Pedro, R.

AU - Sanz, M.

AU - Villalbí Ramón, J.

AU - Díez, A.

AU - García-Carasusan, M.

AU - Manzanera, R.

AU - Beneyto, V.

AU - Masdéu, J.

AU - Garriga, R.

AU - Domínguez, A.

AU - Salleras, L.

AU - Alvarez, J.

AU - Bravo, C.

AU - Flores, J.

AU - Gudiol, F.

AU - Grau, R.

AU - Matia, L.

AU - Monterde, R.

AU - Morell, F.

AU - Oromí, J.

AU - Sabrià, M.

AU - Trilla, A.

AU - Vaqué, J.

PY - 2002/9

Y1 - 2002/9

N2 - OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/ 1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

AB - OBJECTIVE: To present the main results of the investigation of an outbreak of Legionnaire's disease that occurred in an inner city district of Barcelona between 15 October and 15 November 2000. METHODS: Epidemiological surveys of patients and environmental investigations were initiated on the day the first five cases were notified. Water samples and smears from cooling tower trays were taken for microbiological analysis. Maps of the distribution of cases and possible contamination foci were elaborated. Incidences were calculated for each census tract. RESULTS: A total of 54 patients related to the outbreak were identified, with a case fatality rate of 5.5%. Incidence rate in the area closest to the cooling tower (6.40/ 1000) was significantly higher than that of the rest of the neighbourhood (2.23/1.000, RR 2.87, 95%CI 1.37-6.12, P = 0.0035). Cultures positive for Legionella pneumophila serogroup 1, subtypes Pontiac, Philadelphia or Allentown, were obtained from eight patients. On the 39th day of the investigation it was found that the strain isolated in one of the cooling towers coincided with the serogroup, subtype and molecular profiles identified in clinical samples. CONCLUSIONS: Rapid coordination of clinicians, microbiologists, epidemiologists and environmentalists permitted the source of infection and the affected cases to be correlated within a few days.

KW - Community outbreak

KW - Legionella pneumophila

KW - Typing methods

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An outbreak of Legionnaires' disease in an inner city district: Importance of the first 24 hours in the investigation

Abstract

Keywords

ASJC Scopus subject areas

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