Published Date: 1998-04-13 23:50:00
Subject: PRO/EDR> Legionellosis, lorry drivers - Europe
Archive Number: 19980413.0677

LEGIONELLOSIS, LORRY DRIVERS - EUROPE
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A ProMED-mail post
Date: Mon, 13 Apr 1998 14:09:15 GMT-3
From: John Woodall <WOODALL@SERVER.BIOQMED.UFRJ.BR>
Source: Eurosurveillance Weekly, April 9, 1998
Via: CDPC-mail

Legionnaires' disease in long distance lorry drivers
Two long distance lorry drivers who work for the same haulage company in
the north east of England became ill with _Legionella_ infections on 8 and
11 March 1998. The drivers - one of whom lives in England and the other
in Scotland - drove in separate lorries to Dover and travelled on the
same ferry ship to France before meeting at a lorry park cum hotel in
northern Spain. Neither stayed in the hotel. Both took showers at the
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
legionnaires' 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.
One case of _Legionella_ infection in a long distance lorry driver from
England and Wales was reported in 1994 and four in 1997. These cases
were drivers who had travelled through Belgium, France, Italy, the
Netherlands, Spain, and Slovenia. All were said to have slept in the
cabins of their lorries but took showers at lorry parks, petrol
stations, or at the centres to which their goods were delivered (Public
Health Laboratory Service Communicable Disease Surveillance Centre,
unpublished data).
Showers are a well known source of _Legionella_ infection, and sporadic
cases and outbreaks have been associated with showers in hotels and camp
sites in many European countries. The European Surveillance Scheme for
Travel Associated Legionnaires' Disease (EWGLI) is aware of 50 cases who
stayed overnight at 82 camp sites in Europe during their incubation
periods since 1993 (EWGLI, unpublished data). Camp site shower rooms in
particular may be subject to intermittent water supplies, variable
demand, fluctuations in hot and cold water temperatures, and poor
maintenance. These risk factors may also pertain to shower facilities
for travellers in lorry parks or petrol stations. Use of such
facilities, as well as overnight accommodation, should be considered in
the assessment of people who develop legionnaires' disease in
association with travel.
Reported by Carol Joseph [cjoseph@phls.co.uk], European Surveillance
Scheme for Travel Associated Legionnaires' Disease, PHLS Communicable
Disease Surveillance Centre
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