Published Date: 2000-12-09 23:50:00
Subject: PRO> Legionellosis - Spain: 2000
Archive Number: 20001209.2163
LEGIONELLOSIS - SPAIN: 2000
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See Also
Legionellosis - Spain (Barcelona) 20001116.2005Legionellosis - Spain (Vigo, Arbizu) 20001018.1796
Legionellosis - Spain (Vigo, Arbizu) (02) 20001026.1860
Date: 8 Dec 2000 08:23:22 -0800
From: ProMED-mail <promed@promedmail.org>
Source: Eurosurveillance Weekly - Issue 49, 7 Dec 2000 [edited
Via: CDPC Weekly, Mail-II
Outbreaks of Legionella infection in Spain, 2000
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Seven outbreaks of legionnaires' disease have been notified to Spain's
national centre for epidemiology in 2000. In 4 of them patients acquired
infection in the community and in three the infection was hospital
acquired. The European Working Group for _Legionella_ Infections (EWGLI)
has also reported 4 clusters of legionellosis in tourists who visited Spain
in 2000; 15 cases were identified. This report describes 3 large community
acquired outbreaks.
From 16 Sep to 8 Oct 2000, 70 cases of legionellosis (43 men and 27 women;
aged 20 to 95 years) were reported by the local health authorities of
Alcoi, in the Valencia region. [A total of 2 patients died. Cases were
diagnosed on the basis of urinary antigen tests for _Legionella
pneumophila_ and in 3 cases _L. pneumophila_ serogroup (sg) 1 Pontiac
Knoxville was isolated. Preliminary enquiries revealed an association with
visiting and living in a certain area of the city. Exposure to this same
area focused the investigation on the possibility of aerosol transmission
from contaminated cooling towers. Clinical isolates and water samples from
cooling towers from the area were sent to the national reference
laboratory. All the cooling towers in the suspected area were disinfected.
Intensified surveillance is continuing.
On 9 Oct 2000, 5 cases of legionnaires' disease were diagnosed on the basis
of urinary antigen tests for _L. pneumophila_, and an increased number of
cases of atypical pneumonia was notified to the regional health authorities
of Galicia by a hospital in Vigo (1). The epidemiological investigation
resulted in the identification of 28 cases (21 men and 7 women; aged 30 to
79 years), 3 of whom died. The first case became ill on 18 Sep 2000, and no
cases with dates of onset since 1 Oct 2000 have been notified. Preliminary
enquiries on 10 Oct 2000 showed an association with visiting and living in
a certain area of the city. A hospital based matched case control study
carried out on 11 Oct 2000 with 17 cases and 37 controls confirmed that
living, working, or walking in the area near the hospital was associated
with illness (odds ratio 4.29; 95 percent confidence interval 1.6 to 18.0).
One clinical isolate and water samples from cooling towers from the area
were sent to the National Reference Laboratory. The clinical isolate was
identified as _L. pneumophila_ SG 1 Pontiac and all the environmental
samples were negative. All the cooling towers in the suspected area were
disinfected.
From 14 Sep to 16 Nov 2000, 40 cases of legionellosis were reported by the
local health authorities of Barcelona, Catalonia. One patient died. Cases
were diagnosed on the basis of urinary antigen tests for _L. pneumophila_.
Preliminary enquiries showed an association with visiting and living in a
neighborhood of the city of Barcelona. Exposure to this area and the
absence of any other potential source focused the investigation on the
possibility of aerosol transmission from contaminated cooling towers.
Samples from suspect cooling towers were taken, and the towers were then
disinfected. Intensified surveillance is continuing.
References:
1. Hervada X, Cano R. A community outbreak of legionnairesÂ’ disease:
Galicia, Spain. Eurosurveillance Weekly 2000; 4: 001026.
<http://www.eurosurv.org/2000/001026>
Reported by Salvador de Mateo de Ontanon <smateo@isciii.es> and Rosa Cano
<rcano@isciii.es> Centro Nacional de EpidemiologĂa, Madrid, Spain.
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