A community outbreak of Legionnaires’ disease associated with a cooling tower in Vic and Gurb, Catalonia (Spain) in 2005
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We report the investigation of a community-acquired outbreak of Legionnaires’ disease. An epidemiological, environmental, and meteorological investigation was undertaken. Fifty-five cases were reported in October and November 2005. The exposure occurred in a large area, with 12 cases (21.8%) located between 1,800 and 3,400 metres from the source. Water sample cultures showed that Legionella pneumophila serogroup 1 (Lp-1) was present in five cooling towers in two industrial locations in Gurb (plants A and B). Two Lp-1 strains were recovered from plants A and B, but only Lp-1 strains from plant A showed a pulsed-field gel electrophoresis (PFGE) profile identical to those obtained from three of the cases. Inspection of the cooling towers in plant A revealed inadequate maintenance. Weather conditions in October 2005, with mostly high temperatures and high humidity, together with the flat terrain could have been favouring factors. This study showed a community outbreak from a cooling tower as a common source in a large area. Climate and terrain could explain the dissemination of contaminated aerosols.
KeywordsCooling Tower Environmental Investigation Coxiella Burnetii Urinary Antigen Test Community Outbreak
We thank the physicians of Vic Hospital (Dr. Rafael Toribio, Dra. Marian Navarro, Sra. María José Martínez) and the inspectors of the Regional Services of the Health Protection Agency of Barcelona (Sr. Ramon Casals, Sra. Cristina Ferreruela, Sra. Montse Malats, Sra. Maria Encarnació Amat) for their participation and support in investigating the outbreak.
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