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Query: UMLS:C0023241 (Legionella)
 6,990 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

An outbreak of Legionnaires' Disease (LD) in a college in Tang Shan in the winter of 1987 was reported. Indirect fluorescent assay (IFA) for the antibodies against Legionella Pneumophila (Lp) serogroups I, VI and VIII was carried out in 52 students and 6 teachers. It was found that the antibody titer of LP VI greater than or equal to 1:256 was in 12 students. The clinical figures of these patients were classified into three types: pneumonia 3, fever 9 and asymptomatic 1. It was postulated that the outbreak was associated with water contamination of the college bathroom. There were more patients in two dormitories than in the others, which was suggested that the possibility of a spread of the disease from a person to the others.
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PMID:[An epidemiological investigation of an outbreak of Legionnaires' disease in a college in Tang Shan]. 226 16

Prior studies by the authors suggested high levels of Legionella pneumophila in the recreational and water supply reservoirs in central Oklahoma. This high exposure potential was supported by a relatively high prevalence of seropositive, asymptomatic infections among healthy blood donors in the area. In contrast, the present 9-month laboratory-based study confirmed only one clinical Legionella infection among 117 unidentified pulmonary disease patients admitted to the Oklahoma City Veterans Administration Medical Center. Comparison with the reports of others and with reported legionellosis in Oklahoma indicates that differences in cohort definition and variations in utilization and interpretation of clinical analyses leads to wide variations in the reported incidence of legionellosis.
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PMID:Incidence of Legionella pneumophila infections among Oklahoma pulmonary disease patients. 230 95

Between May 7 and June 7, 1986, 27 residents of a rural county in Maryland developed legionellosis, and two died. Legionella pneumophila serogroup 1 was cultured from the sputum of two patients and identified in lung tissue of a third patient by direct fluorescent antibody staining. An additional 11 patients had four-fold rises in antibody titer to L. pneumophila, and 13 had single titers greater than or equal to 1:256. To determine risk factors for disease, we performed a case-control study. Twelve of 16 case-patients reported visiting store A in the two weeks before onset of illness compared with four of 28 control-patients. A serologic survey of employees showed that employees of store A were 3.63 times more likely than control employees to have titers of antibody to L. pneumophila greater than or equal to 1:256 (95% confidence intervals 0.8, 16.7). Cultures of soil specimens, samples of water from the hot water system of store A and from stagnant ponds near store A collected five weeks after the end of the outbreak were negative for Legionella species. Store A was adjacent to a site of excavation and construction during May 1986, when the community was experiencing an extended drought. This investigation suggests that exposure to excavation and construction activity may be a risk factor for legionellosis.
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PMID:A rural outbreak of Legionnaires' disease linked to visiting a retail store. 231 63

Following investigation of an outbreak of legionellosis in South Australia, numerous Legionella-like organisms were isolated from water samples. Because of the limited number of commercially available direct fluorescent-antibody reagents and the cross-reactions found with some reagents, non-pneumophila legionellae proved to be difficult to identify and these isolates were stored at -70 degrees C for later study. Latex agglutination reagents for Legionella pneumophila and Legionella anisa developed by the Institute of Medical and Veterinary Science, Adelaide, Australia, were found to be useful as rapid screening aids. Autofluorescence was useful for placing isolates into broad groups. Cellular fatty acid analysis, ubiquinone analysis, and DNA hybridization techniques were necessary to provide definitive identification. The species which were isolated most frequently were L. pneumophila, followed by L. anisa, Legionella jamestowniensis, Legionella quinlivanii, Legionella rubrilucens, Legionella spiritensis, and a single isolate each of Legionella erythra, Legionella jordanis, Legionella birminghamensis, and Legionella cincinnatiensis. In addition, 10 isolates were found by DNA hybridization studies to be unrelated to any of the 26 currently known species, representing what we believe to be 6 possible new species.
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PMID:Problems associated with identification of Legionella species from the environment and isolation of six possible new species. 231 47

An environmental survey was carried out which consisted of periodic and random sampling of water tanks and showers in two large Dublin hospitals. Of the samples 5.3% yielded Legionella bacteria. Legionella pneumophila of serogroups 3, 5 and 6 were isolated from these sites with viable counts ranging from 3.0 x 10(2) - 2.5 x 10(3) c.f.u./litre. The implementation of periodic sampling may, however, not be a worthwhile exercise unless an environmental site has been associated with cases of legionellosis. Emphasis should be placed on the prevention of contamination of environmental sites with legionellae and on the development and implementation of protocols and procedures for the isolation of legionellae to gain the necessary expertise should an epidemiological survey be required.
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PMID:Legionella in Dublin hospital water supplies. 231 4

Two immunocompromised children, aged 3 years and 1 1/2 month, developed an hospital-acquired Legionnaire's disease. In one case, Legionella pneumophila serotype 1 was identified by culture in pleural fluid; LP1 was isolated in all the warm water samples in the hospital. Clinical, epidemiological data and laboratory findings are discussed.
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PMID:[Nosocomial Legionnaires' disease in children. Preventive measures]. 232 78

Legionella inevitably are imported from natural reservoirs into drinking-water supplies. Bacterial growth predominantly occurs at water temperatures between 40 degrees C und 50 degrees C (104 degrees F and 122 degrees F). Heat conduction to insufficiently insulated cold water tubes implies the possibility of increased contamination also there. Problems with contamination arise in parts of the water supplies with stagnant warm water. Therefore, reservoirs should be descaled regularly. In general, for prophylaxis are recommended raising the temperature of warm water to 60 degrees C (140 degrees F), regular microbiological control of water quality and regular technical maintenance of waterworks where warm water stagnates for some time. Patients bearing a higher risk of Legionella-infections require intensified precautionary measures. The diagnosis of legionellosis should be based on the direct evidence of immunofluorescence-stained microorganisms. Finding increased antibody titers alone is not always correlated with the response to Legionella-specific therapy.
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PMID:[Aspects of hospital hygiene in Legionella infections]. 232 22

Epidemiologic studies have suggested that legionnaires' disease can be transmitted to susceptible hosts by contaminated aerosolized water from cooling towers and evaporative condensers; however, epidemic strains of Legionella have not been isolated by air sampling at such sites during epidemiologic investigations. An outbreak of legionnaires' disease occurred at a retirement hotel; Legionella pneumophila serogroup 1 was isolated from an evaporative condenser and from potable water. A case-control study showed that the only significant exposure risk was in area A. L. pneumophila serogroup 1 was isolated during air sampling near the evaporative condenser exhaust site, the air conditioning intake vent, and an air vent in area A, but not in shower stalls. Monoclonal antibody subtype patterns of L. pneumophila serogroup 1 isolates from patients matched those from the evaporative condenser but not from shower water. Air sampling and monoclonal antibody subtyping results support epidemiologic evidence that the evaporative condenser was the source of this outbreak.
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PMID:Role of air sampling in investigation of an outbreak of legionnaires' disease associated with exposure to aerosols from an evaporative condenser. 234 5

A large outbreak of Legionnaires' disease was associated with Stafford District General Hospital. A total of 68 confirmed cases was treated in hospital and 22 of these patients died. A further 35 patients, 14 of whom were treated at home, were suspected cases of Legionnaires' disease. All these patients had visited the hospital during April 1985. Epidemiological investigations demonstrated that there had been a high risk of acquiring the disease in the out patient department (OPD), but no risk in other parts of the hospital. The epidemic strain of Legionella pneumophila, serogroup 1, subgroup Pontiac 1a was isolated from the cooling water system of one of the air conditioning plants. This plant served several departments of the hospital including the OPD. The water in the cooling tower and a chiller unit which cooled the air entering the OPD were contaminated with legionellae. Bacteriological and engineering investigations showed how the chiller unit could have been contaminated and how an aerosol containing legionellae could have been generated in the U-trap below the chiller unit. These results, together with the epidemiological evidence, suggest that the chiller unit was most likely to have been the major source of the outbreak. Nearly one third of hospital staff had legionella antibodies. These staff were likely to have worked in areas of the hospital ventilated by the contaminated air conditioning plant, but not necessarily the OPD. There was evidence that a small proportion of these staff had a mild legionellosis and that these 'influenza-like' illnesses had been spread over a 5-month period. A possible explanation of this finding is that small amounts of aerosol from cooling tower sources could have entered the air-intake and been distributed throughout the areas of the hospital served by this ventilation system. Legionellae, subsequently found to be of the epidemic strain, had been found in the cooling tower pond in November 1984 and thus it is possible that staff were exposed to low doses of contaminated aerosol over several months. Control measures are described, but it was later apparent that the outbreak had ended before these interventions were introduced. The investigations revealed faults in the design of the ventilation system.
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PMID:The Stafford outbreak of Legionnaires' disease. 234 81

An increase in endemic rate of nosocomial Legionella pneumophila pneumonia prompted an investigation that revealed 16.2% (12/74) of patient care hot-water sites surveyed were culture-positive for L. pneumophila. No positive cultures were recovered from cooling towers, air intakes, or construction areas. Heat flushing of hospital hot-water outlets to temperatures greater than 60 degrees C for 30 min achieved a 66% reduction in positive Legionella cultures. After 4 1/2 months, different serotypes recurred in previously eradicated areas and there were new positive cultures. Continuous supplemental chlorination of the hot-water system (2 parts per million [ppm]) significantly reduced the number of culture-positive samples from 37.4% (43/115) to 7.0% (8/115) after 6 weeks (P less than .005). Of 30 sites surveyed 6 months after hot-water chlorination, 67% (20) were still culture-negative. Of those positive, 70% had less than or equal to 150 L. pneumophila/ml and 90% were from bathtubs. Adverse effects of chlorination on users and plumbing have not been seen. There have been no definite cases of nosocomial L. pneumophila in areas served by supplemental chlorine during the first 17 months of the chlorination project. Technology allowing tighter regulation of chlorine and use of silicates to control corrosion have made continuous hot-water chlorination a safe and effective option in Legionella control.
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PMID:Reduction in Legionella pneumophila through heat flushing followed by continuous supplemental chlorination of hospital hot water. 198 27


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