title: Two outbreaks of Legionnaires' disease in Bolton Health District.
abstract: In 1988, there were two outbreaks of legionellosis in Bolton Health District. Altogether 37 cases of Legionnaires' disease and 23 cases of non-pneumonic legionellosis were identified. Twenty-five patients with Legionnaires' disease were associated with an engineering plant, 4 with Bolton town centre, and 8 with both the plant and town centre. Twenty-two people with non-pneumonic legionellosis were linked with the engineering plant and one with the plant and the town centre. A case-control study carried out among 37 employees with legionellosis and 109 control subjects at the plant showed that infection was associated with one of the 15 cooling towers on the site. Legionella pneumophila indistinguishable by serological and genetic typing methods was isolated from this cooling tower and from sputum samples from two patients. In the town centre, no one tower was linked with infection and L. pneumophila was not cultured from any of the nine towers identified. Control measures were implemented and to date there have been no further cases of legionellosis associated with Bolton Health District.
authors.affiliation: Public Health Laboratory Service, Communicable Disease Surveillance Centre, London.
authors.forename: E
authors.initials: E
authors.lastname: Mitchell
authors.forename: M
authors.initials: M
authors.lastname: O'Mahony
authors.forename: J M
authors.initials: JM
authors.lastname: Watson
authors.forename: D
authors.initials: D
authors.lastname: Lynch
authors.forename: C
authors.initials: C
authors.lastname: Joseph
authors.forename: C
authors.initials: C
authors.lastname: Quigley
authors.forename: R
authors.initials: R
authors.lastname: Aston
authors.forename: G N
authors.initials: GN
authors.lastname: Constable
authors.forename: R J
authors.initials: RJ
authors.lastname: Farrand
authors.forename: S
authors.initials: S
authors.lastname: Maxwell
mesh_terms: D000328:Adult; D000368:Aged; D000389:Air Conditioning; D000907:Antibodies, Bacterial / Q000032:analysis; D016022:Case-Control Studies; D004196:Disease Outbreaks; D004738:Engineering; D004739:England / Q000453:epidemiology; D005260:Female; D006801:Humans; D007875:Legionella / Q000276:immunology / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D009784:Occupational Diseases / Q000453:epidemiology*; D012307:Risk Factors; D012907:Smoking; D013183:Sputum / Q000382:microbiology; D014871:Water Microbiology; D014881:Water Supply
chemical_list: D000907:Antibodies, Bacterial