title: The role of arbitrarily primed PCR in identifying the source of an outbreak of Legionnaires' disease.
abstract: An outbreak of community-acquired Legionnaires' disease (LD) occurred in Providence, R.I., in fall 1993. To find the outbreak source, exposures of 17 case patients were compared to those of 33 matched controls. Case patients were more likely than controls to have visited a section of downtown (area A) during the 2 weeks before illness (11 [65%] versus 9 [27%]; matched odds ratio, 6.5; P = 0.01). Water samples were cultured from 27 aerosol-producing devices within area A. Legionella pneumophila serogroup 1 isolates underwent monoclonal antibody (MAb) subtyping and arbitrarily primed PCR (AP-PCR). All four L. pneumophila serogroup 1 isolates available from case patients who visited area A had identical MAb and AP-PCR patterns. Among 14 environmental isolates, 5 had MAb patterns that matched the case patient isolates, but only 1 had a matching AP-PCR pattern. This investigation implicates a cooling tower in area A as the outbreak source and illustrates the usefulness of AP-PCR for identifying sources of LD outbreaks.
authors.affiliation: Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
authors.forename: C G
authors.initials: CG
authors.lastname: Whitney
authors.forename: J
authors.initials: J
authors.lastname: Hofmann
authors.forename: J M
authors.initials: JM
authors.lastname: Pruckler
authors.forename: R F
authors.initials: RF
authors.lastname: Benson
authors.forename: B S
authors.initials: BS
authors.lastname: Fields
authors.forename: U
authors.initials: U
authors.lastname: Bandyopadhyay
authors.forename: E F
authors.initials: EF
authors.lastname: Donnally
authors.forename: C
authors.initials: C
authors.lastname: Giorgio-Almonte
authors.forename: L A
authors.initials: LA
authors.lastname: Mermel
authors.forename: S
authors.initials: S
authors.lastname: Boland
authors.forename: B T
authors.initials: BT
authors.lastname: Matyas
authors.forename: R F
authors.initials: RF
authors.lastname: Breiman
mesh_terms: D004196:Disease Outbreaks; D006801:Humans; D016952:Legionella pneumophila / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000453:epidemiology; D016133:Polymerase Chain Reaction / Q000379:methods*; D014481:United States