title: Environmental investigation of a legionellosis outbreak in western Sydney: the role of molecular profiling.
abstract: This investigation used DNA profiling in an attempt to identify the environmental source of a community outbreak of 11 cases of Legionnaires' disease. Nine of these cases were culture positive and a single strain (DNA profile) of Legionella pneumophila serogroup 1 was isolated from eight cases. Spot water samples were collected from 51 cooling towers implicated by case exposure histories; this same strain was isolated from four towers at three separate locations up to 6 km apart. None of these locations had been frequently implicated by case histories. Because we did not perform an analytic epidemiological investigation, we were unable to identify a single environmental source for the outbreak. It is also possible that this outbreak was multifocal. The use of molecular profiling should not overshadow the importance of epidemiological methods in these environmental investigations. More data is needed regarding the prevalence, distribution, and clinical significance (virulence) of environmental L. pneumophila strains. This would aid interpretation of molecular profiling used in investigations of community legionellosis outbreaks.
authors.affiliation: Western Sector Public Health Unit, New South Wales. timh2@nch.edu.au
authors.forename: T C
authors.initials: TC
authors.lastname: Heath
authors.forename: C
authors.initials: C
authors.lastname: Roberts
authors.forename: B
authors.initials: B
authors.lastname: Jalaludin
authors.forename: I
authors.initials: I
authors.lastname: Goldthrope
authors.forename: A G
authors.initials: AG
authors.lastname: Capon
mesh_terms: D001315:Australia / Q000453:epidemiology; D015373:Bacterial Typing Techniques; D004269:DNA, Bacterial / Q000145:classification*; D004196:Disease Outbreaks; D004787:Environmental Pollution / Q000032:analysis*; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000453:epidemiology* / Q000382:microbiology; D012680:Sensitivity and Specificity; D013045:Species Specificity; D014505:Urban Population
chemical_list: D004269:DNA, Bacterial