Legionellosis: a new disease of Western hemisphere?
Legionnaires' disease is an acute bacterial pneumonia caused by an organism of the family of Legionellaceae. L. pneumophila serotype 1 is responsible for most infections. The incidence of Legionnaires' disease in Belgium is not known because the diagnosis cannot be made based on clinical or radiological grounds and because there is a microbiological underdiagnosis. Legionellae are widely distributed in nature, as free living organisms, in protozoa, and in biofilms. As a consequence, these bacteria are particularly resistant to disinfection and heating. We recently investigated an outbreak of legionnaires' disease among visitors to a fair in Kapellen, Belgium. The annual commercial fair at Kapellen was held between October 29 to November 7, 1999. Ninety-three people, who met the case definition, were identified. Among these 93 patients, 41 could be considered as confirmed cases, 14 as presumptive, and 38 as possible cases. Five patients died in as a consequence of the epidemic. A case-control study showed a causal link between a visit to the fair and the occurrence of the infection. A contaminated aerosol from a whirlpool was probably responsible for the outbreak. This epidemic illustrates the need for preventive measures to control for the growth of Legionellae in aerosol producing instruments.
Goossens
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University Hospital Antwerp Laboratory for Microbiology, Wilrijkstraat 10-B-2650 Antwerpen.
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000391:Air Microbiology; D001530:Belgium / Q000453:epidemiology; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D003428:Cross Infection / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks / Q000517:prevention & control; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D015994:Incidence; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000453:epidemiology* / Q000382:microbiology; D008297:Male; D008875:Middle Aged; D012307:Risk Factors