title: Legionnaires' disease outbreak in an automobile engine manufacturing plant.
abstract: We investigated 4 cases of legionnaires' disease (LD) reported among workers at an Ohio automotive plant in March 2001. A "confirmed" case of LD was defined as x-ray-confirmed pneumonia and a confirmatory laboratory test. A "possible" case of LD was defined as elevated titers of antibody and respiratory symptoms. Legionella pneumophila serogroup 1 (LP1) was isolated from 1 case patient. Legionella was isolated from 18 (9%) of 197 environmental samples; 3 isolates were LP1 but did not match the case isolate. We conducted a case-control study; 17 case patients with confirmed or possible LD and 86 control subjects (workers with low antibody titers and without symptoms) were enrolled. Visiting a specific cleaning line (odds ratio, [OR], 7.29; 95% confidence interval [CI], 2.31-23.00) and working in the cleaning region of the plant (OR, 3.22; 95% CI, 1.11-9.38) were associated with LD. LD can be transmitted in industrial settings in which aerosols are produced. Clinicians should consider LD when treating persons from these settings for pneumonia.
authors.affiliation: Respiratory Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
authors.forename: Alicia M
authors.initials: AM
authors.lastname: Fry
authors.forename: Miai
authors.initials: M
authors.lastname: Rutman
authors.forename: Terry
authors.initials: T
authors.lastname: Allan
authors.forename: Heidi
authors.initials: H
authors.lastname: Scaife
authors.forename: Ellen
authors.initials: E
authors.lastname: Salehi
authors.forename: Robert
authors.initials: R
authors.lastname: Benson
authors.forename: Barry
authors.initials: B
authors.lastname: Fields
authors.forename: Scott
authors.initials: S
authors.lastname: Nowicki
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Parrish
authors.forename: Joseph
authors.initials: J
authors.lastname: Carpenter
authors.forename: Ellen
authors.initials: E
authors.lastname: Brown
authors.forename: Claressa
authors.initials: C
authors.lastname: Lucas
authors.forename: Timothy
authors.initials: T
authors.lastname: Horgan
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Koch
authors.forename: Richard E
authors.initials: RE
authors.lastname: Besser
mesh_terms: D000336:Aerosols; D001336:Automobiles; D016022:Case-Control Studies; D016001:Confidence Intervals; D004196:Disease Outbreaks; D006801:Humans; D007221:Industry; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000453:epidemiology*; D009784:Occupational Diseases / Q000175:diagnosis / Q000453:epidemiology*; D016017:Odds Ratio; D009820:Ohio / Q000453:epidemiology; D012307:Risk Factors
chemical_list: D000336:Aerosols