title: Legionnaires' disease outbreak in Murcia, Spain.
abstract: An explosive outbreak of Legionnaires' disease occurred in Murcia, Spain, in July 2001. More than 800 suspected cases were reported; 449 these cases were confirmed, which made this the world's largest outbreak of the disease reported to date. Dates of onset for confirmed cases ranged from June 26 to July 19, with a case-fatality rate of 1%. The epidemic curve and geographic pattern from the 600 competed epidemiologic questionnaires indicated an outdoor point-source exposure in the northern part of the city. A case-control study matching 85 patients living outside the city of Murcia with two controls each was undertaken to identify to outbreak source; the epidemiologic investigation implicated the cooling towers at a city hospital. An environmental isolate from these towers with an identical molecular pattern as the clinical isolates was subsequently identified and supported that epidemiologic conclusion.
authors.affiliation: Regional Health Council of Murcia, Murcia, Spain. anam.garcia9@carm.es
authors.forename: Anna
authors.initials: A
authors.lastname: García-Fulgueiras
authors.forename: Carmen
authors.initials: C
authors.lastname: Navarro
authors.forename: Daniel
authors.initials: D
authors.lastname: Fenoll
authors.forename: José
authors.initials: J
authors.lastname: García
authors.forename: Paulino
authors.initials: P
authors.lastname: González-Diego
authors.forename: Teresa
authors.initials: T
authors.lastname: Jiménez-Buñuales
authors.forename: Miguel
authors.initials: M
authors.lastname: Rodriguez
authors.forename: Rosa
authors.initials: R
authors.lastname: Lopez
authors.forename: Francisco
authors.initials: F
authors.lastname: Pacheco
authors.forename: Joaquín
authors.initials: J
authors.lastname: Ruiz
authors.forename: Manuel
authors.initials: M
authors.lastname: Segovia
authors.forename: Beatriz
authors.initials: B
authors.lastname: Balandrón
authors.forename: Carmen
authors.initials: C
authors.lastname: Pelaz
mesh_terms: D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D004196:Disease Outbreaks; D004783:Environmental Microbiology; D005260:Female; D006801:Humans; D016952:Legionella pneumophila / Q000145:classification / Q000302:isolation & purification; D007877:Legionnaires' Disease / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D012307:Risk Factors; D013030:Spain / Q000453:epidemiology; D011795:Surveys and Questionnaires; D014195:Travel