Outbreak of Legionnaires' disease in West Fife: review of environmental guidelines needed.
OBJECTIVE
The objectives of this study were to investigate the source of and outbreak of Legionnaires' disease in West Fife in 2004; to control the spread of legionella from this source; and to make recommendations for future practice based on the findings from the investigation.


METHODS
Outbreak investigation.


METHODS
A multi-agency team investigated links between the cases of legionellosis using detailed interviews, movement mapping, a timeline and extensive environmental sampling.


RESULTS
The investigation found evidence that individuals affected by legionella during this outbreak had been in, or near (within 800 m), sullage tanks in Rosyth Dockyard within a period of 4 months.


CONCLUSIONS
In the absence of laboratory isolation of Legionella spp. from the human cases, it was impossible to state definitely that a previously unrecognized source of environmental legionella aerosolization was responsible for the outbreak. However, strong epidemiological and environmental evidence would support this hypothesis.
Public Health Department, NHS Fife, Cameron House, Cameron Hospital, Windygates KY8 5RG, UK. Jackie.hyland@nhs.net
J M
JM
Hyland
N
N
Hamlet
C
C
Saunders
J
J
Coppola
J
J
Watt
D004196:Disease Outbreaks; D004777:Environment; D006801:Humans; D007373:Interinstitutional Relations; D007877:Legionnaires' Disease / Q000453:epidemiology*; D015980:Public Health Practice / Q000592:standards*; D012606:Scotland / Q000453:epidemiology