title: Cluster of Legionnaires disease in a newly built block of flats, Denmark, December 2008 - January 2009.
abstract: During December 2008 to January 2009, two persons contracted Legionnaires’ disease in a newly built block of flats in a suburb of Copenhagen in Denmark. Polymerase chain reaction and culture was used to diagnose Legionnaires’ disease in this cluster. Isolates from both patients tested positive for Legionella pneumophila serogroup 1 subgroup Philadelphia sequence type 1 and the same strain was detected in hot water samples taken from the residential area indicating that the hot water supply system was the most likely source of infection. Legionella was not detected in the cold water. Two interventions were conducted to limit the Legionella colonisation of the piping and storage tanks and the effect was monitored by investigating water samples from various sites in the block of flats. Only the second intervention had a sufficient effect on the Legionella colonisation. The cluster described here points to several risk factors regarding growth of Legionella in hot water systems: (i) stagnancy of water from when the building is constructed and piping installed and until residents move in, (ii) stagnancy and low temperature (from room temperature to approximately 38°C) of water in shower hoses and (iii) failure in operation of and control measures for the hot water system.
authors.affiliation: Department of Microbiological Surveillance and Research, Statens Serum Institut, Copenhagen, Denmark. lkd@ssi.dk
authors.forename: L H
authors.initials: LH
authors.lastname: Krøjgaard
authors.forename: K A
authors.initials: KA
authors.lastname: Krogfelt
authors.forename: H J
authors.initials: HJ
authors.lastname: Albrechtsen
authors.forename: S A
authors.initials: SA
authors.lastname: Uldum
mesh_terms: D000328:Adult; D016000:Cluster Analysis; D003718:Denmark; D006358:Hot Temperature; D006798:Housing; D006801:Humans; D007875:Legionella / Q000302:isolation & purification*; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000517:prevention & control; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012307:Risk Factors; D014871:Water Microbiology; D018508:Water Purification; D014881:Water Supply