A large community outbreak of Legionnaires’ disease in Vila Franca de Xira, Portugal, October to November 2014

Abstract

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Rapid investigation of cases and clusters of Legionnaires' disease in England and Wales using direct molecular typing

“…Incident 7 occurred in May 2014 when a common exposure was identified between two apparently sporadic cases with LD onset 6 months apart (November 2014-May 2015. Both patients were found to be infected by L. pneumophila sg1, mAb subgroup 'Philadelphia', ST37.…”

“…Seven of the infecting STs, namely 1, 23, 37, 46, 47, 48 and 62, are known internationally to cause LD cases and account for 3463 out of the 10 513 (32.9 %, query performed 13 February 2016) entries in the L. pneumophila SBT database (www.hpa-bioinformatics.org.uk/legionella/ legionella_sbt/php/sbt_homepage.php). ST1268 has never been isolated before or since Incident 1; this is not uncommon as other outbreaks have been caused by unique strain types (Bennett et al, 2014;Shivaji et al, 2014). ST1534 is present on the SBT database with only two isolates characterized in the UK and Switzerland, respectively.…”

“…They can also infect humans causing either a self-limiting 'flu-like syndrome known as Pontiac fever, or a severe and potentially lethal pneumonia known as Legionnaires' disease (LD) (Phin et al, 2014). Since the first described LD outbreak that affected 182 people with 29 fatalities in Philadelphia, USA in 1976 (Fraser et al, 1977), several other outbreaks have occurred worldwide with high mortality and public health cost (Bennett et al, 2014;Den Boer et al, 2002;Shivaji et al, 2014).…”

Rolling epidemic of Legionnaires’ disease outbreaks in small geographic areas

“…Other reported sources include humidifiers and produce misters 4 . Human to human transmission generally does not occur but was reported in a LD outbreak in Portugal 5 . The outbreak started on November 2014 and 334 confirmed cases were reported within 1 month 5 .…”

“…Human to human transmission generally does not occur but was reported in a LD outbreak in Portugal 5 . The outbreak started on November 2014 and 334 confirmed cases were reported within 1 month 5 . The source of the outbreak was a wet cooling system, but person to person transmission was reported in one case 6 .…”