An outbreak of Legionnaires’ disease associated with a display spa pool in retail premises, Stoke-on-Trent, United Kingdom, July 2012

Coetzee, Nicol; Duggal, Harsh; Hawker, Jeremy; Ibbotson, Sue; Harrison, T G; Phin, Nick; Laza-Stanca, Vasile; Johnston, R.; Iqbal, Z; Rehman, Yasmin; Knapper, Elizabeth; Robinson, Sam; Aigbogun, N

doi:10.2807/ese.17.37.20271-en

Cited by 40 publications

(9 citation statements)

References 11 publications

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“…32−35 The use of private whirlpools 36,37 and public whirlpools 35,38,39 were linked to patients with LD or Pontiac fever. Several outbreaks of LD were reported in which a whirlpool on display was considered the infection source, 32,34,40,41 and some outbreaks linked to whirlpools occurred on cruise ships. 33,42 Potting Soil and Compost.…”

Section: ■ Resultsmentioning

confidence: 99%

“…A total of 36 articles were selected that described whirlpools as a potential or confirmed source. Several studies provided the highest LOE (Ia) in source investigations concerning whirlpools. − The use of private whirlpools , and public whirlpools ,, were linked to patients with LD or Pontiac fever. Several outbreaks of LD were reported in which a whirlpool on display was considered the infection source, ,,, and some outbreaks linked to whirlpools occurred on cruise ships. , …”

Section: Confirmed Legionella Sourcesmentioning

confidence: 99%

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Confirmed and Potential Sources of Legionella Reviewed

Heijnsbergen

Schalk

Euser

et al. 2015

Environ. Sci. Technol.

130

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Legionella bacteria are ubiquitous in natural matrices and man-made systems. However, it is not always clear if these reservoirs can act as source of infection resulting in cases of Legionnaires' disease. This review provides an overview of reservoirs of Legionella reported in the literature, other than drinking water distribution systems. Levels of evidence were developed to discriminate between potential and confirmed sources of Legionella. A total of 17 systems and matrices could be classified as confirmed sources of Legionella. Many other man-made systems or natural matrices were not classified as a confirmed source, since either no patients were linked to these reservoirs or the supporting evidence was weak. However, these systems or matrices could play an important role in the transmission of infectious Legionella bacteria; they might not yet be considered in source investigations, resulting in an underestimation of their importance. To optimize source investigations it is important to have knowledge about all the (potential) sources of Legionella. Further research is needed to unravel what the contribution is of each confirmed source, and possibly also potential sources, to the LD disease burden.

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Section: ■ Resultsmentioning

confidence: 99%

Section: Confirmed Legionella Sourcesmentioning

confidence: 99%

Confirmed and Potential Sources of Legionella Reviewed

Heijnsbergen

Schalk

Euser

et al. 2015

Environ. Sci. Technol.

130

View full text Add to dashboard Cite

show abstract

“…It is unlikely that these last six cases would have approached the Hotel A, that was on the outskirts of town and away from the beach. In this sense, the pattern of distribution of cases of this outbreak is very reminiscent of patterns seen in outbreaks caused by cooling towers where bioaerosols can travel hundreds of meters from the source ( Sabria et al, 2006 ; Ferré et al, 2009 ; Weiss et al, 2017 ; Dyke et al, 2019 ) rather than outbreaks caused by hot tubs where typically only users or people staying in their vicinity are affected ( Benkel et al, 2000 ; Götz et al, 2001 ; Den Boer et al, 2002 ; Coetzee et al, 2012 ). This could be due to several reasons.…”

Section: Discussionmentioning

confidence: 90%

A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel

Gumá

Drašar

Santandreu³

et al. 2023

Front. Microbiol.

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During the period October–November 2017, an outbreak of Legionnaires’ disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires’ disease (TALD). Most cases belonged to different hotel cluster alerts. No cases were reported among the local population residing in the area. All tourist establishments associated with one or more TALD cases were inspected and sampled by public health inspectors. All relevant sources of aerosol emission detected were investigated and sampled. The absence of active cooling towers in the affected area was verified, by documents and on-site. Samples from hot tubs for private use located on the terraces of the penthouse rooms of a hotel in the area were included in the study. Extremely high concentrations (> 106 CFU/l) of Legionella pneumophila, including the outbreak strain, were found in the hot tubs of vacant rooms of this hotel thus identifying the probable source of infection. Meteorological situation may have contributed to the geographical distribution pattern of this outbreak. In conclusion, hot tubs for private use located outdoors should be considered when investigating community outbreaks of Legionnaires’ disease of unclear origin.

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“…Investigations into an outbreak of legionellosis in Staffordshire (UK) using molecular typing strongly suggested that the source of the contamination was a spa pool located in an enclosed commercial building. Staying in the vicinity of the contaminated pool led to the development of 21 cases of disease (Coetzee et al 2012 ). A study from north-eastern France, carried out to identify the source of legionellosis in a spa, demonstrated the importance of responding to new cases quickly.…”

Section: Occurrence Of Legionella Bacteria In Anth...mentioning

confidence: 99%

Legionellosis risk—an overview of Legionella spp. habitats in Europe

Kanarek

Bogiel

Breza-Boruta

2022

Environ Sci Pollut Res

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An increase in the number of reports of legionellosis in the European Union and the European Economic Area have been recorded in recent years. The increase in cases is significant: from 6947 reports in 2015 to 11,298 in 2019. This is alarming as genus Legionella, which comprises a large group of bacteria inhabiting various aquatic systems, poses a serious threat to human health and life, since more than 20 species can cause legionellosis, with L. pneumophila being responsible for the majority of cases. The ability to colonize diverse ecosystems makes the eradication of these microorganisms difficult. A detailed understanding of the Legionella habitat may be helpful in the effective control of this pathogen. This paper provides an overview of Legionella environments in Europe: natural (lakes, groundwater, rivers, compost, soil) and anthropogenic (fountains, air humidifiers, water supply systems), and the role of Legionella spp. in nosocomial infections, which are potentially fatal for children, the elderly and immunocompromised patients. Graphical abstract

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An outbreak of Legionnaires’ disease associated with a display spa pool in retail premises, Stoke-on-Trent, United Kingdom, July 2012

Abstract: Binary file ES_Abstracts_Final_ECDC.txt matches

Cited by 40 publications

References 11 publications

Confirmed and Potential Sources of Legionella Reviewed

Confirmed and Potential Sources of Legionella Reviewed

A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel

Legionellosis risk—an overview of Legionella spp. habitats in Europe

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