Outbreak of Legionnaire’s Disease Caused by<i>Legionella pneumophila</i>Serogroups 1 and 13

Kuroki, Toshiro; Amemura-Maekawa, Junko; Ohya, Hitomi; Furukawa, Ichiro; Suzuki, Miyuki; Masaoka, Tomoka; Aikawa, Kastuhiro; Hibi, Kazumi; Morita, Masatomo; Lee, Ken-ichi; Ohnishi, Makoto; Kura, Fumiaki

doi:10.3201/eid2302.161012

Cited by 28 publications

(23 citation statements)

References 9 publications

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“…In five events, various species or serogroups were involved [27,30,42,58,62], one of which was the first case where the same genotype of L. rubrilucens was isolated from the LD patient’s sputum and the hot spring water [30]. …”

Section: Discussionmentioning

confidence: 99%

Legionellosis Associated with Recreational Waters: A Systematic Review of Cases and Outbreaks in Swimming Pools, Spa Pools, and Similar Environments

Leoni

Catalani

Marini

et al. 2018

IJERPH

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Legionella spp. is widespread in many natural and artificial water systems, such as hot water distribution networks, cooling towers, and spas. A particular risk factor has been identified in the use of whirlpools and hot tubs in spa facilities and public baths. However, there has been no systematic synthesis of the published literature reporting legionellosis cases or outbreaks related to swimming/spa pools or similar environments used for recreational purposes (hot springs, hot tubs, whirlpools, natural spas). This study presents the results of a systematic review of the literature on cases and outbreaks associated with these environments. Data were extracted from 47 articles, including 42 events (17 sporadic cases and 25 outbreaks) and 1079 cases, 57.5% of which were diagnosed as Pontiac fever, without any deaths, and 42.5% were of Legionnaires’ disease, with a fatality rate of 6.3%. The results are presented in relation to the distribution of Legionella species involved in the events, clinical manifestations and diagnosis, predisposing conditions in the patients, favourable environmental factors, and quality of the epidemiological investigation, as well as in relation to the different types of recreational water sources involved. Based on the epidemiological and microbiological criteria, the strength of evidence linking a case/outbreak of legionellosis with a recreational water system was classified as strong, probable, and possible; in more than half of the events the resulting association was strong.

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Section: Discussionmentioning

confidence: 99%

Legionellosis Associated with Recreational Waters: A Systematic Review of Cases and Outbreaks in Swimming Pools, Spa Pools, and Similar Environments

Leoni

Catalani

Marini

et al. 2018

IJERPH

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“…1) (https://www.niid.go.jp/ niid/ja/survei/2085-idwr/ydata/7310-report-ja2016-20.html), with the diagnosis of urinary antigen being prevalent. Several outbreaks of Legionnaires' disease associated with public bath facilities have occurred (5)(6)(7)(8)(9)(10), and bathing facilities were found to be the main source of infection in Japan (8), although most such facilities had circulation systems fitted with filters and used hot spring water. Even for sporadic cases, infection source surveys were conducted by some public health centers, and bathing facilities could be identified as the source of infection by using molecular epidemiology (11,12).…”

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confidence: 99%

Legionella pneumophila and Other Legionella Species Isolated from Legionellosis Patients in Japan between 2008 and 2016

Amemura-Maekawa

Kura

Chida³

et al. 2018

Appl Environ Microbiol

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The Reference Center in Japan collected 427 clinical isolates between 2008 and 2016, including 7 representative isolates from corresponding outbreaks. The collection included 419 isolates, of which 372 belonged to serogroup 1 (SG1) (87%) and the others belonged to SG2 to SG15 except for SG7 and SG11, and 8 isolates of other species (, ,, ,, and ). isolates were genotyped by sequence-based typing (SBT) and represented 187 sequence types (STs), of which 126 occurred in a single isolate (index of discrimination of 0.984). These STs were analyzed using minimum spanning tree analysis, resulting in the formation of 18 groups. The pattern of overall ST distribution among isolates was diverse. In particular, some STs were frequently isolated and were suggested to be related to the infection sources. The major STs were ST23 (35 isolates), ST120 (20 isolates), and ST138 (16 isolates). ST23 was the most prevalent and most causative ST for outbreaks in Japan and Europe. ST138 has been observed only in Japan, where it has caused small-scale outbreaks; 81% of those strains (13 isolates) were suspected or confirmed to infect humans through bath water sources. On the other hand, 11 ST23 strains (31%) and 5 ST120 strains (25%) were suspected or confirmed to infect humans through bath water. These findings suggest that some ST strains frequently cause legionellosis in Japan and are found under different environmental conditions. serogroup 1 (SG1) is the most frequent cause of legionellosis. Our previous genetic analysis indicated that SG1 environmental isolates represented 8 major clonal complexes, consisting of 3 B groups, 2 C groups, and 3 S groups, which included major environmental isolates derived from bath water, cooling towers, and soil and puddles, respectively. Here, we surveyed clinical isolates collected from patients with legionellosis in Japan between 2008 and 2016. Most strains belonging to the B group were isolated from patients for whom bath water was the suspected or confirmed source of infection. Among the isolates derived from patients whose suspected infection source was soil or dust, most belonged to the S1 group and none belonged to the B or C groups. Additionally, the U group was discovered as a new group, which mainly included clinical isolates with unknown infection sources.

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“…根据世界卫生组织(WHO)于2016年12 月发布的最新估计, 2015年有38.3万人死于哮喘 [15,16] , 而罹患哮喘的最大风险因素是吸入可能导致过敏反应或刺激呼吸道的微生物颗粒, 如尘螨、花粉、霉菌等 [15,17] . [18] . 军团菌病是由于感染了嗜肺军团菌 (Legionella pneumophila)获得的肺部疾病.…”

Section: 研究者们发现不同室内环境如学校、医院或住unclassified

“…军团菌病是由于感染了嗜肺军团菌 (Legionella pneumophila)获得的肺部疾病. 该病菌对健康的人和免疫力较强的人威胁不大, 但是会引起老年患者和免疫力低下病人的感染 [18,19] . [20] .…”

Section: 研究者们发现不同室内环境如学校、医院或住unclassified

“…同时也是室内机会性致病菌的来源之一. 大量研究表明, 淋浴装置和热水龙头在使用过程中可以向空气中释放军团杆菌 [18,42,43] . 军团杆菌可以引起军团杆菌病和庞蒂亚克热 [18] , 这些疾病与肺炎等呼吸系统疾病类似, 严重时可能导致老年人死亡.…”

Section: 管道和空调系统是室内细菌的另一个重要来源unclassified

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An overview about varieties and detection methods of pathogenic microorganisms in indoor air

Weng

Aili

et al. 2018

Chin. Sci. Bull.

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Outbreak of Legionnaire’s Disease Caused byLegionella pneumophilaSerogroups 1 and 13

Cited by 28 publications

References 9 publications

Legionellosis Associated with Recreational Waters: A Systematic Review of Cases and Outbreaks in Swimming Pools, Spa Pools, and Similar Environments

Legionellosis Associated with Recreational Waters: A Systematic Review of Cases and Outbreaks in Swimming Pools, Spa Pools, and Similar Environments

Legionella pneumophila and Other Legionella Species Isolated from Legionellosis Patients in Japan between 2008 and 2016

An overview about varieties and detection methods of pathogenic microorganisms in indoor air

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