2016
DOI: 10.1056/nejmc1505356
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Probable Person-to-Person Transmission of Legionnaires’ Disease

Abstract: To the Editor: Legionnaires' disease is an often severe form of pneumonia that is typically acquired by susceptible persons (e.g., elderly persons and smokers) through inhalation of aerosols that contain legionella species. 1-4 A cluster of cases of this disease occurred in Vila Franca de Xira, Portugal, in 2014. 5 One of the first cases of disease in this cluster occurred in a 48-year-old man (Patient 1), a smoker, who had been employed since October 6, 2014, as a maintenance worker at an industrial cooling t… Show more

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Cited by 173 publications
(133 citation statements)
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“…L. pneumophila has been isolated from human feces (Rowbotham 1998) and is regularly isolated from the sputa of Legionnaires' disease patients, suggesting that human infection may not actually be a dead end. Further support for this has also come from a recently reported case of probable person-to-person transmission of Legionnaires' disease (Correia et al 2016). Scenarios involving human-to-human transmission and/or human-to-environment transmission could simultaneously explain why these specific strains have emerged recently, spread widely, and are primarily associated with human infection.…”
Section: Discussionmentioning
confidence: 93%
See 1 more Smart Citation
“…L. pneumophila has been isolated from human feces (Rowbotham 1998) and is regularly isolated from the sputa of Legionnaires' disease patients, suggesting that human infection may not actually be a dead end. Further support for this has also come from a recently reported case of probable person-to-person transmission of Legionnaires' disease (Correia et al 2016). Scenarios involving human-to-human transmission and/or human-to-environment transmission could simultaneously explain why these specific strains have emerged recently, spread widely, and are primarily associated with human infection.…”
Section: Discussionmentioning
confidence: 93%
“…It is thought that the conservation of signaling pathways and cellular functions from protozoa to higher eukaryotes allows Legionella to also infect human alveolar macrophages. However, although humans have traditionally been considered a dead-end host for Legionella, one probable case of person-to-person transmission has recently been reported (Correia et al 2016).…”
mentioning
confidence: 99%
“…Transmission from these water systems to humans requires aerosol generation, as can occur from showerheads, cooling towers, hot tubs, and decorative fountains (7). Only one case of possible person-to-person transmission has been reported (8). Legionnaires' disease is typically diagnosed by a Legionella urinary antigen test or culture of lower respiratory secretions using selective media; epidemiologic links to environmental sources can be confirmed when isolates from clinical and environmental specimens match by molecular typing (9).…”
Section: Introductionmentioning
confidence: 99%
“…Human infection occurs mainly by the inhalation of contaminated water droplets originating from a wide range of aerosolgenerating devices (12,13). Yet the first case of person-to-person spread was reported in 2016 (14). In the lungs, L. pneumophila invades and grows in the resident macrophage population and ultimately triggers severe inflammation (3).…”
mentioning
confidence: 99%