The Largest Outbreak of Legionellosis in Japan Associated with Spa Baths

Okada, Mika; Kawano, Keiichi; Kura, Fumiaki; Amemura-Maekawa, Junko; Watanabe, Haruo; Yagita, Kenji; Endo, Tokiko; Suzuki, Sen

doi:10.11150/kansenshogakuzasshi1970.79.365

Cited by 47 publications

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“…diversity could be due to a direct addition of different Legionella spp. into the river population from the natural hot spring water or the water distribution system in the thermal bath establishment (24,33). The thermal discharge water could also modify the Legionella sp.…”

Section: Discussionmentioning

confidence: 99%

High Diversity and Abundance of Legionella spp. in a Pristine River and Impact of Seasonal and Anthropogenic Effects

Parthuisot

West

Lebaron

et al. 2010

Appl Environ Microbiol

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The diversity and dynamics of Legionella species along a French river watershed subject to different thermal and wastewater discharges during an annual cycle were assessed by 16S rRNA gene sequencing and by a fingerprint technique, single-strand conformation polymorphism. A high diversity of Legionella spp. was observed at all the sampling sites, and the dominant Legionella clusters identified were most closely related to uncultured bacteria. The monthly monitoring revealed that Legionella sp. diversity changes were linked only to season at the wastewater site whereas there was some evidence for anthropogenic effects on Legionella sp. diversity downstream of the thermal bath. Quantification of Legionella pneumophila and Legionella spp. by culture and quantitative PCR (qPCR) was performed. Whereas only L. pneumophila was quantified on culture media, the qPCR assay revealed that Legionella spp. were ubiquitous and abundant from the pristine source of the river to the downstream sampling sites. These results suggest that Legionella spp. may be present at significant concentrations in many more freshwater environments than previously thought, highlighting the need for further ecological studies and culturing efforts.

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Section: Discussionmentioning

confidence: 99%

High Diversity and Abundance of Legionella spp. in a Pristine River and Impact of Seasonal and Anthropogenic Effects

Parthuisot

West

Lebaron

et al. 2010

Appl Environ Microbiol

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“…Hot springs, public baths, and cooling towers are the most probable sources of legionellosis. In Japan, several legionellosis outbreaks caused by Legionella pneumophila have been reported (13,16,17,19,29,33). To prevent this infectious disease, surveillance investigations of manmade water systems, such as cooling towers, showerheads, and water distribution pipelines, should be carried out regularly.…”

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confidence: 99%

Specific Detection of Viable Legionella Cells by Combined Use of Photoactivated Ethidium Monoazide and PCR/Real-Time PCR

Chang

Sugiyama

Taguri³

et al. 2009

Appl Environ Microbiol

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Legionella organisms are prevalent in manmade water systems and cause legionellosis in humans. A rapid detection method for viable Legionella cells combining ethidium monoazide (EMA) and PCR/real-time PCR was assessed. EMA could specifically intercalate and cleave the genomic DNA of heat-and chlorine-treated dead Legionella cells. The EMA-PCR assay clearly showed an amplified fragment specific for Legionella DNA from viable cells, but it could not do so for DNA from dead cells. The number of EMA-treated dead Legionella cells estimated by real-time PCR exhibited a 10 4 -to 10 5 -fold decrease compared to the number of dead Legionella cells without EMA treatment. Conversely, no significant difference in the numbers of EMA-treated and untreated viable Legionella cells was detected by the real-time PCR assay. The combined assay was also confirmed to be useful for specific detection of culturable Legionella cells from water samples obtained from spas. Therefore, the combined use of EMA and PCR/real-time PCR detects viable Legionella cells rapidly and specifically and may be useful in environmental surveillance for Legionella.

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“…This microbe can survive in a wide range of temperature (5-65 C) and pH (5.5-9.5), particularly in warm and damp environments of 35-45 C which is their favorable growth temperature range. Because of their high survival rate in a thermal and wet environment, which happens to be the atmosphere regularly established in a whirlpool spa, numerous outbreaks of LG have been traced to the spa water as the source of their causative agents (2,17,20,21,23,31).Tracing the source of LG was often determined by linking environmental isolates to clinical isolates by various molecular subtyping methods, of which at least 7 kinds have been reported (15). Among them, amplified fragment length polymorphism (AFLP) and pulsefield gel electrophoresis (PFGE) were two methods most often used and highly recommended (3, 13).…”

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confidence: 99%

A Legionellosis Case Due to Contaminated Spa Water and Confirmed by Genomic Identification in Taiwan

Tseng

Tzeng

et al. 2006

Microbiology and Immunology

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Legionellosis (LG, infection by members of the genus Legionella) can range from mild respiratory illness to acute life-threatening pneumonia. The majority of LG cases are caused by Legionella pneumophila (LP), particularly serogroup 1 (18). Since the first outbreak in Philadelphia in 1976 (12), LP has been recognized as an important etiological agent of hospital-and community-acquired pneumonia. This microbe can survive in a wide range of temperature (5-65 C) and pH (5.5-9.5), particularly in warm and damp environments of 35-45 C which is their favorable growth temperature range. Because of their high survival rate in a thermal and wet environment, which happens to be the atmosphere regularly established in a whirlpool spa, numerous outbreaks of LG have been traced to the spa water as the source of their causative agents (2,17,20,21,23,31).Tracing the source of LG was often determined by linking environmental isolates to clinical isolates by various molecular subtyping methods, of which at least 7 kinds have been reported (15). Among them, amplified fragment length polymorphism (AFLP) and pulsefield gel electrophoresis (PFGE) were two methods most often used and highly recommended (3, 13).

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The Largest Outbreak of Legionellosis in Japan Associated with Spa Baths

Cited by 47 publications

References 0 publications

High Diversity and Abundance of Legionella spp. in a Pristine River and Impact of Seasonal and Anthropogenic Effects

High Diversity and Abundance of Legionella spp. in a Pristine River and Impact of Seasonal and Anthropogenic Effects

Specific Detection of Viable Legionella Cells by Combined Use of Photoactivated Ethidium Monoazide and PCR/Real-Time PCR

A Legionellosis Case Due to Contaminated Spa Water and Confirmed by Genomic Identification in Taiwan

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