A community outbreak of Legionnaires' disease linked to hospital cooling towers: An epidemiological method to calculate dose of exposure

International Journal of Epidemiology

Volumn 28, Issue 2, 1999, Pages 353-359

  Brown, Clive M ^b   Nuorti, Pekka J ^b   Breiman, Robert F ^b   Hathcock, A Leroy ^b   Fields, Barry S ^b   Lipman, Harvey B ^b   Llewellyn, Gerald C ^b   Hofmannb, Jo ^b   Cetron, Martin ^a  

^a CENTERS FOR DISEASE CONTROL AND PREVENTION   (United States)

^b NONE

Author keywords

Aerosol exposure; Disease outbreaks; Dose response; Environmental exposure; Legionnaires' disease; Water microbiology

Indexed keywords

MONOCLONAL ANTIBODY;

ADULT; AGED; ARTICLE; CASE CONTROL STUDY; CONTROLLED STUDY; COOLING TOWER; DISEASE CONTROL; ENVIRONMENTAL EXPOSURE; EPIDEMIC; HOSPITAL; HUMAN; LEGIONELLA PNEUMOPHILA; LEGIONNAIRE DISEASE; MAJOR CLINICAL STUDY; MICROBIOLOGY; POLYMERASE CHAIN REACTION; PRACTICE GUIDELINE; PRIORITY JOURNAL; RISK FACTOR; UNITED STATES;

EID: 0032916907     PISSN: 03005771     EISSN: None     Source Type: Journal    
DOI: 10.1093/ije/28.2.353     Document Type: Article

References (25)

1. Centers for Disease Control and Prevention. Legionnaires' disease associated with cooling-towers. MMWR 1994;43:491-3,9.
2. Addis DG, Davis JP, Martin L et al. Community-acquired Legionnaires' disease associated with a cooling-tower: evidence for longer distance transport of Legionella pneumophila. Am J Epidemiol 1989;130:557-68.
3. Addis DG, Davis JP, Wand PJ et al. Two cases of community-acquired Legionnaires' disease: evidence for association with a cooling-tower. J Infect Dis 1989;159:572-75.
4. Klaucke DN, Vogt DL, LaRue D et al. Legionnaires' disease: the epidemiology of two outbreaks in Burlington, Vermont. 1980. Am J Epidemiol 1984;119:382-91.
5. Cordes GC, Fraser DW, Skaliy P et al. Legionnaires' disease outbreak at an Atlanta, Georgia, country club: evidence for spread from an evaporative condenser. Am J Epidemiol 1980;111:425-31.
6. Breiman RF, Cozen W, Fields BS et al. Role of air sampling in investigation of an outbreak of Legionnaires' disease associated with exposure to aerosols from an evaporative condenser. J Infect Dis 1990; 161:1257-61.
7. Jernigan D, Hofmann J, Cetron MS et al. and the Cruise Ship Working Group. 'Outbreak of Legionnaires' Disease among cruise ship passengers exposed to a contaminated whirlpool spa'. Lancet 1996;347: 494-98.
8. Hlady WG, Mullen RC, Mintz CS et al. Outbreak of Legionnaires disease linked to a decorative fountain by molecular epidemiology. Am J Epidemiol 1993;138:555-62.
9. Mahoney FJ, Hoge CW, Farley TA et al. Communitywide outbreak of Legionnaires' disease associated with a grocery store mist machine. J Infect Dis 1992;165:736-39.
10. Hanrahan JP, Dale LM, Scharf VB et at. A community outbreak of legionellosis: transmission by potable hot water. Am J Epidemiol 1987; 125:639-49.
11. Dean AG, Dean JA, Coulombier D et al. Epi Info, Version 6: A Word Processing. Database, and Statistics Program for Epidemiology and Microcomputers. Atlanta, Georgia: Centers for Disease Control and Prevention, USA, 1994.
12. SAS for Personal Computers, Release 6.08, Cary, NC: SAS Institute, 1993.
13. Barbaree JM, Fields BS, Martin WT et al. Procedures for the Recovery of Legionella from the Environment. Centers for Disease Control and Prevention, Atlanta, Nov 1994.
14. Wilkinson HW. Hospital Laboratory Diagnosis of Legionella Infections. Centers for Disease Control and Prevention, Atlanta, Jan 1988.
15. Kohler RB, Zimmerman SE, Wilson SD. Rapid radioimmunoassay diagnosis of Legionnaires' disease, detection and partial characterization of urinary antigen. Ann Intern Med 1981;94:601-05.
16. Luck PC, Helbig JH, Gunter U et al. Epidemiologic investigation by macrorestriction analysis and by using monoclonal antibodies of nosocomial pneumonia caused by Legionella pneumophila serogroup I. J Clin Microbiol 1994;32:2692-97.
17. Belkum AV, Struelens M, Quint W. Typing of Legionella pnuemophila strains by polymerase chain reaction mediated DNA fingerprinting. J Clin Microbiol 1993;31:2198-200.
18. Garbe PL, Davis BJ, Weisfeld JS et al. Nosocomial Legionnaires' disease, epidemiologic demonstration of cooling-towers as a source. JAMA 1985;254:521-24.
19. Bhopal RS, Fallon RJ, Buist EC, Black RJ, Urquhart JD. Proximity of the home to a cooling tower and risk of non-outbreak legionnaires' disease. Br Med J 1991;302:378-83.
20. Plouffe JF, File TM Jr, Breiman R et al. Reevaluation of the definition of Legionnaires' disease: use of the urinary antigen assay. Community Based Pneumonia Incidence Study Group. Clin Infect Dis 1995;20: 1286-91.
21. Dondero TJ, Rendtorff RC, Mallison GF et al. An outbreak of Legionnaires' disease associated with a contaminated air-conditioning cooling-tower. N Engl JMed 1980;302:365-70.
22. Maesaki S, Kohno S, Koga H et al. An outbreak of Legionnaires' disease in a nursing home. Intern Med 1992;31:508-12.
23. Marston BJ, Plouffe JF, File TM et al. Incidence of community-acquired pneumonia requiring hospitalization: population-based active surveillance in Ohio. Arch Intern Med 1997;157:1709-18.
24. Marston BJ, Lipman HB, Breiman RF. Surveillance for Legionnaires' disease. Risk factors for morbidity and mortality. Arch Intern Med 1994;154:2417-22.
25. Bentham RH, Broadbent CR. A model for autumn outbreaks of Legionnaires' disease associated with cooling-towers, linked to system operation and size. Epidemiol Infect 1993;111:287-95.