A Community-Wide Outbreak of Legionnaires Disease Linked to Industrial Cooling Towers—How Far Can Contaminated Aerosols Spread?

A community-wide outbreak of legionnaires disease occurred in Pas-de-Calais, France, in November 2003–January 2004. Eighteen (21%) of 86 laboratory-confirmed cases were fatal. A case-control study identified smoking, silicosis, and spending >100 min outdoors daily as risk factors for acquiring th...

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Bibliographic Details
Published in:The Journal of infectious diseases 2006-01, Vol.193 (1), p.102-111
Main Authors: Nhu Nguyen, Tran Minh, Ilef, Daniele, Jarraud, Sophie, Rouil, Laurence, Campese, Christine, Che, Didier, Haeghebaert, Sylvie, Ganiayre, François, Marcel, Frederic, Etienne, Jerome, Desenclos, Jean-Claude
Format: Article
Language:English
Subjects:
Adult
Aerosols
Aged
Aged, 80 and over
Air Conditioning
Air Microbiology
Bacteria
Bacterial diseases
Bacterial diseases of the respiratory system
Biological and medical sciences
Case-Control Studies
Communes
Disease Outbreaks
Diseases
Epidemiology
Female
France - epidemiology
Fundamental and applied biological sciences. Psychology
Human bacterial diseases
Humans
Industrial plants
Industry
Infectious diseases
Legionella
Legionella pneumophila
Legionella pneumophila - classification
Legionella pneumophila - genetics
Legionella pneumophila - isolation & purification
Legionnaires disease
Legionnaires' Disease - epidemiology
Legionnaires' Disease - microbiology
Male
Medical sciences
Microbiology
Middle Aged
Predisposing factors
Risk Factors
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Summary:A community-wide outbreak of legionnaires disease occurred in Pas-de-Calais, France, in November 2003–January 2004. Eighteen (21%) of 86 laboratory-confirmed cases were fatal. A case-control study identified smoking, silicosis, and spending >100 min outdoors daily as risk factors for acquiring the disease. Legionella pneumophila strain Lens was isolated from cooling towers, wastewater, and air samples from plant A. This unique strain matched all 23 clinical isolates, as assessed by pulsed-field gel electrophoresis subtyping. Modeling of atmospheric dispersion of aerosols emitted from plant A cooling towers showed good coverage of the communes where patients lived and showed that the dispersion extended over a distance of at least 6 km from plant A. No other aerosol-producing installation was identified as a plausible source, and no common source of indoor exposure was found. These findings implicate plant A as the most likely outbreak source and suggest that the distance of airborne transmission of L. pneumophila may be greater than previously reported
ISSN:0022-1899
1537-6613
DOI:10.1086/498575