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. 1991 Aug;107(1):133–141. doi: 10.1017/s0950268800048767

An outbreak of Legionnaires' disease in Gloucester.

D A Hunt 1, K A Cartwright 1, M C Smith 1, J Middleton 1, C L Bartlett 1, J V Lee 1, P J Dennis 1, D Harper 1
PMCID: PMC2272039  PMID: 1879480

Abstract

Fourteen people living in or near the city of Gloucester fell ill with Legionnaires' disease caused by Legionella pneumophila serogroup (SG) 1 between 27 August and 27 October 1986. Another patient had fallen ill on 30 May. Nine of the 15 were diagnosed retrospectively during a case finding exercise. There were three deaths. Three cases of Pontiac fever were also diagnosed. The source was probably one or more wet cooling towers. Nineteen premises in the city with such towers were identified, and three just outside Gluocester. Samples from 11 of the 22 premises grew Legionella spp.; from nine of these L. pneumophila SG 1 (Pontiac) was isolated. The efficacy of regular addition of biocide in addition to hypochlorite added at the time of disinfection in inhibiting the growth of Legionella spp. was demonstrated. A survey of patients' movements during their likely incubation period showed that there was no single building that all patients had visited, but there were two areas of the city which nearly all had visited or passed through by car. A case-control study demonstrated an association with one of these areas. Cooling towers near both areas may have been sources but the evidence is insufficient to incriminate any single one. The unexpected finding of L. pneumophila SG 1 (Pontiac) in nine towers supports the hypothesis that there may have been multiple sources. Cooling towers may have been contaminated by mains water or by drift from other towers.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Anderson P., Bartlett C., Cook G., Woodward M. Legionnaires disease in Reading--possible association with a cooling tower. Community Med. 1985 Aug;7(3):202–207. [PubMed] [Google Scholar]
  2. Bartlett C. L., Bibby L. F. Epidemic legionellosis in England and Wales 1979--1982. Zentralbl Bakteriol Mikrobiol Hyg A. 1983 Jul;255(1):64–70. [PubMed] [Google Scholar]
  3. Harrison T. G., Taylor A. G. A rapid microagglutination test for the diagnosis of Legionella pneumophila (serogroup 1) infection. J Clin Pathol. 1982 Sep;35(9):1028–1031. doi: 10.1136/jcp.35.9.1028. [DOI] [PMC free article] [PubMed] [Google Scholar]
  4. Mitchell E., O'Mahony M., Watson J. M., Lynch D., Joseph C., Quigley C., Aston R., Constable G. N., Farrand R. J., Maxwell S. Two outbreaks of Legionnaires' disease in Bolton Health District. Epidemiol Infect. 1990 Apr;104(2):159–170. doi: 10.1017/s095026880005932x. [DOI] [PMC free article] [PubMed] [Google Scholar]
  5. Morton S., Bartlett C. L., Bibby L. F., Hutchinson D. N., Dyer J. V., Dennis P. J. Outbreak of legionnaires' disease from a cooling water system in a power station. Br J Ind Med. 1986 Sep;43(9):630–635. doi: 10.1136/oem.43.9.630. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. O'Mahony M. C., Stanwell-Smith R. E., Tillett H. E., Harper D., Hutchison J. G., Farrell I. D., Hutchinson D. N., Lee J. V., Dennis P. J., Duggal H. V. The Stafford outbreak of Legionnaires' disease. Epidemiol Infect. 1990 Jun;104(3):361–380. doi: 10.1017/s0950268800047385. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Saunders N. A., Harrison T. G., Haththotuwa A., Kachwalla N., Taylor A. G. A method for typing strains of Legionella pneumophila serogroup 1 by analysis of restriction fragment length polymorphisms. J Med Microbiol. 1990 Jan;31(1):45–55. doi: 10.1099/00222615-31-1-45. [DOI] [PubMed] [Google Scholar]
  8. Taylor A. G., Harrison T. G. Formalised yolk sac antigen in early diagnosis of Legionnaires' disease caused by Legionella pneumophila serogroup 1. Lancet. 1981 Sep 12;2(8246):591–592. doi: 10.1016/s0140-6736(81)90988-0. [DOI] [PubMed] [Google Scholar]
  9. Tillett H. E. Statistical analysis of case-control studies of communicable diseases. Int J Epidemiol. 1986 Mar;15(1):126–133. doi: 10.1093/ije/15.1.126. [DOI] [PubMed] [Google Scholar]
  10. Timbury M. C., Donaldson J. R., McCartney A. C., Fallon R. J., Sleigh J. D., Lyon D., Orange G. V., Baird D. R., Winter J., Wilson T. S. Outbreak of Legionnaires' disease in Glasgow Royal Infirmary: microbiological aspects. J Hyg (Lond) 1986 Dec;97(3):393–403. doi: 10.1017/s0022172400063580. [DOI] [PMC free article] [PubMed] [Google Scholar]
  11. Watkins I. D., Tobin J. O., Dennis P. J., Brown W., Newnham R., Kurtz J. B. Legionella pneumophila serogroup 1 subgrouping by monoclonal antibodies--an epidemiological tool. J Hyg (Lond) 1985 Oct;95(2):211–216. doi: 10.1017/s0022172400062641. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Williams A., Baskerville A., Dowsett A. B., Conlan J. W. Immunocytochemical demonstration of the association between Legionella pneumophila, its tissue-destructive protease, and pulmonary lesions in experimental legionnaires' disease. J Pathol. 1987 Nov;153(3):257–264. doi: 10.1002/path.1711530310. [DOI] [PubMed] [Google Scholar]

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