Abstract
This Memorandum describes the following aspects of legionellosis: clinical presentations of legionella infection, general epidemiology (including nosocomial outbreaks and travel-associated legionnaires' disease), surveillance and reporting of cases, the organism and its environment, and measures for prevention and control. These topics were discussed by experts at a meeting in Geneva on 27-29 November 1989. This article also includes their conclusions and recommendations for research in critical areas including surveillance and preventive activities that have been found to be effective.
Full text
PDF









Selected References
These references are in PubMed. This may not be the complete list of references from this article.
- Aubertin J., Dabis F., Fleurette J., Bornstein N., Salamon R., Brottier E., Brune J., Vincent P., Migueres J., Jover A. Prevalence of legionellosis among adults: a study of community-acquired pneumonia in France. Infection. 1987;15(5):328–331. doi: 10.1007/BF01647732. [DOI] [PubMed] [Google Scholar]
- Barbaree J. M., Fields B. S., Feeley J. C., Gorman G. W., Martin W. T. Isolation of protozoa from water associated with a legionellosis outbreak and demonstration of intracellular multiplication of Legionella pneumophila. Appl Environ Microbiol. 1986 Feb;51(2):422–424. doi: 10.1128/aem.51.2.422-424.1986. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 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]
- Berendt R. F. Survival of Legionella pneumophila in aerosols: effect of relative humidity. J Infect Dis. 1980 May;141(5):689–689. doi: 10.1093/infdis/141.5.689. [DOI] [PubMed] [Google Scholar]
- Bornstein N., Marmet D., Surgot M., Nowicki M., Arslan A., Esteve J., Fleurette J. Exposure to Legionellaceae at a hot spring spa: a prospective clinical and serological study. Epidemiol Infect. 1989 Feb;102(1):31–36. doi: 10.1017/s0950268800029654. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bornstein N., Vieilly C., Nowicki M., Paucod J. C., Fleurette J. Epidemiological evidence of legionellosis transmission through domestic hot water supply systems and possibilities of control. Isr J Med Sci. 1986 Sep;22(9):655–661. [PubMed] [Google Scholar]
- Centers for Disease Control (CDC) Rat-bite fever in a college student--California. MMWR Morb Mortal Wkly Rep. 1984 Jun 8;33(22):318–320. [PubMed] [Google Scholar]
- Colbourne J. S., Pratt D. J., Smith M. G., Fisher-Hoch S. P., Harper D. Water fittings as sources of Legionella pneumophila in a hospital plumbing system. Lancet. 1984 Jan 28;1(8370):210–213. doi: 10.1016/s0140-6736(84)92126-3. [DOI] [PubMed] [Google Scholar]
- Cordes L. G., Wilkinson H. W., Gorman G. W., Fikes B. J., Fraser D. W. Atypical Legionella-like organisms: fastidious water-associated bacteria pathogenic for man. Lancet. 1979 Nov 3;2(8149):927–930. doi: 10.1016/s0140-6736(79)92623-0. [DOI] [PubMed] [Google Scholar]
- Dennis P. J., Lee J. V. Differences in aerosol survival between pathogenic and non-pathogenic strains of Legionella pneumophila serogroup 1. J Appl Bacteriol. 1988 Aug;65(2):135–141. doi: 10.1111/j.1365-2672.1988.tb01501.x. [DOI] [PubMed] [Google Scholar]
- Dutka B. J., Walsh K., Ewan P., El-Shaarawi A., Tobin R. S. Incidence of Legionella organisms in selected Ontario (Canada) cities. Sci Total Environ. 1984 Nov;39(3):237–249. doi: 10.1016/0048-9697(84)90081-0. [DOI] [PubMed] [Google Scholar]
- Feeley J. C., Gorman G. W., Weaver R. E., Mackel D. C., Smith H. W. Primary isolation media for Legionnaires disease bacterium. J Clin Microbiol. 1978 Sep;8(3):320–325. doi: 10.1128/jcm.8.3.320-325.1978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Fitzgeorge R. B., Dennis P. J. Isolation of Legionella pneumophila from water supplies: comparison of methods based on the guinea-pig and culture media. J Hyg (Lond) 1983 Oct;91(2):179–187. doi: 10.1017/s0022172400060186. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Foy H. M., Broome C. V., Hayes P. S., Allan I., Cooney M. K., Tobe R. Legionnaires' disease in a prepaid medical-care group in Seattle 1963--75. Lancet. 1979 Apr 7;1(8119):767–770. doi: 10.1016/s0140-6736(79)91219-4. [DOI] [PubMed] [Google Scholar]
- Goldberg D. J., Wrench J. G., Collier P. W., Emslie J. A., Fallon R. J., Forbes G. I., McKay T. M., Macpherson A. C., Markwick T. A., Reid D. Lochgoilhead fever: outbreak of non-pneumonic legionellosis due to Legionella micdadei. Lancet. 1989 Feb 11;1(8633):316–318. doi: 10.1016/s0140-6736(89)91319-6. [DOI] [PubMed] [Google Scholar]
- Helms C. M., Massanari R. M., Wenzel R. P., Pfaller M. A., Moyer N. P., Hall N. Legionnaires' disease associated with a hospital water system. A five-year progress report on continuous hyperchlorination. JAMA. 1988 Apr 22;259(16):2423–2427. [PubMed] [Google Scholar]
- Joly J. R., Boissinot M., Duchaine J., Duval M., Rafrafi J., Ramsay D., Letarte R. Ecological distribution of Legionellaceae in the Quebec city area. Can J Microbiol. 1984 Jan;30(1):63–67. doi: 10.1139/m84-011. [DOI] [PubMed] [Google Scholar]
- Joly J. R., Déry P., Gauvreau L., Coté L., Trépanier C. Legionnaires' disease caused by Legionella dumoffii in distilled water. CMAJ. 1986 Dec 1;135(11):1274–1277. [PMC free article] [PubMed] [Google Scholar]
- Korvick J. A., Yu V. L. Legionnaires' disease: an emerging surgical problem. Ann Thorac Surg. 1987 Mar;43(3):341–347. doi: 10.1016/s0003-4975(10)60633-9. [DOI] [PubMed] [Google Scholar]
- Lode H., Kemmerich B., Schäfer H., Grothe R., Hartmann R., Ehret W., Ruckdeschel G. Significance of non-pneumophila Legionella species in adult community-acquired and nosocomial pneumonias. Klin Wochenschr. 1987 May 15;65(10):463–468. doi: 10.1007/BF01712839. [DOI] [PubMed] [Google Scholar]
- Morris G. K., Patton C. M., Feeley J. C., Johnson S. E., Gorman G., Martin W. T., Skaliy P., Mallison G. F., Politi B. D., Mackel D. C. Isolation of the Legionnaires' disease bacterium from environmental samples. Ann Intern Med. 1979 Apr;90(4):664–666. doi: 10.7326/0003-4819-90-4-664. [DOI] [PubMed] [Google Scholar]
- Negrón-Alvíra A., Pérez-Suarez I., Hazen T. C. Legionella spp. in Puerto Rico cooling towers. Appl Environ Microbiol. 1988 Oct;54(10):2331–2334. doi: 10.1128/aem.54.10.2331-2334.1988. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Ortiz-Roque C. M., Hazen T. C. Abundance and distribution of Legionellaceae in Puerto Rican waters. Appl Environ Microbiol. 1987 Sep;53(9):2231–2236. doi: 10.1128/aem.53.9.2231-2236.1987. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Politi B. D., Fraser D. W., Mallison G. F., Mohatt J. V., Morris G. K., Patton C. M., Feeley J. C., Telle R. D., Bennett J. V. A major focus of Legionnaires' disease in Bloomington, Indiana. Ann Intern Med. 1979 Apr;90(4):587–591. doi: 10.7326/0003-4819-90-4-587. [DOI] [PubMed] [Google Scholar]
- Rowbotham T. J. Isolation of Legionella pneumophila from clinical specimens via amoebae, and the interaction of those and other isolates with amoebae. J Clin Pathol. 1983 Sep;36(9):978–986. doi: 10.1136/jcp.36.9.978. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Thacker S. B., Choi K., Brachman P. S. The surveillance of infectious diseases. JAMA. 1983 Mar 4;249(9):1181–1185. [PubMed] [Google Scholar]
- Tobin J. O., Beare J., Dunnill M. S., Fisher-Hoch S., French M., Mitchell R. G., Morris P. J., Muers M. F. Legionnaires' disease in a transplant unit: isolation of the causative agent from shower baths. Lancet. 1980 Jul 19;2(8186):118–121. doi: 10.1016/s0140-6736(80)90005-7. [DOI] [PubMed] [Google Scholar]
- Tomov A., Tsvetkova E., Tsanev N., Kassovsky V., Gotev N. Isolation of Legionella pneumophila in Bulgaria. Zentralbl Bakteriol Mikrobiol Hyg A. 1981 Nov;250(4):521–528. [PubMed] [Google Scholar]
- Wadowsky R. M., Yee R. B. Glycine-containing selective medium for isolation of Legionellaceae from environmental specimens. Appl Environ Microbiol. 1981 Nov;42(5):768–772. doi: 10.1128/aem.42.5.768-772.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Wilkinson H. W., Cruce D. D., Broome C. V. Validation of Legionella pneumophila indirect immunofluorescence assay with epidemic sera. J Clin Microbiol. 1981 Jan;13(1):139–146. doi: 10.1128/jcm.13.1.139-146.1981. [DOI] [PMC free article] [PubMed] [Google Scholar]
