Abstract:
During the period October-November 2017, an outbreak of Legionnaires\' disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires\' disease (TALD). Most cases belonged to different hotel cluster alerts. No cases were reported among the local population residing in the area. All tourist establishments associated with one or more TALD cases were inspected and sampled by public health inspectors. All relevant sources of aerosol emission detected were investigated and sampled. The absence of active cooling towers in the affected area was verified, by documents and on-site. Samples from hot tubs for private use located on the terraces of the penthouse rooms of a hotel in the area were included in the study. Extremely high concentrations (> 106 CFU/l) of Legionella pneumophila, including the outbreak strain, were found in the hot tubs of vacant rooms of this hotel thus identifying the probable source of infection. Meteorological situation may have contributed to the geographical distribution pattern of this outbreak. In conclusion, hot tubs for private use located outdoors should be considered when investigating community outbreaks of Legionnaires\' disease of unclear origin.
摘要:
在2017年10月至11月期间,在帕尔马诺瓦的旅游区(Mallorca,西班牙)。大多数病例由欧洲疾病预防和控制中心(ECDC)报告为军团病(TALD)的旅行相关病例。大多数情况属于不同的酒店集群警报。居住在该地区的当地居民中没有报告病例。公共卫生检查员对与一个或多个TALD病例相关的所有旅游场所进行了检查和采样。对检测到的所有相关气溶胶排放源进行了调查和采样。核实了受影响地区没有主动式冷却塔,通过文件和现场。该研究包括位于该地区一家酒店顶层公寓露台上的私人热水浴缸样本。极高的浓度(>106CFU/l)的嗜肺军团菌,包括爆发的菌株,在这家酒店空房的热水浴缸中发现,从而确定了可能的感染源。气象形势可能促成了此次疫情的地理分布格局。总之,在调查不明来源的军团病社区暴发时,应考虑室外私人使用的热水浴缸。