Epidemic Legionnaires' Disease Two Decades Later: Old Sources, New Diagnostic Methods
Identifieur interne : 001E44 ( Main/Curation ); précédent : 001E43; suivant : 001E45Epidemic Legionnaires' Disease Two Decades Later: Old Sources, New Diagnostic Methods
Auteurs : Anthony E. Fiore [États-Unis] ; J. Pekka Nuorti [États-Unis] ; Orin S. Levine [États-Unis] ; Arthur Marx [États-Unis] ; Andre C. Weltman [États-Unis] ; Suzanne Yeager [États-Unis] ; Robert F. Benson [États-Unis] ; Janet Pruckler [États-Unis] ; Paul H. Edelstein [États-Unis] ; Patricia Greer [États-Unis] ; Sherif R. Zaki [États-Unis] ; Barry S. Fields [États-Unis] ; Jay C. Butler [États-Unis]Source :
- Clinical Infectious Diseases [ 1058-4838 ] ; 1998-02.
Abstract
In July 1995 we investigated a pneumonia outbreak in a Pennsylvania town. We conducted epidemiological and molecular microbiological studies to determine the outbreak source and interrupt transmission of disease. Legionnaires' disease (LD) was quickly identified by urine antigen testing, and a newly developed immunohistochemical stain confirmed nosocomial transmission to a hospital inpatient. LD was confirmed in 22 patients. Case-patients were more likely than controls to have been within 1,000 feet of the hospital (matched odds ratio, 21.0; 95% confidence interval, 2.9–368) during the 2 weeks prior to illness. Legionella pneumophila serogroup 1 (Lp-1) was isolated from hospital cooling towers (CTs) and rooftop air samples but not from hospital potable water or community CTs. Hospital CT and air Lp-1 isolates matched all five patient isolates by monoclonal antibody, arbitrarily primed polymerase chain reaction, and pulsed-field gel electrophoresis subtyping. Strategies to prevent LD must include minimizing transmission from CTs.
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DOI: 10.1086/516309
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Fiore</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Nuorti, J Pekka" sort="Nuorti, J Pekka" uniqKey="Nuorti J" first="J. 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Pekka Nuorti</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Levine, Orin S" sort="Levine, Orin S" uniqKey="Levine O" first="Orin S." last="Levine">Orin S. Levine</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Marx, Arthur" sort="Marx, Arthur" uniqKey="Marx A" first="Arthur" last="Marx">Arthur Marx</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Weltman, Andre C" sort="Weltman, Andre C" uniqKey="Weltman A" first="Andre C." last="Weltman">Andre C. Weltman</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Yeager, Suzanne" sort="Yeager, Suzanne" uniqKey="Yeager S" first="Suzanne" last="Yeager">Suzanne Yeager</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Benson, Robert F" sort="Benson, Robert F" uniqKey="Benson R" first="Robert F." last="Benson">Robert F. Benson</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Pruckler, Janet" sort="Pruckler, Janet" uniqKey="Pruckler J" first="Janet" last="Pruckler">Janet Pruckler</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Edelstein, Paul H" sort="Edelstein, Paul H" uniqKey="Edelstein P" first="Paul H." last="Edelstein">Paul H. Edelstein</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Greer, Patricia" sort="Greer, Patricia" uniqKey="Greer P" first="Patricia" last="Greer">Patricia Greer</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Zaki, Sherif R" sort="Zaki, Sherif R" uniqKey="Zaki S" first="Sherif R." last="Zaki">Sherif R. Zaki</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Fields, Barry S" sort="Fields, Barry S" uniqKey="Fields B" first="Barry S." last="Fields">Barry S. Fields</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Butler, Jay C" sort="Butler, Jay C" uniqKey="Butler J" first="Jay C." last="Butler">Jay C. Butler</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">ISTEX</idno><idno type="RBID">ISTEX:AEBE8D350CF6D732C9E51C219505C021F5FF7200</idno><date when="1998" year="1998">1998</date><idno type="doi">10.1086/516309</idno><idno type="url">https://api.istex.fr/document/AEBE8D350CF6D732C9E51C219505C021F5FF7200/fulltext/pdf</idno><idno type="wicri:Area/Main/Corpus">002151</idno><idno type="wicri:Area/Main/Curation">001E44</idno></publicationStmt><sourceDesc><biblStruct><analytic><title level="a">Epidemic Legionnaires' Disease Two Decades Later: Old Sources, New Diagnostic Methods</title><author><name sortKey="Fiore, Anthony E" sort="Fiore, Anthony E" uniqKey="Fiore A" first="Anthony E." last="Fiore">Anthony E. Fiore</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Nuorti, J Pekka" sort="Nuorti, J Pekka" uniqKey="Nuorti J" first="J. Pekka" last="Nuorti">J. Pekka Nuorti</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Levine, Orin S" sort="Levine, Orin S" uniqKey="Levine O" first="Orin S." last="Levine">Orin S. Levine</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Marx, Arthur" sort="Marx, Arthur" uniqKey="Marx A" first="Arthur" last="Marx">Arthur Marx</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Weltman, Andre C" sort="Weltman, Andre C" uniqKey="Weltman A" first="Andre C." last="Weltman">Andre C. Weltman</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Yeager, Suzanne" sort="Yeager, Suzanne" uniqKey="Yeager S" first="Suzanne" last="Yeager">Suzanne Yeager</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Benson, Robert F" sort="Benson, Robert F" uniqKey="Benson R" first="Robert F." last="Benson">Robert F. Benson</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Pruckler, Janet" sort="Pruckler, Janet" uniqKey="Pruckler J" first="Janet" last="Pruckler">Janet Pruckler</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Edelstein, Paul H" sort="Edelstein, Paul H" uniqKey="Edelstein P" first="Paul H." last="Edelstein">Paul H. Edelstein</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Greer, Patricia" sort="Greer, Patricia" uniqKey="Greer P" first="Patricia" last="Greer">Patricia Greer</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Zaki, Sherif R" sort="Zaki, Sherif R" uniqKey="Zaki S" first="Sherif R." last="Zaki">Sherif R. Zaki</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Fields, Barry S" sort="Fields, Barry S" uniqKey="Fields B" first="Barry S." last="Fields">Barry S. Fields</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author><author><name sortKey="Butler, Jay C" sort="Butler, Jay C" uniqKey="Butler J" first="Jay C." last="Butler">Jay C. Butler</name><affiliation wicri:level="2"><mods:affiliation>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg, Pennsylvania</mods:affiliation><country xml:lang="fr">États-Unis</country><placeName><region type="state">Pennsylvanie</region></placeName><wicri:cityArea>From the Epidemic Intelligence Service (Epidemiology Program Office), the Childhood and Respiratory Diseases Branch, the Division of Bacterial and Mycotic Diseases, and the Division of Viral and Rickettsial Diseases, Molecular Pathology and Ultrastructure Activity Section, National Center for Infectious Disease, Centers for Disease Control and Prevention, Atlanta, Georgia, Philadelphia, Pennsylvania, Harrisburg</wicri:cityArea></affiliation></author></analytic><monogr></monogr><series><title level="j">Clinical Infectious Diseases</title><title level="j" type="abbrev">Clinical Infectious Diseases</title><idno type="ISSN">1058-4838</idno><idno type="eISSN">1537-6591</idno><imprint><publisher>The University of Chicago Press</publisher><date type="published" when="1998-02">1998-02</date><biblScope unit="volume">26</biblScope><biblScope unit="issue">2</biblScope><biblScope unit="page" from="426">426</biblScope><biblScope unit="page" to="433">433</biblScope></imprint><idno type="ISSN">1058-4838</idno></series><idno type="istex">AEBE8D350CF6D732C9E51C219505C021F5FF7200</idno><idno type="DOI">10.1086/516309</idno></biblStruct></sourceDesc><seriesStmt><idno type="ISSN">1058-4838</idno></seriesStmt></fileDesc><profileDesc><textClass></textClass><langUsage><language ident="en">en</language></langUsage></profileDesc></teiHeader><front><div type="abstract">In July 1995 we investigated a pneumonia outbreak in a Pennsylvania town. We conducted epidemiological and molecular microbiological studies to determine the outbreak source and interrupt transmission of disease. Legionnaires' disease (LD) was quickly identified by urine antigen testing, and a newly developed immunohistochemical stain confirmed nosocomial transmission to a hospital inpatient. LD was confirmed in 22 patients. Case-patients were more likely than controls to have been within 1,000 feet of the hospital (matched odds ratio, 21.0; 95% confidence interval, 2.9–368) during the 2 weeks prior to illness. Legionella pneumophila serogroup 1 (Lp-1) was isolated from hospital cooling towers (CTs) and rooftop air samples but not from hospital potable water or community CTs. Hospital CT and air Lp-1 isolates matched all five patient isolates by monoclonal antibody, arbitrarily primed polymerase chain reaction, and pulsed-field gel electrophoresis subtyping. Strategies to prevent LD must include minimizing transmission from CTs.</div></front></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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