Pontiac fever, a unique epidemiologic form of legionellosis, is characterized by a short (one- to two-day) incubation period and a self-limited grippe-like illness without pneumonia. In 1968, the first documented outbreak of this syndrome affected persons who had entered a health department building in Pontiac, Michigan. Epidemiologic analyses clearly implicated as airborne agent and suggested that evaporative condenser water aerosols being disseminated by a defective air conditioning system played a key role in the outbreak. Guinea pigs that were exposed in the building and to laboratory aerosols of evaporative condenser water developed bronchopneumonia. Legionella pneumophilia (serogroup 1) was isolated from the exposed guinea pigs' lungs. Paired acute and convalescent serum specimens from 37 patients were tested by the indirect fluorescent antibody technique using L. pneumophila serogroup 1 antigen, and 31 (84%) had rises in titer from less than 32 to greater than or equal to 64.
Ten new Legionella species were characterized on the basis of biochemical reactions, antigens, cellular fatty acids, isoprenoid quinones, and deoxyribonucleic acid relatedness. Nine of the new species were isolated from the environment, and one, Legionella hackeliae, was isolated from a bronchial biopsy specimen obtained from a patient with pneumonia. The species all exhibited the following biochemical reactions typical of the legionellae: growth on buffered cysteine-yeast extract agar, but not on blood agar; growth requirement for cysteine; gram negative; nitrate negative; urease negative; nonfermentative; catalase positive; production of a brown pigment on tyrosine-containing yeast extract agar; liquefaction of gelatin; and motility. Legionella s4iritensis was weakly positive for hydrolysis of hippurate; the other species were hippurate negative. Legionella cherrii, Legionella steigerwaltii, and Legionella parisiensis exhibited bluish white autofluorescence. Legionella rubrilucens and Legionella erythra exhibited red aqtofluorescence. The other species, L. spiritensis, L . hacke liae, Legionella maceachernii, Legionella jamestowniensis, and Legionella santicrucis did not auto fluoresce bluish white or red. All species had cellular fatty acid contents qualitatively similar to those of previously described legionellae and had major amounts of ubiquinones with more than 10 isoprene units in the side chains. Each new species was serologically distinct from previously described Legionella species. As determined by the hydroxyapatite method at 60°C, two strains of L. maceachernii were 100% related, and four strains of L. cherrii were 94 to 99% related. The other new species were represented by single strains. The levels of relatedness of the new species to each other and to previously described legionellae ranged from 1 to 67%. L . maceachernii, L. japestowniensis, and L. hackeliae were less than 25% related to other species. L. rubrilucens and L. erythra, and two red-autofluorescing species, were about 60% interrelated. L. spiritensis (a non-autofluorescing species) was 34% related to L. rubrilucens. L . santicrucis was 64% related to Legionella sainthelensi. The three bluish white-autofluorescing species, L. parisiensis, L. cherrii, and L. steigerwaltii, were most closely related to other bluish white-autofluorescing species, especially Legionella bozemanii, Legionella dumofli, Legionella gormanii, and "Legionella anisa" (35 to 67%).
We analyzed 24 environmental samples collected in or near the Indiana Memorial Union, where an epidemic of Legionnaires' disease occurred in early 1978. We conducted fluorescent antibody analyses and culture on F-G and charcoal yeast extract agars of each sample directly; splenic tissue of guinea pigs inoculated with the sample; and yolk sacs from embryonated eggs inoculated with splenic tissue of guinea pigs injected with the sample. Legionnaires' disease (LD) bacterium was isolated from seven of the 24 samples: one water sample from the air-conditioner cooling tower of the Union; three water samples from a stream near the Union; and three mud samples from the same stream. The LD bacterium strains were of three different serotypes. These findings indicate that LD bacteria may be widespread in nature.
During July 1978 an outbreak of Legionnaires' disease characterized by high fever, prostration, and pneumonia occurred at an Atlanta, Georgia, country club. All eight cases involved club members whose primary club activity was golfing. The degree of golfing activity during the likely exposure period was a risk factor for acquiring the illness. Legionella pneumophila was isolated from the evaporative condenser within the clubhouse. The fact that the stream of air blowing from the exhaust duct of the evaporative condenser was directed toward a nearby practice green and the 10th and 16th tees supports the hypothesis that this outbreak represents airborne dissemination of L. pneumophila from the evaporative condenser to an outdoor site where susceptible golfers contracted the illness.
Legionella pneumophila suspended in tap water was exposed to biocides recommended for inhibiting biological growth in cooling towers and evaporative condensers of air-conditioning systems. Chlorine, 2,2-dibromo-3-nitrilopropionamide, and a compound containing didecyldimethylammonium chloride and isopropanol were effective in destroying concentratiois of 10(5) to 10(6) viable cells per ml. Formulations consisting of 5-chloro-2-methyl-4-isothiazolin-3-one and 2-methyl-4-isothiazolin-3-one, disodium ethylene bis(thiocarbamate) and sodium dimethyl dithiocarbamate, and a phenolic with pentachlorophenate and sodium salts of other chlorophenols were less effective.
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