Nosocomial Legionnaires' disease in England and Wales, 1980–92

Abstract

Two hundred and eighteen nosocomial cases of Legionnaires' disease with 68 deaths were reported to the National Surveillance Scheme for Legionnaires Disease between 1980 and 1992, representing 15% of the reported infections acquired in England and Wales. Twenty-two nosocomial outbreaks accounted for 135 (62%) of these cases, the remainder occurring as single cases either in hospitals where other single cases or outbreaks had been reported in different years or as 'sporadic' cases in hospitals from which no other cases were reported. A clinical history prior to onset of Legionnaires' disease was available for 124 patients, 61 of whom had undergone recent transplant therapy or were immunosuppressed for other reasons. Sixty cases (27%) were diagnosed by culture of the organism and isolates from 56 patients were typed; 25 (42%) were non L. pneumophila serogroup 1 infections. Methods for prevention and control of nosocomial outbreaks are discussed, in particular the susceptibility to Legionnaires' disease of certain groups of hospital patients.

Isolation of Legionella pneumophila from surface and ground waters in Osogbo, Nigeria

“…Outbreaks in the USA have been frequently associated with cooling towers in summer and fall (Bentham and Broadbent, 1993). In England and Wales, the Legionellae surveillance carried out showed a similar trend to what had been reported in the USA, reaching its peak in 1988 (Joseph et al, 1995;.…”

Comparative assessment of virulence traits in Legionella spp.

“…The Centers for Disease Control and Prevention (CDC) figures between 1980 and 1998 show a general decline in mortality after reaching a peak in 1988 (Benin et al, 2002). In England and Wales, the legionellae surveillance carried out showed a similar trend to what has been reported in the USA, reaching its peak in 1988 (Joseph et al, 1995(Joseph et al, , 1997. One major recent outbreak of Legionnaires' disease occurred in the Netherlands during which 188 individuals attending a flower show were hospitalized.…”

Detection of Legionella pneumophila antigen in urine samples by the BinaxNOW immunochromatographic assay and comparison with both Binax Legionella Urinary Enzyme Immunoassay (EIA) and Biotest Legionella Urin Antigen EIA

“…were isolated from 139 patients; only 78 (56%) of the isolates belonged to serogroup 1, of which approximately 76% were reactive with the MAb 3/1 (data not published). The diagnosis of such infections has especially far-reaching implications for nosocomially acquired legionellosis, which is caused signi®-cantly more often by MAb 3/1(MAb 2)-negative or non-serogroup 1 isolates than community-acquired legionellosis [26,27]). Therefore, beside urinary antigen detection, DFA and attempts to culture legionellae remain important tools for diagnosing legionellosis in this group of patients.…”