Investigation of an outbreak of Legionnaires' disease: Hereford, UK 2003

David Kirrage, Gary Reynolds, Gillian E. Smith, Babatunde Olowokure*

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

33 Citations (Scopus)

Abstract

This report describes the investigation and control of a community outbreak of Legionnaires' disease in Hereford, UK, in November 2003. Outbreak investigation consisted of epidemiological survey, identification and environmental investigation of potential sources, microbiological analysis of clinical and environmental samples and mapping the location of potential sources and the movement and residence of cases. Each identified source was allocated a 'composite score' based on different zones of exposure and wind direction. Altogether, 28 cases were identified, with an overall case fatality rate of 7%. All cases had epidemiological links to Hereford city centre. The 'composite score' identified a cluster of cooling towers as being the most likely source of the outbreak. Environmental samples from one of the cooling towers in the cluster and clinical samples from two patients were positive for Legionella pneumophilia serogroup 1 and were indistinguishable by molecular sub-typing. In this outbreak, the use of microbiological, environmental and epidemiological techniques facilitated the rapid identification of a cooling tower as the source of this outbreak. This study illustrates the continuing importance of cooling towers as a source of Legionnaires' disease and the utility of obtaining and comparing both clinical and environmental samples.

Original languageEnglish
Pages (from-to)1639-1644
Number of pages6
JournalRespiratory Medicine
Volume101
Issue number8
DOIs
Publication statusPublished - Aug 2007

Keywords

  • Cooling tower
  • Disease outbreak
  • Environmental exposure
  • Epidemiology
  • Legionnaires' disease

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