Nosocomial legionellosis, Paris, France. Evidence for transmission by potable water

• Published in: The American journal of medicine Vol. 78; no. 4; pp. 581 - 588
• Main Authors: Neill, Marguerite A., Gorman, George W., Gibert, Claude, Roussel, Andre, Hightower, Allen W., McKinney, Roger M., Broome, Claire V.
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01.01.1985; Elsevier
• Subjects: Adult; Aged; Air Conditioning - instrumentation; Bacterial diseases; Bacterial diseases of the respiratory system; Biological and medical sciences; Cross Infection - microbiology; Cross Infection - transmission; Environmental Microbiology; Epidemiologic Methods; Female; Hospitals, Teaching; Human bacterial diseases; Humans; Infectious diseases; Legionella - isolation & purification; Legionella pneumophila; Legionnaires' Disease - microbiology; Legionnaires' Disease - transmission; Male; Medical sciences; Middle Aged; Paris; Water Microbiology; Water Supply; Paris; Infection; Drinking water; Pneumonia; Respiratory disease; Bacteriosis; Legionellosis; Hospital; Epidemiology; Paris
• ISSN: 0002-9343; 1555-7162
• DOI: 10.1016/0002-9343(85)90399-7

During a five-week period in 1981, six cases of legionellosis due to Legionella pneumophila serogroup 1 were recognized in a hospital in Paris, France. Four cases were clearly nosocomial In origin. There was a direct association between development of disease and exposure to potable hot water (p = 0.003). The entire hot water system was contaminated with L. pneumophila serogroup 1; monoclonal antibody testing demonstrated that the case isolate and the potable water isolates belonged to the same subgroup. Although serogroup 1 was isolated from both the cooling tower and its drift, the cooling tower isolate was antigenically distant from the case isolate. In other nosocomial outbreaks of legionellosis, multiple sources have been found within the hospital environment, but an epidemiologic association of disease with potable water had not been shown. The significant association of cases with exposure to the potable hot water supply, and the identification of case and potable water Isolates of the same subtype, suggest that the potable hot water was responsible for transmission of disease In this outbreak.