Pontiac fever among retirement home nurses associated with airborne legionella

• Published in: The Journal of hospital infection Vol. 78; no. 4; pp. 269 - 273
• Main Authors: Hautemaniere, A, Remen, T, Mathieu, L, Deloge-Abarkan, M, Hartemann, P, Zmirou-Navier, D
• Format: Journal Article
• Language: English
• Published: Kidlington Elsevier Ltd 01.08.2011; Elsevier; WB Saunders
• Subjects: Adult; Aerosol; Aerosols; Air Microbiology; Biological and medical sciences; Colony-forming cells; Data processing; Dose-response effects; Epidemiology; Female; Fever; Hospitals; Humans; Infectious Disease; Infectious diseases; Legionella; Legionella - isolation & purification; Legionellosis; Legionellosis - diagnosis; Legionellosis - epidemiology; Legionellosis - pathology; Life Sciences; Long-Term Care; Male; Medical personnel; Medical sciences; Microbiology and Parasitology; Middle Aged; Nurses; Nursing; Occupational Exposure; Pontiac fever; Santé publique et épidémiologie; Shower; Water Microbiology; Legionella; Shower; Pontiac fever; Occupational exposure; Epidemiology; Aerosol; Legionellaceae; Health care staff; Fever; Infection; Work safety; Aerosols; Bacteria; Occupational medicine; Public health; Nurse
• ISSN: 0195-6701; 1532-2939
• DOI: 10.1016/j.jhin.2011.03.022

Summary The aim of this study was to ascertain incidence of symptoms compatible with Pontiac fever (PF) and to assess their association with exposure to legionella bacteria among retirement home nurses who help residents take their shower. Within a non-epidemic framework, 104 nurses of 19 retirement homes were followed up during an average period of four months. Data on symptoms, number and location of showers they attended were recorded daily by each participant. Water and aerosol bacterial quality was characterised at the end of follow-up using the culturable and the in-situ hybridisation techniques. Among 11 Pontiac-like episodes, eight cases complied with the study definition of PF. Water concentrations >103 cfu legionella per litre were associated with an increased risk of PF, with dose–response patterns. No association was established between the aerosol legionella concentrations and PF events. A threshold value of 103 cfu legionella per litre of water might be used with a view to protection from legionella-associated occupational conditions.