Legionella E-news -- 2 May 2000

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Legionella E-news, 2 May 2000
HC Information Resources Inc.
Matthew R. Freije, Editor

**IN THIS ISSUE**
1. Major outbreak in Melbourne
2. Food humidifier blamed for South Wales hotel outbreak
3. Home water heaters

1. MAJOR OUTBREAK IN MELBOURNE
Health authorities have reported 46 cases of Legionnaires' disease among individuals who visited the new Melbourne (Australia) Aquarium between 11 and 21 April. A 47th case involves a 26-year-old man who had walked near the building. The count is expected to rise as additional laboratory tests are completed. Nine patients are in critical condition. Two women, ages 79 and 83, have died. The source of contamination has not been confirmed, but cooling towers at the aquarium have been disinfected as a precaution. Health authorities suspect that dust from a nearby construction site could have contaminated the towers. Clive Broadbent has been hired to conduct an inspection. Source: news media 

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2. HUMIDIFIER BLAMED FOR SOUTH WALES HOTEL OUTBREAK
You may remember from the last issue of Legionella E-news that a food display humidifier was the focus of the investigation of this outbreak. Evidence suggests that the humidifier was indeed the source of contamination, because the strain of Legionella pneumophila serogroup 1 found in the two patients who died from Legionnaires' disease was indistinguishable from isolates found in the food display humidifier. The humidifier was used to produce mist over food in a refrigerated display unit. Source: Eurosurveillance Weekly; reported by Susan Hahné and Roland Salmon, CDSC Wales, and Arun Mukerjee and Bharat Pankhania, Bro Taf Health Authority.

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3. HOME WATER HEATERS
The following was excerpted and adapted from our upcoming publication, Home plumbing systems: How to reduce your risk of Legionnaires' disease: Studies indicate that homes with gas water heaters are less likely to have legionellae than are homes with electric water heaters. Of the 211 homes surveyed in the Quebec City area, legionellae were found in none of the 33 houses with gas water heaters but were found in 69 (33%) of the 178 houses with electric water heaters.(77) Lee's Pittsburgh study also showed a significant association between electric water heaters and Legionella.(73) In Stout's study, which found the lowest percentage of legionellae-positive homes overall (6.4%), 207 of the 218 homes examined had gas water heaters.(76) Gas heaters benefit from the location of their heat source below the water tank. Thus, the bottom of the tank, where sediment accumulates, is sufficiently hot to prevent legionellae growth. In contrast, most electric units have heating elements on the side of the tank, so the sediment at the bottom is cool enough to allow legionellae growth.(77) In addition, electric water heaters tend to have lower temperatures than do gas heaters. In the Quebec City houses studied by Alary and Joly, the temperature at the faucets was above 60°C (140°F) in most of the houses with gas or oil heaters but was between 50°C (122°F) and 59°C (138°F) in most of the houses with electric heaters.(77) 

77. Alary M. and J.R. Joly. "Risk factors for contamination of domestic hot water systems for Legionella." Applied and Environmental Microbiology 57 (1991);2360-2367. 

73. Lee, T.C., J.E. Stout, V.L. Yu. "Factors Predisposing to Legionella pneumophila Colonization in Residential Water Systems." Archives of Environmental Health 43 (1988);59-62.

76. Stout, J.E., V. L. Yu, Y.C. Lee, S. Vaccarello, W. Diven, and T.C. Lee. "Legionella pneumophila in residential water supplies: environmental surveillance with clinical assessment for Legionnaires' disease." Epidemiol. Infect. 109 (1992); 49-57.

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