Legionella E-news -- 3 December 2001

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**IN THIS ISSUE**

1. Update on Norway Outbreak

2. Follow-up to Last Issue's Survivor Letter

3. 2002 Legionella Courses - 4 New Locations

4. The Role of Protozoa in Legionella Control

5. New Online Publications on Waterborne Disease

 

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1. UPDATE ON NORWAY OUTBREAK

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The September issue of E-news included information on an outbreak in

Stavanger, Norway. At that time 17 confirmed and 2 probable cases of

Legionnaires' disease had been identified, with 2 deaths. A final report

on the outbreak, published in the 29 November 2001 issue of

Eurosurveillance Weekly, states that 26 confirmed (by urinary antigen)

and 2 probable cases were identified. 21 of the 28 patients were men. 7

of the 28 have died, one of which was one of the two probable cases. The

age range of the 28 cases was 16 to 94 years, with a mean age of 54. The

age range of those who died was 43 to 94 years, with a mean age of 81.

All the patients had been in the same area in the city centre within the

incubation period. Legionella pneumophila serogroup 1 was found in water

samples collected from the cooling tower of a hotel where three of the

patients had been staying. The outlet of the cooling tower was situated

five meters above ground, close to a bus terminal. Nine isolates from

patients and five isolates from the cooling tower showed similarities

and were different from other known Norwegian legionella isolates. [The

report did not indicate that the isolates matched exactly.]

 

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2. FOLLOW-UP TO LAST ISSUE'S SURVIVOR LETTER

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I prefaced the story with a note that the writer of the letter did not

mention whether Legionnaires' disease was confirmed by laboratory tests.

I have since found out, from the hospital that treated the patient, that

Legionnaires' disease was indeed confirmed by sputum culture.

 

Many of you responded to the request for feedback as to whether we

should include Legionnaires' survivor letters in future issues of E-

news, or focus strictly on technical content. Most thought the survivor

letters were a good idea, but a few suggested technical content only. I

appreciated your suggestions. As a compromise, we will consider

including letters from survivors of confirmed Legionnaires' disease

every 10 or 12 issues, but only those letters that indicate a lesson in

prevention, diagnosis, or treatment.

 

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3. 2002 LEGIONELLA COURSES - 4 NEW LOCATIONS

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Here are locations for the Legionella Prevention Training Course in the

first half to 2002:

 

* Dallas: 30-31 January

* Montreal: 7-8 March

* New York City: 21-22 March

* Chicago: 1-2 May

 

Hotel information should be available at

http://hcinfo.com/legionellaseminar.htm within one or two weeks.

 

To register for the seminars, or get more information, visit

http://hcinfo.com/legionellaseminar.htm or e-mail hcinfo@hcinfo.com.

 

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4. THE ROLE OF PROTOZOA IN LEGIONELLA CONTROL

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Sharon G. Berk, Martha J.M. Wells, and Anthony L. Newsome of Tennessee

Technological University, Middle Tennessee State University, conducted

an EPA-funded study from 1 October 1996 to 30 September 2000 entitled

"Protozoa in Risk Assessment of Legionellosis-Inadequacy of Guidelines

and Monitoring."  The study examined several aspects of protozoa in

actual cooling tower water. The project included a number of objectives,

one of which was to evaluate the efficacy of commonly used biocides and

combinations of biocides. The results indicate that protozoa may play

important roles in maintaining Legionellae in cooling towers, that

conditions of cooling towers may facilitate production and release of

vesicles containing legionellae from protozoa, and that certain biocides

may be more effective than others in inhibiting legionellae within

vesicles. The researchers conclude that protozoa should be considered in

monitoring and risk assessment of Legionella in cooling towers and that

biocides should target protozoan hosts. The final report is posted at

http://es.epa.gov/ncer/final/grants/96/envbio/berk.html

 

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5. NEW ONLINE PUBLICATIONS ON WATERBORNE DISEASE

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Because of a special licensing arrangement between HC Information Resources Inc.

and the UK office of John Wiley & Sons, Inc., each chapter of Waterborne Disease:

Epidemiology and Ecology (by Paul R. Hunter, Public Health Laboratory Service,

Chester, UK) is now available online at hcinfo.com. The chapters can be purchased

individually for $11 each. Each downloads in less than 30 seconds. Chapters 1-4 and

31-33 cover epidemiology, water supply and distribution, drinking water, illness

associated with recreational water, chemical poisoning, cancer, and adverse

pregnancy outcomes. The other chapters cover a specific water-related illness or

pathogen, one per chapter, discussing, as applicable, clinical features, diagnosis,

treatment, environmental detection, ecology, epidemiology, and microbiology.

References are included at the end of each chapter. To order or get more

information, visit http://hcinfo.com/waterbornedisease.htm.

 

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Please mention Legionella E-news in listservs or on your web site.

Sample announcement: "Legionella E-news is a free monthly e-newsletter

that covers recent outbreaks, new publications, and new technology. To

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If you have suggestions, information to offer, or complaints, please

send a message to hcinfo@hcinfo.com. We appreciate feedback!

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(c) Copyright 2001, HC Information Resources Inc.

You have permission to send this newsletter to others, post it on your

web site, or include it in listserv posts, under the strict condition

that you include the following notice to properly credit the source:

"Excerpted from Legionella E-news, a free e-newsletter available at

http://hcinfo.com."

 

THANK YOU!

 

Matt Freije

HC Information Resources Inc.

http://hcinfo.com