We express our gratitude to the Public Health Department of Bremen for participating in the case-control study as well as all other involved Public Health institutions for their organizational and technical support. We acknowledge the work of the laboratory staff at the Technical University of Dresden, at the Governmental Institute of Public Health of Lower Saxony, at the London Food, Water and Environmental Laboratory, Local and Regional Services, Colindale, UK, Respiratory and Systemic Infection Laboratory, Health Protection Agency, Centre for Infections, UK and at Chelmsford Health Protection Agency Food Water and Environmental Laboratory, UK. In addition, we also acknowledge the epidemiological advice of J. Seydel, Head of the Department of Epidemiology at the Medical School Hannover, Germany and the assistance of Harwich and Dover Port Health Authorities, UK.
1. Fraser, DW, et al. Legionnaires' disease: description of an epidemic of pneumonia. New England Journal of Medicine 1977; 297: 1189–1197.
2. Joseph, C. Legionnaires' disease in Europe 2000–2002. Epidemiology and Infection 2004; 132: 417–424.
3. Jernigan, DB, et al. Outbreak of Legionnaires' disease among cruise ship passengers exposed to a contaminated whirlpool spa. Lancet 1996; 347: 494–499.
4. Anon. Legionella on board a cruise ship [Editorial]. CDR Weekly 1998; 27: 237.
5. Rowbotham, TJ. Legionellosis associated with ships: 1977 to 1997. Communicable Disease and Public Health 1998; 3: 146–151.
6. Regan, CM, et al. Outbreak of Legionnaires' disease on a cruise ship: lessons for international surveillance and control. Communicable Disease and Public Health 2003; 2: 152–156.
7. Kura, F, et al. Outbreak of Legionnaires' disease on a cruise ship linked to spa-bath filter stones contaminated with Legionella pneumophila serogroup 5. Epidemiology and Infection 2006; 134: 385–391.
8. Edelstein, PH, Cetron, MS. Editorial response: sea, wind and pneumonia. Clinical Infectious Diseases 1999; 28: 39–41.
9. Pastoris, MC, et al. Legionnaires' disease on a cruise ship linked to the water supply system: clinical and public health implications. Clinical Infectious Diseases 1999; 28: 33–38.
10. EWGLI. European Working Group for Legionella Infections (www.ewgli.org). Accessed 25 October 2006.
12. Lück, PC, Helbig, JH, Schuppler, M. Epidemiology and laboratory diagnosis of Legionella infections. Journal of Laboratory Medicine 2002; 26: 174–182.
13. Helbig, JH, et al. Clinical utility of urinary antigen detection for diagnosis of community-acquired, travel-associated, and nosocomial legionnaires' disease. Journal of Clinical Microbiology 2003; 41: 838–840.
14. International Organization for Standardization (ISO). Water quality – detection and enumeration of Legionella. ISO 11731. Geneva, 1998.
15. Helbig, JH, et al. Antigenic lipopolysaccharide components of Legionella pneumophila recognized by monoclonal antibodies: possibilities and limitations for division of the species into serogroups. Journal of Clinical Microbiology 1997; 35: 2841–2845.
16. Gaia, V, et al. Consensus sequence-based scheme for epidemiological typing of clinical and environmental isolates of Legionella pneumophila. Journal of Clinical Microbiology 2005; 43: 2047–2052.
17. Armon, R, et al. Controlling biofilm formation by hydrogen peroxide and silver combined disinfectant. Water Science and Technology 2000; 42: 187–192.
18. Health & Safety Executive/Health Protection Agency. Management of Spa Pools: Controlling the risk of infection. London: Health Protection Agency, 2006.
19. Den Boer, JW, et al. A large outbreak of Legionnaires' disease at a flower show, the Netherlands, 1999. Emerging Infectious Diseases 2002; 8: 37–43.