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Outbreak of Legionnaires' disease at University Hospital, Nottingham. Epidemiology, microbiology and control

Published online by Cambridge University Press:  15 May 2009

A. Colville
Department of Microbiology andPublic Health Laboratory
J. Crowley
Environmental Microbiology Reference Unit, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH
D. Dearden
Department of Microbiology andPublic Health Laboratory
R. C. B. Slack
Department of Microbiology andPublic Health Laboratory
J. V. Lee
Environmental Microbiology Reference Unit, University Hospital, Queen's Medical Centre, Nottingham NG7 2UH
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Twelve patients in a large teaching hospital contracted Legionnaires' disease over a period of 11 months. The source was a domestic hot water system in one of the hospital blocks, which was run at a temperature of 43 °C. Five different subtypes of Legionella pneumophila serogroup 1 have been isolated from water in different parts of the hospital, over a period of time. Only one subtype, Benidorm RFLP 14, was implicated in disease. Circumstantial evidence suggested that the outbreak may have been due to recent colonization of the hot water system with a virulent strain of Legionella pneumophila. The outbreak was controlled by raising the hot water temperature to 60 °C, but careful surveillance uncovered two further cases in the following 30 months. Persistent low numbers of Legionella pneumophila were isolated from the domestic hot water of wards where Legionnaires' disease had been contracted, until an electrolytic unit was installed releasing silver and copper ions into this supply.

Research Article
Copyright © Cambridge University Press 1993



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