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Abstract
Castellani
Pastoris M, Lo Monaco R, Goldoni P, et
al. "Legionnaires'
disease on a cruise ship linked to the water supply system: clinical
and public health implications," Clinical
Infectious Disease,
1999, 28:1 (Jan), 33-8
The occurrence of legionnaires' disease has been described previously
in passengers of cruise ships, but determination of the source has been
rare. A 67-year-old, male cigarette smoker with heart disease
contracted legionnaires' disease during a cruise in September 1995 and
died 9 days after disembarking. Legionella pneumophila serogroup 1 was
isolated from the patient's sputum and the ship's water supply. Samples
from the air-conditioning system were negative. L. pneumophila
serogroup 1 isolates from the water supply matched the patient's
isolate, by both monoclonal antibody subtyping and genomic
fingerprinting. None of 116 crew members had significant antibody
titers to L. pneumophila serogroup 1. One clinically suspected case of
legionnaires' disease and one confirmed case were subsequently
diagnosed among passengers cruising on the same ship in November 1995
and October 1996, respectively. This is the first documented evidence
of the involvement of a water supply system in the transmission of
legionella infection on ships. These cases were identified because of
the presence of a unique international system of surveillance and
collaboration between public health authorities.
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