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Abstract
Pastoris, MC., Lo Monaco, R, Goldoni, P, Mentore, B, Balestra, G,
Ciceroni, L, Visca, P. "Legionnaires' disease on a cruise ship linked
to the water supply system: Clinical and public health implications, Clinical
Infectious Diseases,
1999,
28:1 (Jan), 33-38
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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