Authors
Jeroen W Den Boer, Ed PF Yzerman, Joop Schellekens, Kamilla D Lettinga, Hendriek C Boshuizen, Jim E Van Steenbergen, Arnold Bosman, Susan Van den Hof, Hans A Van Vliet, Marcel F Peeters, Ruud J Van Ketel, Peter Speelman, Jacob L Kool, Marina AE Conyn Van Spaendonck
Publication date
2002/1
Journal
Emerging infectious diseases
Volume
8
Issue
1
Pages
37
Publisher
Centers for Disease Control and Prevention
Description
In 1999, an outbreak of Legionnaires’ disease affected many visitors to a flower show in the Netherlands. To identify the source of the outbreak, we performed an environmental investigation, as well as a case-control study among visitors and a serologic cohort study among exhibitors to measure exposure to possible sources. Of 77,061 visitors, 188 became ill (133 confirmed and 55 probable cases), for an attack rate of 0.23% for visitors and 0.61% for exhibitors. Two whirlpool spas in halls 3 and 4 of the exhibition and a sprinkler in hall 8 were culture positive for Legionella pneumophila. One of three genotypes found in both whirlpool spas was identical to the isolates from 28 of 29 culture-positive patients. Persons who paused at the whirlpool spa in hall 3 were at increased risk for becoming ill. This study illustrates that whirlpool spas may be an important health hazard if disinfection fails.
Total citations
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Scholar articles
DBJWY EP, J Schellekens, KD Lettinga, HC Boshuizen… - Emerg. Infect. Dis, 2002
JW Den Boer, EPF Yzerman, J Schellekens… - EMERGING INFECTIOUS DISEASES, 2002