A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel
During the period October–November 2017, an outbreak of Legionnaires’ disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires...
| Main Authors: | , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Frontiers Media S.A.
2023-04-01
|
| Series: | Frontiers in Microbiology |
| Subjects: | |
| Online Access: | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1137470/full |
| _version_ | 1797839914796056576 |
|---|---|
| author | Mercedes Gumá Vladimir Drasar Beatriz Santandreu Rosa Cano Baharak Afshar Antonio Nicolau Magdalena Bennassar Jorge del Barrio Pau Crespi Sebastian Crespi |
| author_facet | Mercedes Gumá Vladimir Drasar Beatriz Santandreu Rosa Cano Baharak Afshar Antonio Nicolau Magdalena Bennassar Jorge del Barrio Pau Crespi Sebastian Crespi |
| author_sort | Mercedes Gumá |
| collection | DOAJ |
| description | During the period October–November 2017, an outbreak of Legionnaires’ disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires’ disease (TALD). Most cases belonged to different hotel cluster alerts. No cases were reported among the local population residing in the area. All tourist establishments associated with one or more TALD cases were inspected and sampled by public health inspectors. All relevant sources of aerosol emission detected were investigated and sampled. The absence of active cooling towers in the affected area was verified, by documents and on-site. Samples from hot tubs for private use located on the terraces of the penthouse rooms of a hotel in the area were included in the study. Extremely high concentrations (> 106 CFU/l) of Legionella pneumophila, including the outbreak strain, were found in the hot tubs of vacant rooms of this hotel thus identifying the probable source of infection. Meteorological situation may have contributed to the geographical distribution pattern of this outbreak. In conclusion, hot tubs for private use located outdoors should be considered when investigating community outbreaks of Legionnaires’ disease of unclear origin. |
| first_indexed | 2024-04-09T16:05:55Z |
| format | Article |
| id | doaj.art-0e50a67f316d4bb3a4db768545ace8b9 |
| institution | Directory Open Access Journal |
| issn | 1664-302X |
| language | English |
| last_indexed | 2024-04-09T16:05:55Z |
| publishDate | 2023-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Microbiology |
| spelling | doaj.art-0e50a67f316d4bb3a4db768545ace8b92023-04-25T05:46:30ZengFrontiers Media S.A.Frontiers in Microbiology1664-302X2023-04-011410.3389/fmicb.2023.11374701137470A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotelMercedes Gumá0Vladimir Drasar1Beatriz Santandreu2Rosa Cano3Baharak Afshar4Antonio Nicolau5Magdalena Bennassar6Jorge del Barrio7Pau Crespi8Sebastian Crespi9Conselleria de Salut i Consum, Govern Balear, Palma de Mallorca, SpainPublic Health Institute Ostrava, National Legionella Reference Laboratory, Ostrava, CzechiaEnvironmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, SpainCentro Nacional de Epidemiología and CIBERESP, Instituto de Salud Carlos III, Madrid, SpainRespiratory and Vaccine Preventable Bacteria Reference Unit (RVPBRU), UK Health Security Agency (UKHSA), London, United KingdomConselleria de Salut i Consum, Govern Balear, Palma de Mallorca, SpainEnvironmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, SpainEnvironmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, SpainEnvironmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, SpainEnvironmental Health and Laboratory Services, Biolinea Int., Palma de Mallorca, SpainDuring the period October–November 2017, an outbreak of Legionnaires’ disease involving 27 cases occurred in the tourist area of Palmanova (Mallorca, Spain). The majority of cases were reported by the European Centre of Disease Prevention and Control (ECDC) as travel associated cases of Legionnaires’ disease (TALD). Most cases belonged to different hotel cluster alerts. No cases were reported among the local population residing in the area. All tourist establishments associated with one or more TALD cases were inspected and sampled by public health inspectors. All relevant sources of aerosol emission detected were investigated and sampled. The absence of active cooling towers in the affected area was verified, by documents and on-site. Samples from hot tubs for private use located on the terraces of the penthouse rooms of a hotel in the area were included in the study. Extremely high concentrations (> 106 CFU/l) of Legionella pneumophila, including the outbreak strain, were found in the hot tubs of vacant rooms of this hotel thus identifying the probable source of infection. Meteorological situation may have contributed to the geographical distribution pattern of this outbreak. In conclusion, hot tubs for private use located outdoors should be considered when investigating community outbreaks of Legionnaires’ disease of unclear origin.https://www.frontiersin.org/articles/10.3389/fmicb.2023.1137470/fullLegionnaires’ diseasecommunity outbreakoutdoor hot tubshoteloutbreak investigation |
| spellingShingle | Mercedes Gumá Vladimir Drasar Beatriz Santandreu Rosa Cano Baharak Afshar Antonio Nicolau Magdalena Bennassar Jorge del Barrio Pau Crespi Sebastian Crespi A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel Frontiers in Microbiology Legionnaires’ disease community outbreak outdoor hot tubs hotel outbreak investigation |
| title | A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel |
| title_full | A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel |
| title_fullStr | A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel |
| title_full_unstemmed | A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel |
| title_short | A community outbreak of Legionnaires’ disease caused by outdoor hot tubs for private use in a hotel |
| title_sort | community outbreak of legionnaires disease caused by outdoor hot tubs for private use in a hotel |
| topic | Legionnaires’ disease community outbreak outdoor hot tubs hotel outbreak investigation |
| url | https://www.frontiersin.org/articles/10.3389/fmicb.2023.1137470/full |
| work_keys_str_mv | AT mercedesguma acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT vladimirdrasar acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT beatrizsantandreu acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT rosacano acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT baharakafshar acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT antonionicolau acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT magdalenabennassar acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT jorgedelbarrio acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT paucrespi acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT sebastiancrespi acommunityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT mercedesguma communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT vladimirdrasar communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT beatrizsantandreu communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT rosacano communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT baharakafshar communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT antonionicolau communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT magdalenabennassar communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT jorgedelbarrio communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT paucrespi communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel AT sebastiancrespi communityoutbreakoflegionnairesdiseasecausedbyoutdoorhottubsforprivateuseinahotel |