1
|
Hammami N, Laisnez V, Wybo I, Uvijn D, Broucke C, Van Damme A, Van Zandweghe L, Bultynck W, Temmerman W, Van De Ginste L, Moens T, Robesyn E. A cluster of Legionnaires' disease in Belgium linked to a cooling tower, August-September 2016: practical approach and challenges. Epidemiol Infect 2019; 147:e326. [PMID: 31858932 PMCID: PMC7006017 DOI: 10.1017/s0950268819001821] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2019] [Revised: 10/02/2019] [Accepted: 10/03/2019] [Indexed: 11/06/2022] Open
Abstract
A cluster of Legionnaires' disease (LD) with 10 confirmed, three probable and four possible cases occurred in August and September 2016 in Dendermonde, Belgium. The incidence in the district was 7 cases/100 000 population, exceeding the maximum annual incidence in the previous 5 years of 1.5/100 000. Epidemiological, environmental and geographical investigations identified a cooling tower (CT) as the most likely source. The case risk around the tower decreased with increasing distance and was highest within 5 km. Legionella pneumophila serogroup 1, ST48, was identified in a human respiratory sample but could not be matched with the environmental results. Public health authorities imposed measures to control the contamination of the CT and organised follow-up sampling. We identified obstacles encountered during the cluster investigation and formulated recommendations for improved LD cluster management, including faster coordination of teams through the outbreak control team, improved communication about clinical and environmental sample analysis, more detailed documentation of potential exposures obtained through the case questionnaire and earlier use of a geographical information tool to compare potential sources and for hypothesis generation.
Collapse
Affiliation(s)
- N. Hammami
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Ghent, Belgium
| | - V. Laisnez
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Ghent, Belgium
| | - I. Wybo
- Department of Microbiology and Infection Control, National Reference Centre for Legionella Pneumophila, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium
| | - D. Uvijn
- Agency for Care and Health, Environmental Health, Flemish Community, Ghent, Belgium
| | - C. Broucke
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Ghent, Belgium
| | - A. Van Damme
- Agency for Care and Health, Infection Prevention and Control, Flemish Community, Ghent, Belgium
| | - L. Van Zandweghe
- Pneumology Department, Sint-Blasius Hospital, Dendermonde, Belgium
| | - W. Bultynck
- Pneumology Department, Sint-Blasius Hospital, Dendermonde, Belgium
| | - W. Temmerman
- Pneumology Department, Sint-Blasius Hospital, Dendermonde, Belgium
| | - L. Van De Ginste
- Pneumology Department, Sint-Blasius Hospital, Dendermonde, Belgium
| | - T. Moens
- Agency for Care and Health, Environmental Health, Flemish Community, Ghent, Belgium
| | - E. Robesyn
- European Centre for Disease Prevention and Control, Surveillance and Response Support Unit, Stockholm, Sweden
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| |
Collapse
|