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A Large Outbreak of Legionnaires’ Disease at a Flower Show, the Netherlands, 1999
Open accessAbstract
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.
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Citations
Cited by
Bioaerosol Health Effects and Exposure Assessment: Progress and Prospects
(2003) · The Annals of Occupational Hygiene · doi:10.1093/annhyg/meg032 · Cited by 1,232
Epidemiology and clinical management of Legionnaires' disease
Phin, N., Parry-Ford, F., Harrison, T., Stagg, H. R., Zhang, N., Kumar, K., Lortholary, O., Zumla, A., & Abubakar, I. (2014) · The Lancet Infectious Diseases · doi:10.1016/s1473-3099(14)70713-3 · Cited by 438
Current and Emerging Legionella Diagnostics for Laboratory and Outbreak Investigations
Mercante, J. W., & Winchell, J. M. (2015) · Clinical Microbiology Reviews · doi:10.1128/cmr.00029-14 · Cited by 339
Fang, Z., Ouyang, Z., Zheng, H., & Wang, X. (2008) · Aerosol Science and Technology · doi:10.1080/02786820802068657 · Cited by 112
Metadata
- Authors
- Den Boer, J. W., Yzerman, E. P. F., Schellekens, J., Lettinga, K. D., Boshuizen, H. C., Van Steenbergen, J. E., Bosman, A., Van den Hof, S., Van Vliet, H. A., Peeters, M. F., Van Ketel, R. J., Speelman, P., Kool, J. L., & Van Spaendonck, M. A. E. C.
- Venue
- Emerging Infectious Diseases
- Published
- 2002-01
- Volume
- 8
- Issue
- 1
- Pages
- 37-43
- ISSN
- 1080-6040 (ISSN-L)
- 1080-6059
- OpenAlex
- W2148202852
- Cited by
- 270
- References
- 0
- FWCI
- 8.01
- Type
- journal article
- Language
- en
- Open access
- diamond
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- Den Boer, J. W., Yzerman, E. P. F., Schellekens, J., Lettinga, K. D., Boshuizen, H. C., Van Steenbergen, J. E., Bosman, A., Van den Hof, S., Van Vliet, H. A., Peeters, M. F., Van Ketel, R. J., Speelman, P., Kool, J. L., & Van Spaendonck, M. A. E. C. (2002). A Large Outbreak of Legionnaires’ Disease at a Flower Show, the Netherlands, 1999. Emerging Infectious Diseases. https://doi.org/10.3201/eid0801.010176
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Contains information from the Semantic Scholar Academic Graph Datasets, made available under the ODC Attribution License (ODC-BY 1.0).
Semantic Scholar’s data is described in: Kinney, R., et al. (2023). The Semantic Scholar Open Data Platform. arXiv:2301.10140.
