Castellani Pastoris M, Lo Monaco R, Goldoni P, Mentore B, Balestra G, Ciceroni L, Visca P
Department of Bacteriology and Medical Mycology, University La Sapienza, Rome, Italy.
Clin Infect Dis. 1999 Jan;28(1):33-8. doi: 10.1086/515083.
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.
此前已有关于游轮乘客感染军团病的报道，但确定感染源的情况却很罕见。一名67岁、患有心脏病且吸烟的男性在1995年9月的一次游轮旅行中感染了军团病，并在离船9天后死亡。从患者痰液和船上供水系统中分离出嗜肺军团菌1血清型。空调系统样本检测为阴性。通过单克隆抗体分型和基因组指纹图谱分析，从供水系统分离出的嗜肺军团菌1血清型菌株与患者的菌株相匹配。116名船员中无人对嗜肺军团菌1血清型有显著抗体滴度。随后，在1995年11月和1996年10月分别在同一艘船上航行的乘客中，又诊断出1例临床疑似军团病病例和1例确诊病例。这是有记录以来首次证明供水系统参与了船上军团菌感染的传播。由于公共卫生当局之间存在独特的国际监测与合作系统，这些病例得以被发现。
