Benin Andrea L, Benson Robert F, Arnold Kathryn E, Fiore Anthony E, Cook Patricia G, Williams L Keoki, Fields Barry, Besser Richard E
Epidemic Intelligence Service, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
J Infect Dis. 2002 Jan 15;185(2):237-43. doi: 10.1086/338060. Epub 2001 Dec 18.
Travel-associated outbreaks of legionnaires disease (LD) and combined outbreaks of LD and Pontiac fever (PF) are rarely identified. During one travel-associated combined outbreak at a hotel, a cohort study of potentially exposed persons and an environmental investigation were performed. Two LD and 22 PF cases were identified. Legionella pneumophila serogroup 6 (Lp6) isolates from the index patient and the hotel whirlpool spa were found to be identical by amplified fragment-length polymorphism typing. Disease occurred in 10 of 26 guests who were exposed to the spa versus 2 of 29 guests who were exposed only to the pool area (38% vs. 7%; P=.005). Immunoglobulin M (IgM) antibody to the outbreak Lp6 strain was more common among persons with PF (4 of 9) than among non-ill persons (2 of 32) (44% vs. 6%; P=.02). Spa exposure correlated with disease (P=.001) and IgM seropositivity (P=.007). New laboratory techniques facilitate outbreak investigation; to expedite outbreak interruption and measure the impact of travel-associated legionellosis, surveillance must be improved.
与旅行相关的军团病（LD）暴发以及LD与庞蒂亚克热（PF）的合并暴发很少被发现。在一家酒店发生的一次与旅行相关的合并暴发期间，对可能暴露的人员进行了队列研究并开展了环境调查。共发现2例LD病例和22例PF病例。通过扩增片段长度多态性分型发现，首例患者和酒店漩涡式水疗池分离出的嗜肺军团菌血清群6（Lp6）菌株完全相同。暴露于水疗池的26名客人中有10人发病，而仅暴露于泳池区域的29名客人中有2人发病（38%对7%；P = 0.005）。针对此次暴发的Lp6菌株的免疫球蛋白M（IgM）抗体在PF患者（9人中有4人）中比在未患病者（32人中有2人）中更常见（44%对6%；P = 0.02）。暴露于水疗池与发病（P = 0.001）和IgM血清阳性（P = 0.007）相关。新的实验室技术有助于暴发调查；为加快暴发控制并衡量与旅行相关的军团菌病的影响，必须加强监测。
