Agency for Care and Health, Infection Prevention and Control, Flemish Community, Ghent, Belgium.
Department of Microbiology and Infection Control, National Reference Centre for Legionella Pneumophila, Universitair Ziekenhuis Brussel, Vrije Universiteit Brussel, Brussels, Belgium.
Epidemiol Infect. 2019 Dec 20;147:e326. doi: 10.1017/S0950268819001821.
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.
2016 年 8 月至 9 月，比利时登德尔蒙德发生了一起军团病（LD）集群疫情，共有 10 例确诊病例、3 例疑似病例和 4 例可能病例。该地区的发病率为 7 例/10 万人，超过了前 5 年 1.5 例/10 万人的最高年发病率。流行病学、环境和地理调查将一个冷却塔（CT）确定为最有可能的来源。离塔越远，病例风险越低，在 5 公里范围内风险最高。在人类呼吸道样本中发现了嗜肺军团菌血清群 1，ST48，但无法与环境结果相匹配。公共卫生当局采取措施控制 CT 的污染，并组织了后续抽样。我们确定了在集群调查中遇到的障碍，并为改进 LD 集群管理提出了建议，包括通过疫情控制小组更快地协调团队，改进关于临床和环境样本分析的沟通，通过病例问卷更详细地记录潜在暴露情况，并更早地使用地理信息工具来比较潜在来源并生成假设。
