Finnish National Institute for Health and Welfare, Helsinki, Finland.
ECDC Fellowship Programme, Field Epidemiology path (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.
Euro Surveill. 2023 Mar;28(11). doi: 10.2807/1560-7917.ES.2023.28.11.2200673.
In Finland, all microbiology laboratories notify findings and physicians notify Legionnaires' disease (LD) cases to the National Infectious Disease Register. All cases are interviewed, and water samples obtained from potential places of exposure. isolates from humans and water are compared by whole genome sequencing (WGS). In March 2021, serogroup 1 (Lp 1) pneumonia cases increased in one Finnish city (120,000 inhabitants) where single LD cases are detected annually. We identified 12 LD cases, nine living in different residential buildings and three nosocomial, linked by identical human and/or water isolates. Three of these cases were from January 2020, October 2020 and February 2021 and identified retrospectively. Eleven were diagnosed by urinary antigen test, 10 by PCR and five by culture; age ranged between 52 and 85 years, and 10 had underlying diseases. Nine of 12 homes of LD cases and 15 of 26 water samples from the hospital were positive for Lp 1, with concentrations up to 640,000 cfu/L. Water samples from regional storage tanks were negative. Positivity in homes and the hospital suggested inadequate maintenance measures. Enhanced surveillance combined with WGS was crucial in detecting this unusual LD outbreak related to domestic and hospital water systems.
在芬兰，所有微生物学实验室将发现结果通知给国家传染病登记处，并通知医生军团病（LD）病例。所有病例都接受访谈，并从潜在的暴露地点获取水样。从人类和水中分离的细菌通过全基因组测序（WGS）进行比较。2021 年 3 月，芬兰一个城市（12 万居民）的血清群 1（Lp1）肺炎病例增加，该城市每年都会检测到单一的 LD 病例。我们发现了 12 例 LD 病例，其中 9 例居住在不同的住宅楼中，3 例为医院获得性病例，这些病例由相同的人类和/或水分离株连接在一起。其中 3 例为 2020 年 1 月、2020 年 10 月和 2021 年 2 月的回顾性病例。11 例通过尿抗原检测、10 例通过 PCR 和 5 例通过培养诊断；年龄在 52 至 85 岁之间，10 例有基础疾病。12 例 LD 病例中有 9 例，26 例医院水样中有 15 例为 Lp1 阳性，浓度高达 640,000 cfu/L。区域储水箱中的水样呈阴性。家庭和医院的阳性结果表明维护措施不足。增强监测结合 WGS 对于检测与家庭和医院水系统有关的这种不寻常的 LD 暴发至关重要。
