Keller D W, Hajjeh R, DeMaria A, Fields B S, Pruckler J M, Benson R S, Kludt PE Lett S M, Mermel L A, Giorgio C, Breiman R F
Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
Clin Infect Dis. 1996 Feb;22(2):257-61. doi: 10.1093/clinids/22.2.257.
In August and September 1993, we investigated an outbreak of legionnaires' disease in Fall River, Massachusetts, that involved 11 persons; the attack rate was highest in Flint, a community of Fall River. All cases were infected with Legionella pneumophila serogroup 1 (Lp-1). A case-control study revealed that cases were more likely than matched controls to have visited sites in neighborhood A of Flint. Environmental sampling in Flint found that four of nine aerosol-producing devices sampled contained legionellae; only two, conjoined cooling towers on building A, contained Lp-1. Three independent methods of subtyping--monoclonal antibody subtyping, arbitrary primer polymerase chain reaction, and pulsed-field gel electrophoresis--revealed that Lp-1 isolates from three cases with culture-positive legionnaires' disease matched those from the cooling towers on building A. Water samples from the homes of cases with culture-positive legionnaires' disease contained no legionellae. The results of this epidemiologic and laboratory investigation indicate that the cooling towers on building A were the source of the outbreak of legionnaires' disease and confirm the importance of cooling towers in the transmission of legionnaires' disease.
1993年8月和9月，我们对马萨诸塞州福尔里弗市爆发的军团病疫情展开了调查，此次疫情涉及11人；发病率在福尔里弗市的一个社区弗林特最高。所有病例均感染了嗜肺军团菌血清1型（Lp-1）。一项病例对照研究表明，与匹配的对照组相比，病例更有可能去过弗林特A区的一些场所。在弗林特进行的环境采样发现，所采样的9个产生气溶胶的装置中有4个含有军团菌；只有两个，即A楼相连的冷却塔，含有Lp-1。三种独立的分型方法——单克隆抗体分型、任意引物聚合酶链反应和脉冲场凝胶电泳——显示，从3例培养确诊为军团病的病例中分离出的Lp-1与从A楼冷却塔中分离出的Lp-1相匹配。培养确诊为军团病的病例家中的水样未检测到军团菌。这项流行病学和实验室调查结果表明，A楼的冷却塔是此次军团病疫情的源头，并证实了冷却塔在军团病传播中的重要性。
