Epidemiology and Infection

Table of Contents - 2008 - Volume 136, Issue 06  

Original Papers

A large Legionnaires' disease outbreak in Pamplona, Spain: early detection, rapid control and no case fatality

J. CASTILLAa1a2 c1, A. BARRICARTEa1a2, J. ALDAZa1, M. GARCÍA CENOZa1, T. FERRERa1, C. PELAZa3, S. PINEDAa4, B. BALADRÓNa3, I. MARTÍNa4, B. GOÑIa1, P. ARATAJOa5, J. CHAMORROa5, F. LAMEIROa6, L. TORROBAa5, I. DORRONSOROa6, V. MARTÍNEZ-ARTOLAa5, M. J. ESPARZAa7, M. A. GASTAMINZAa1, P. FRAILEa1 and P. ALDAZa1

a1 Instituto de Salud Pública de Navarra, Pamplona, Spain

a2 CIBER de Epidemiología y Salud Pública (CIBERESP), Spain

a3 Centro Nacional de Microbiología, Instituto de Salud Carlos III, Majadahonda, Madrid, Spain

a4 Programa de Epidemiología Aplicada de Campo, Centro Nacional de Epidemiología, Instituto de Salud Carlos III, Madrid, Spain

a5 Hospital Virgen del Camino, Pamplona, Spain

a6 Hospital de Navarra, Pamplona, Spain

a7 Centro de Salud del II Ensanche, Pamplona, Spain

Abstract

An outbreak of Legionnaire's disease was detected in Pamplona, Spain, on 1 June 2006. Patients with pneumonia were tested to detect Legionella pneumophila antigen in urine (Binax Now; Binax Inc., Scarborough, ME, USA), and all 146 confirmed cases were interviewed. The outbreak was related to district 2 (22 012 inhabitants), where 45% of the cases lived and 50% had visited; 5% lived in neighbouring districts. The highest incidence was found in the resident population of district 2 (3/1000 inhabitants), section 2 (14/1000). All 31 cooling towers of district 2 were analysed. L. pneumophila antigen (Binax Now) was detected in four towers, which were closed on 2 June. Only the strain isolated in a tower situated in section 2 of district 2 matched all five clinical isolates, as assessed by mAb and two genotyping methods, AFLP and PFGE. Eight days after closing the towers, new cases ceased appearing. Early detection and rapid coordinated medical and environmental actions permitted immediate control of the outbreak and probably contributed to the null case fatality.

(Accepted June 04 2007)

(Online publication July 30 2007)

Correspondence:

c1 Author for correspondence: Dr J. Castilla, Instituto de Salud Pública de Navarra, Leyre 15, 31003 Pamplona, Navarra, Spain. (Email: jcastilc@navarra.es)

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