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      Community-acquired Legionnaires’ Disease in a Newly Constructed Apartment Building

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          Abstract

          Objectives

          Legionnaires’ disease (LD) is a severe type of pneumonia caused by inhalation of aerosols contaminated with Legionella. On September 22, 2016, a single case of LD was reported from a newly built apartment building in Gyeonggi province. This article describes an epidemiologic investigation of LD and identification of the possible source of infection.

          Methods

          To identify the source of LD, we interviewed the patient’s husband using a questionnaire based on the Legionella management guidelines from the Korea Centers for Disease Control and Prevention. Water samples from the site were collected and analyzed. An epidemiological investigation of the residents and visitors in the apartment building was conducted for 14 days before the index patient’s symptoms first appeared to 14 days after the implementation of environmental control measures.

          Results

          Legionella pneumophila serogroup 1 was isolated from the heated-water samples from the patient’s residence and the basement of the apartment complex. Thirty-two suspected cases were reported from the apartment building during the surveillance period, yet all were confirmed negative based on urinary antigen tests.

          Conclusions

          The likely source of infection was the building’s potable water, particularly heated water. Further study of effective monitoring systems in heated potable water should be considered.

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          Most cited references14

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          The JRS guidelines for the management of community-acquired pneumonia in adults: an update and new recommendations.

          Community-acquired pneumonia (CAP) continues to be a major medical problem. Since CAP is a potentially fatal disease, early appropriate antibiotic treatment is vital. Epidemiologic studies have shown that in the combined cause-of-death category, pneumonia ranks fourth as the leading cause of death in Japan. Therefore, the Japanese Respiratory Society (JRS) provided guidelines for the management of CAP in adults in 2000. Because of evolving resistance to antimicrobials and advances in diagnosis, treatment and prevention of CAP, it is felt that an update should be provided every three years so that important developments can be highlighted and pressing questions can be answered. Thus, the guidelines committee updated its guidelines in 2005. The basic policy and main purposes of the JRS guidelines include; 1) prevention of bacterial resistance and 2) effective and long-term use of medical resources. The JRS guidelines have recommended the exclusion of potential and broad spectrum antibiotics, fluoroquinolones and carbapenems, from the list of first-choice drugs for empirical treatment. In addition, the JRS guidelines have recommended short-term usage of antibiotics of an appropriate dose and pathogen-specific treatment using rapid diagnostic methods if possible.
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            The importance of clinical surveillance in detecting legionnaires' disease outbreaks: a large outbreak in a hospital with a Legionella disinfection system-Pennsylvania, 2011-2012.

            Healthcare-associated Legionnaires' disease (LD) is a preventable pneumonia with a 30% case fatality rate. The Centers for Disease Control and Prevention guidelines recommend a high index of suspicion for the diagnosis of healthcare-associated LD. We characterized an outbreak and evaluated contributing factors in a hospital using copper-silver ionization for prevention of Legionella growth in water.
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              • Record: found
              • Abstract: not found
              • Article: not found

              Community-acquired legionnaires disease: implications for underdiagnosis and laboratory testing.

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                Author and article information

                Journal
                J Prev Med Public Health
                J Prev Med Public Health
                JPMPH
                Journal of Preventive Medicine and Public Health
                Korean Society for Preventive Medicine
                1975-8375
                2233-4521
                July 2017
                28 June 2017
                : 50
                : 4
                : 274-277
                Affiliations
                [1 ]Division of Infectious Disease Control, Gyeonggi Provincial Government, Suwon, Korea
                [2 ]Department of Epidemiology and Medical Informatics, School of Public Health, Korea University, Seoul, Korea
                [3 ]Department of Preventive Medicine, Korea University College of Medicine, Seoul, Korea
                Author notes
                Corresponding author: Kyungho Yang, MD 11 Hyowon-ro, Paldal-gu, Suwon 16444, Korea Tel: +82-31-8008-5428, Fax: +82-31-8008-4179 E-mail: ykh110124@ 123456gmail.com
                Author information
                http://orcid.org/0000-0002-8915-8167
                http://orcid.org/0000-0001-6647-7790
                http://orcid.org/0000-0001-6576-8916
                Article
                jpmph-50-4-274
                10.3961/jpmph.17.066
                5541279
                28768406
                29e77681-d8ca-4ec0-85b0-1dcfe72782a6
                Copyright © 2017 The Korean Society for Preventive Medicine

                This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License ( http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 25 April 2017
                : 12 June 2017
                Categories
                Brief Report

                Public health
                legionella,potable-water system,infection,disease outbreaks,korea
                Public health
                legionella, potable-water system, infection, disease outbreaks, korea

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