scholarly journals Legionnaires' disease outbreak in Rome, Italy

2005 ◽  
Vol 133 (5) ◽  
pp. 853-859 ◽  
Author(s):  
M. C. ROTA ◽  
G. PONTRELLI ◽  
M. SCATURRO ◽  
A. BELLA ◽  
A. R. BELLOMO ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Cooling Tower ◽  
Case Control Study ◽  
Hospital Admissions ◽  
Case Control ◽  
Phenotypic Analysis ◽  
Single Strain ◽  
Increased Risk ◽  
Legionnaires Disease ◽  
Control Study

Between August and October 2003, 15 cases of Legionnaires' disease were detected in the 9th district of Rome. To identify possible sources of Legionella exposure, a matched case-control study was conducted and environmental samples were collected. Hospital discharge records were also retrospectively analysed for the period July–November 2003, and results were compared with the same period during the previous 3 years. The case-control study revealed a significantly increased risk of disease among those frequenting a specific department store in the district (OR 9·8, 95% CI 2·1–46·0), and Legionella pneumophila was isolated from the store's cooling tower. Genotypic and phenotypic analysis of human and environmental isolates demonstrated that the cluster was caused by a single strain of L. pneumophila serogroup 1, and that the cooling tower of the store was the source of infection. The increased number of hospital admissions for microbiologically undiagnosed pneumonia during the study period may indicate that some legionellosis cases were not identified.

scholarly journals Legionnaires' disease and the sick-building syndrome

1989 ◽  
Vol 103 (2) ◽  
pp. 285-292 ◽  
Author(s):  
M. O'Mahony ◽  
A. Lakhani ◽  
A. Stephens ◽  
J. G. Wallace ◽  
E. R. Youngs ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Local Community ◽  
Cooling Tower ◽  
Case Control Study ◽  
Sick Building Syndrome ◽  
Air Conditioning System ◽  
Sick Building ◽  
Air Intake ◽  
Legionnaires Disease ◽  
Control Study

SUMMARYIn October 1985, six cases of legionnaires' disease were associated with a police headquarters building. Four were amongst staff who worked in or visited the communications wing of the headquarters and two cases occurred in the local community. A case-control study implicated the operations room of the communications wing as the main area associated with infection. This wing was air-conditioned and smoke tracer studies showed that drift from the exhaust as well as from the base of the cooling tower entered the main air-intake which serviced the air-conditioning system.Legionella pneumophilaserogroup 1 subgroup pontiac was isolated from water and sludge in the cooling tower pond. Contaminated drift from the top of the cooling tower was probably responsible for the two community cases. An additional discovery was that symptoms suggestive of the sick-building syndrome were associated with working in this wing.

scholarly journals Legionnaires' disease outbreak associated with a cruise liner, August 2003: epidemiological and microbiological findings

2006 ◽  
Vol 135 (5) ◽  
pp. 802-810 ◽  
Author(s):  
K. BEYRER ◽  
S. LAI ◽  
J. DREESMAN ◽  
J. V. LEE ◽  
C. JOSEPH ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Case Control Study ◽  
Prolonged Exposure ◽  
Interdisciplinary Approach ◽  
Case Control ◽  
Case Definition ◽  
Source Of Infection ◽  
Legionnaires Disease ◽  
The Mean ◽  
Control Study

SUMMARYEight cases of Legionnaires' disease were identified among the 215 German passengers after a cruise to the Nordic Sea in August 2003. An unmatched case-control study was conducted to identify risk factors and the source of infection. In total, eight passengers fulfilled the case definition, one of these died. Forty-two passengers served as controls. The attack rate was 4%. The mean age was 60 years for cases and 62 years for controls. Prolonged exposure to the spa pool seemed to be a risk factor of infection (OR 4·85,P=0·09).Legionella pneumophilaserogroup 1, monoclonal antibody (mAb) subgroup ‘Knoxville’ was isolated from clinical and environmental samples. DNA sequence-based typing revealed that these isolates were indistinguishable from each other. The investigation showed the importance of an interdisciplinary approach of microbiology and epidemiology as not all sites on the ship that tested positive forL. pneumophilaactually posed a relevant risk for the passengers.

scholarly journals Large community-acquired Legionnaires’ disease outbreak caused by Legionella pneumophila serogroup 1, Italy, July to August 2018

2020 ◽  
Vol 25 (20) ◽  
Author(s):  
Marino Faccini ◽  
Antonio Giampiero Russo ◽  
Maira Bonini ◽  
Sara Tunesi ◽  
Rossella Murtas ◽  
...  
Keyword(s):  
Crossover Study ◽  
Legionella Pneumophila ◽  
Case Control Study ◽  
Dispersion Model ◽  
Case Control ◽  
Case Crossover ◽  
Large Outbreak ◽  
Legionnaires Disease ◽  
Aerosol Dispersion ◽  
Control Study

In July 2018, a large outbreak of Legionnaires’ disease (LD) caused by Legionella pneumophila serogroup 1 (Lp1) occurred in Bresso, Italy. Fifty-two cases were diagnosed, including five deaths. We performed an epidemiological investigation and prepared a map of the places cases visited during the incubation period. All sites identified as potential sources were investigated and sampled. Association between heavy rainfall and LD cases was evaluated in a case-crossover study. We also performed a case–control study and an aerosol dispersion investigation model. Lp1 was isolated from 22 of 598 analysed water samples; four clinical isolates were typed using monoclonal antibodies and sequence-based typing. Four Lp1 human strains were ST23, of which two were Philadelphia and two were France-Allentown subgroup. Lp1 ST23 France-Allentown was isolated only from a public fountain. In the case-crossover study, extreme precipitation 5–6 days before symptom onset was associated with increased LD risk. The aerosol dispersion model showed that the fountain matched the case distribution best. The case–control study demonstrated a significant eightfold increase in risk for cases residing near the public fountain. The three studies and the matching of clinical and environmental Lp1 strains identified the fountain as the source responsible for the epidemic.

scholarly journals Epidemiological investigation and case–control study: a Legionnaires’ disease outbreak associated with cooling towers in Warstein, Germany, August–September 2013

2015 ◽  
Vol 20 (46) ◽  
Author(s):  
Anna Maisa ◽  
Ansgar Brockmann ◽  
Frank Renken ◽  
Christian Lück ◽  
Stefan Pleischl ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Case Control Study ◽  
Case Fatality ◽  
Case Control ◽  
Cooling Towers ◽  
Multiple Sources ◽  
Source Tracing ◽  
Infection Source ◽  
Legionnaires Disease ◽  
Control Study

Between 1 August and 6 September 2013, an outbreak of Legionnaires’ disease (LD) with 159 suspected cases occurred in Warstein, North Rhine-Westphalia, Germany. The outbreak consisted of 78 laboratory-confirmed cases of LD, including one fatality, with a case fatality rate of 1%. Legionella pneumophila, serogroup 1, subtype Knoxville, sequence type 345, was identified as the epidemic strain. A case–control study was conducted to identify possible sources of infection. In univariable analysis, cases were almost five times more likely to smoke than controls (odds ratio (OR): 4.81; 95% confidence interval (CI): 2.33–9.93; p < 0.0001). Furthermore, cases were twice as likely to live within a 3 km distance from one identified infection source as controls (OR: 2.14; 95% CI: 1.09–4.20; p < 0.027). This is the largest outbreak of LD in Germany to date. Due to a series of uncommon events, this outbreak was most likely caused by multiple sources involving industrial cooling towers. Quick epidemiological assessment, source tracing and shutting down of potential sources as well as rapid laboratory testing and early treatment are necessary to reduce morbidity and mortality. Maintenance of cooling towers must be carried out according to specification to prevent similar LD outbreaks in the future.

scholarly journals An outbreak of legionnaires’ disease in a municipality in northern Portugal

2001 ◽  
Vol 6 (7) ◽  
pp. 121-124 ◽  
Author(s):  
A M Correia ◽  
G Gonçalves ◽  
J Reis ◽  
J M Cruz ◽  
J A Castro e Freitas
Keyword(s):  
Legionella Pneumophila ◽  
Case Control Study ◽  
District Hospital ◽  
Case Control ◽  
Northern Portugal ◽  
Legionnaires Disease ◽  
Control Study

Eleven cases of legionnaires´ disease, all patients living in the same municipality, were admitted to a district hospital in northern Portugal. Preliminary investigations suggested an association with the events of the annual festivities in that municipality. Legionella pneumophila was not isolated from any of the suspected sources, but evidence from a case control study suggested that an aerosol produced by a decorative fountain in the main square during the night of a rock concert was the likely vehicle of infection. The prevalence of smoking was higher among cases than controls.

scholarly journals COVID-19 and Its Symptoms’ Panoply: A Case-Control Study of 919 Suspected Cases in Locked-Down Ovar, Portugal

2021 ◽  
pp. 1-8
Author(s):  
Regina Sá ◽  
Tiago Pinho-Bandeira ◽  
Guilherme Queiroz ◽  
Joana Matos ◽  
João Duarte Ferreira ◽  
...  
Keyword(s):  
Large Scale ◽  
Case Control Study ◽  
Statistical Significance ◽  
Case Control ◽  
Case Definition ◽  
Suspected Case ◽  
Risk Characteristics ◽  
Increased Risk ◽  
Wide Range ◽  
Control Study

<b><i>Background:</i></b> Ovar was the first Portuguese municipality to declare active community transmission of SARS-CoV-2, with total lockdown decreed on March 17, 2020. This context provided conditions for a large-scale testing strategy, allowing a referral system considering other symptoms besides the ones that were part of the case definition (fever, cough, and dyspnea). This study aims to identify other symptoms associated with COVID-19 since it may clarify the pre-test probability of the occurrence of the disease. <b><i>Methods:</i></b> This case-control study uses primary care registers between March 29 and May 10, 2020 in Ovar municipality. Pre-test clinical and exposure-risk characteristics, reported by physicians, were collected through a form, and linked with their laboratory result. <b><i>Results:</i></b> The study population included a total of 919 patients, of whom 226 (24.6%) were COVID-19 cases and 693 were negative for SARS-CoV-2. Only 27.1% of the patients reporting contact with a confirmed or suspected case tested positive. In the multivariate analysis, statistical significance was obtained for headaches (OR 0.558), odynophagia (OR 0.273), anosmia (OR 2.360), and other symptoms (OR 2.157). The interaction of anosmia and odynophagia appeared as possibly relevant with a borderline statistically significant OR of 3.375. <b><i>Conclusion:</i></b> COVID-19 has a wide range of symptoms. Of the myriad described, the present study highlights anosmia itself and calls for additional studies on the interaction between anosmia and odynophagia. Headaches and odynophagia by themselves are not associated with an increased risk for the disease. These findings may help clinicians in deciding when to test, especially when other diseases with similar symptoms are more prevalent, namely in winter.

scholarly journals Irritable bowel syndrome and Parkinson’s disease risk: register-based studies

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Bojing Liu ◽  
Arvid Sjölander ◽  
Nancy L. Pedersen ◽  
Jonas F. Ludvigsson ◽  
Honglei Chen ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Irritable Bowel Syndrome ◽  
Case Control Study ◽  
Case Control ◽  
Twin Registry ◽  
Increased Risk ◽  
Irritable Bowel ◽  
Nested Case Control ◽  
Control Study ◽  
Swedish Twin Registry

AbstractTo examine whether irritable bowel syndrome (IBS) was related to the future risk of Parkinson’s disease (PD), we conducted a nested case-control study in the Swedish total population including 56,564 PD cases identified from the Swedish Patient Register and 30 controls per case individually matched by sex and year of birth. Odds ratios (ORs) with 95% confidence intervals (CIs) for having a prior diagnosis of IBS were estimated using conditional logistic regression. We furthermore conducted a cohort study using the Swedish Twin Registry following 3046 IBS patients identified by self-reported abdominal symptoms and 41,179 non-IBS individuals. Through Cox proportional hazard models, we estimated hazard ratios (HRs) and 95% CIs for PD risk. In the nested case-control study, 253 (0.4%) PD cases and 5204 (0.3%) controls had a previous IBS diagnosis. IBS diagnosis was associated with a 44% higher risk of PD (OR = 1.44, 95% CI 1.27–1.63). Temporal relationship analyses showed 53% and 38% increased risk of PD more than 5 and 10 years after IBS diagnosis, respectively. In the cohort analysis based on the Swedish Twin Registry, there was no statistically significantly increased risk of PD related to IBS (HR = 1.25, 95% CI = 0.87–1.81). Our results suggest a higher risk of PD diagnosis after IBS. These results provide additional evidence supporting the importance of the gut–brain axis in PD.

scholarly journals Relation of severe COVID-19 to polypharmacy and prescribing of psychotropic drugs: the REACT-SCOT case-control study

BMC Medicine ◽  
2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Paul M. McKeigue ◽  
◽  
Sharon Kennedy ◽  
Amanda Weir ◽  
Jen Bishop ◽  
...  
Keyword(s):  
Primary Care ◽  
Rate Ratio ◽  
Case Control Study ◽  
Fatal Outcome ◽  
Case Control ◽  
Care Practice ◽  
Drug Classes ◽  
Increased Risk ◽  
Co Morbidity ◽  
Control Study

Abstract Background The objective of this study was to investigate the relation of severe COVID-19 to prior drug prescribing. Methods Severe cases were defined by entry to critical care or fatal outcome. For this matched case-control study (REACT-SCOT), all 4251 cases of severe COVID-19 in Scotland since the start of the epidemic were matched for age, sex and primary care practice to 36,738 controls from the population register. Records were linked to hospital discharges since June 2015 and dispensed prescriptions issued in primary care during the last 240 days. Results Severe COVID-19 was strongly associated with the number of non-cardiovascular drug classes dispensed. This association was strongest in those not resident in a care home, in whom the rate ratio (95% CI) associated with dispensing of 12 or more drug classes versus none was 10.8 (8.8, 13.3), and in those without any of the conditions designated as conferring increased risk of COVID-19. Of 17 drug classes postulated at the start of the epidemic to be “medications compromising COVID”, all were associated with increased risk of severe COVID-19 and these associations were present in those without any of the designated risk conditions. The fraction of cases in the population attributable to exposure to these drug classes was 38%. The largest effect was for antipsychotic agents: rate ratio 4.18 (3.42, 5.11). Other drug classes with large effects included proton pump inhibitors (rate ratio 2.20 (1.72, 2.83) for = 2 defined daily doses/day), opioids (3.66 (2.68, 5.01) for = 50 mg morphine equivalent/day) and gabapentinoids. These associations persisted after adjusting for covariates and were stronger with recent than with non-recent exposure. Conclusions Severe COVID-19 is associated with polypharmacy and with drugs that cause sedation, respiratory depression, or dyskinesia; have anticholinergic effects; or affect the gastrointestinal system. These associations are not easily explained by co-morbidity. Measures to reduce the burden of mortality and morbidity from COVID-19 should include reinforcing existing guidance on reducing overprescribing of these drug classes and limiting inappropriate polypharmacy. Registration ENCEPP number https://EUPAS35558

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