Re: Four Legionairres cases in Alcoy
http://www.promedmail.org/pls/apex/..._BACK_PAGE,F2400_P1001_PUB_MAIL_ID:1000,83197
Archive Number 20100612.1973
Published Date 12-JUN-2010
Subject PRO/EDR> Legionellosis - Spain: (AN)
LEGIONELLOSIS - SPAIN: (ALICANTE)
*********************************
A ProMED-mail post
<http://www.promedmail.org>
ProMED-mail is a program of the
International Society for Infectious Diseases
<http://www.isid.org>
Date: Fri 11 Jun 2010
Source: Euro Weekly News [edited]
<http://www.euroweeklynews.com/2010061180420/news/costa-blanca/legionnaires-outbreak-in-alcoy.html>
There is a new outbreak of Legionnaires Disease in Alcoy, where 4
cases have already been confirmed. 2 of the victims are currently in
the Virgen de los Lirios Hospital improving favorably. Meanwhile the
regional health authority has said that the 4 cases were all localized
and appear linked.
This raises the outbreaks seen in the town since 1999 to 16, during
which time 300 people have been affected and 11 have died.
The regional health authority wants to avoid the use of the word
'outbreak' which technically can only be used if there are 3 more
cases and that a connection can be found between them. However the
opposition (the Socialist Party and Esquerra Unida) is insisting on
the necessity of an in-depth investigation to find the reasons behind
the recurring outbreak of this illness in the municipality during the
last decade.
The last 2 outbreaks in the town were linked to asphalting machinery.
--
Communicated by:
ProMED-mail
<promed@promedmail.org>
[Legionnaires' disease is the acute pneumonic form of disease caused
by _Legionella_ bacteria, usually _Legionella pneumophila_. About
80-90 percent of cases are caused by _L. pneumophila_ serogroup 1.
Legionnaires' disease is usually acquired by inhalation by a
susceptible person of an infectious dose of aerosolized _Legionella_.
Risk factors in adults include age over 50 years, cigarette smoking,
diabetes, chronic heart or lung disease, and immuno-suppression.
Usually a building's contaminated water system is incriminated as the
source. _Legionella_ are found primarily in the hot water portion of
plumbing systems and in cooling towers. Warm water temperatures of
25-40 deg C (77-104 deg F) support the highest concentrations of the
organism in plumbing systems.
Although I am not aware that legionellosis has been linked to use of
asphalting machinery, as mentioned in the news release above, _L.
pneumophila_ has been isolated from in puddles of rainwater on asphalt
roads, especially in warm weather, and aerosolization of the organism
from puddles by vehicular traffic has been hypothesized as a possible
source for sporadic cases of legionellosis
(<http://www.cdc.gov/eid/content/15/8/1295.htm>).
However, a machine known as a roller follows the asphalt paver to
compact newly laid asphalt. The weight of roller drums is used to
compact the asphalt surface being laid down. Water may be used to
lubricate the drum surface to prevent hot asphalt from sticking to the
drum (see <http://en.wikipedia.org/wiki/Road_roller>). Also, on some
machines, the drums may be filled with water on site to achieve the
desired weight. When empty, the lighter roller drum is easier and
cheaper to transport between work sites. Perhaps aerosolization of
water contaminated with _L. pneumophila_ used for lubrication of the
roller drums or to add weight to these drums was linked to past cases
of legionellosis in Alcoy.
Alcoy is an inland industrial city, with a population of about 61 000,
located in the province of Alicante, along the eastern coast (Costa
Blanca) of Spain (<http://en.wikipedia.org/wiki/Alcoy_(Spain)>). The
HealthMap/ProMED-mail interactive map of Spain can be accessed at
<http://healthmap.org/promed/en?name=Kingdom%20of%20Spain,%20Spain&g=2510769&v=40,-4,5>. -
Mod.ML]
[Regarding earlier reports of Legionellosis in Alcoy & Alicante,
although the ProMED English archives only contain reports in 2001
(Murcia), 2002 & 2003 (Valencia) below, there is a report from 2004
in Spanish in the ProMED/ESP archives: Legionella, brote comunitario -
Espa?a (Alicante) 20041101.2955, but nothing since. - Mod.JW]
