Tap water as the source of a Legionnaires' disease outbreak spread to several residential buildings and one hospital, Finland, 2020 to 2021.

In Finland, all microbiology laboratories notify Legionella findings and physicians notify Legionnaires' disease (LD) cases to the National Infectious Disease Register. All cases are interviewed, and water samples obtained from potential places of exposure. Legionella isolates from humans and water are compared by whole genome sequencing (WGS). In March 2021, Legionella pneumophila serogroup 1 (Lp 1) pneumonia cases increased in one Finnish city (120,000 inhabitants) where single LD cases are detected annually. We identified 12 LD cases, nine living in different residential buildings and three nosocomial, linked by identical human and/or water isolates. Three of these cases were from January 2020, October 2020 and February 2021 and identified retrospectively. Eleven were diagnosed by urinary antigen test, 10 by PCR and five by culture; age ranged between 52 and 85 years, and 10 had underlying diseases. Nine of 12 homes of LD cases and 15 of 26 water samples from the hospital were positive for Lp 1, with concentrations up to 640,000 cfu/L. Water samples from regional storage tanks were negative. Positivity in homes and the hospital suggested inadequate maintenance measures. Enhanced surveillance combined with WGS was crucial in detecting this unusual LD outbreak related to domestic and hospital water systems.

The suitability of the IOM foam sampler for bioaerosol sampling in Occupational Environments.

Concurrent samples were collected with Andersen and IOM foam samplers to determine whether if the IOM foam sampler can be applied to collect culturable microorganisms. Two different kinds of aerosols were studied: peat dust in a power plant and mist from coolant fluid aerosolized during grinding of blades and rollers in a paper mill. In the power plant, the concentrations of fungi were 2-3 times higher in the IOM samples than in the Andersen samples. However, more fungal genera were identified in the latter case. The methods yielded similar concentrations of bacteria and actinobacteria in the power plant. On the other hand, the performance of the IOM foam sampler was very poor in the paper mill, where stress-sensitive gram-negative bacteria dominated; low concentration of bacteria was detected in only one IOM sample even though the concentration of bacteria often exceeded even the upper detection limit in the Andersen impactor samples. It could be concluded that the IOM foam sampler performs quite well for collecting inhalable fungi and actinobacteria. However, the Andersen sampler provides better information on fungal genera and concentrations of gram-negative bacteria. Personal sampling with the IOM foam sampler provided an important benefit in the power plant, where the concentration ratio of personal to stationary samples was much higher for bacteria than for inhalable or respirable dust.

Amoebae and other protozoa in material samples from moisture-damaged buildings.

Mold growth in buildings has been shown to be associated with adverse health effects. The fungal and bacterial growth on moistened building materials has been studied, but little attention has been paid to the other organisms spawning in the damaged materials. We examined moist building materials for protozoa, concentrating on amoebae. Material samples (n = 124) from moisture-damaged buildings were analyzed for amoebae, fungi, and bacteria. Amoebae were detected in 22% of the samples, and they were found to favor cooccurrence with bacteria and the fungi Acremonium spp., Aspergillus versicolor, Chaetomium spp., and Trichoderma spp. In addition, 11 seriously damaged samples were screened for other protozoa. Ciliates and flagellates were found in almost every sample analyzed. Amoebae are known to host pathogenic bacteria, such as chlamydiae, legionellae, and mycobacteria and they may have a role in the complex of exposure that contributes to the health effects associated with moisture damage in buildings.