RESUMEN
A nosocomial case of Legionella pneumophila pneumonia likely caused by a serogroup 3 strain was detected by a urinary antigen test in Spain in 2018. Although Legionella bacteria could not be isolated from respiratory samples, molecular methods implicated the sink faucet of the patient's room as the probable infection source.
Asunto(s)
Infección Hospitalaria , Legionella pneumophila , Enfermedad de los Legionarios/diagnóstico , Enfermedad de los Legionarios/microbiología , Anciano , Resultado Fatal , Historia del Siglo XXI , Humanos , Legionella pneumophila/genética , Enfermedad de los Legionarios/epidemiología , Enfermedad de los Legionarios/historia , Masculino , Serogrupo , Serotipificación , España/epidemiología , Microbiología del AguaRESUMEN
Two cases of Legionnaires' disease and 1 of Pontiac fever occurred among the crew of a merchant ship operating off the shores of Australia. PCR assays identified potential sources in the ship's cabins. Modification of maritime regulations for Legionnaires' disease prevention in commercial vessels is needed for nonpassenger merchant ships.
Asunto(s)
Brotes de Enfermedades , Legionelosis , Enfermedad de los Legionarios/epidemiología , Navíos , Enfermedad Relacionada con los Viajes , Australia/epidemiología , Historia del Siglo XXI , Humanos , Océano Índico , Legionelosis/genética , Enfermedad de los Legionarios/historia , Enfermedad de los Legionarios/microbiología , Enfermedad de los Legionarios/transmisión , Persona de Mediana Edad , Estaciones del AñoAsunto(s)
Aire Acondicionado , Brotes de Enfermedades , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios , Salud Pública , Aire Acondicionado/efectos adversos , Aire Acondicionado/historia , Aire Acondicionado/instrumentación , Centers for Disease Control and Prevention, U.S. , Infecciones Comunitarias Adquiridas/epidemiología , Infección Hospitalaria/epidemiología , Diseño de Equipo , Historia del Siglo XX , Humanos , Subtipo H1N1 del Virus de la Influenza A/aislamiento & purificación , Gripe Humana/epidemiología , Gripe Humana/historia , Enfermedad de los Legionarios/diagnóstico , Enfermedad de los Legionarios/epidemiología , Enfermedad de los Legionarios/historia , Philadelphia , Salud Pública/historia , Estados Unidos/epidemiologíaAsunto(s)
Brotes de Enfermedades , Genoma Bacteriano , Legionella pneumophila/clasificación , Legionella pneumophila/genética , Enfermedad de los Legionarios/epidemiología , Enfermedad de los Legionarios/microbiología , Alemania/epidemiología , Historia del Siglo XXI , Humanos , Enfermedad de los Legionarios/historia , Tipificación de Secuencias Multilocus , SerogrupoAsunto(s)
Enfermedad de los Legionarios/epidemiología , Historia del Siglo XXI , Humanos , Incidencia , Enfermedad de los Legionarios/historia , Enfermedad de los Legionarios/mortalidad , Mortalidad , Ciudad de Nueva York/epidemiología , Ciudad de Nueva York/etnología , Vigilancia de la Población , Factores de RiesgoAsunto(s)
Centers for Disease Control and Prevention, U.S./organización & administración , Epidemiología/normas , Medicina Basada en la Evidencia/normas , Enfermedad de los Legionarios/historia , Centers for Disease Control and Prevention, U.S./historia , Métodos Epidemiológicos , Epidemiología/historia , Epidemiología/tendencias , Medicina Basada en la Evidencia/métodos , Medicina Basada en la Evidencia/tendencias , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Liderazgo , Masculino , Práctica de Salud Pública/historia , Práctica de Salud Pública/normas , Estados UnidosRESUMEN
Legionnaires' disease is now routinely discussed as an 'emerging infectious disease' (EID) and is said to be one of the earliest such diseases to be recognised. It first appeared in 1976 and its cause was identified in 1977, the same year that Ebola fever, Hantaan virus and Campylobacter jejuni arrived. The designation of Legionnaires' disease as an EID was retrospective; it was not and could not be otherwise as the category only gained currency in the early 1990s. In this article we reflect on the changing medical understanding and social profile of Legionnaires' disease in the decade or so from its recognition to the creation of EIDs, especially its ambivalent position between public health and clinical medicine. However, we question any simple opposition, between public health experts who approached Legionnaires' disease as a new and worrying environmental threat that could be prevented, and clinicians who saw it as another cause of pneumonia that could be managed by improved diagnosis and treatment. We argue that in the British context of public spending cuts and the reform of public health, the category of 'new' diseases, in which Legionnaires' disease was central, was mobilised ahead of the EID lobby of the early 1990s, by interested groups in medicine to defend infectious diseases services.
Asunto(s)
Enfermedades Transmisibles Emergentes/historia , Brotes de Enfermedades/historia , Legionella pneumophila , Enfermedad de los Legionarios/historia , Aire Acondicionado , Antibacterianos/historia , Antibacterianos/uso terapéutico , Actitud Frente a la Salud , Instituciones de Salud/historia , Instituciones de Salud/legislación & jurisprudencia , Historia del Siglo XX , Humanos , Enfermedad de los Legionarios/epidemiología , Medicina Estatal/historia , Reino Unido/epidemiología , Microbiología del AguaRESUMEN
The ability to diagnose and treat infectious diseases and handle infectious disease outbreaks continues to improve. For the most part, the major plagues of antiquity remain historical footnotes, yet, despite many advances, there is clear evidence that major pandemic illness is always just one outbreak away. In addition to the HIV pandemic, the smaller epidemic outbreaks of Legionnaire's disease, hantavirus pulmonary syndrome, and severe acute respiratory syndrome, among many others, points out the potential risk associated with a lack of preplanning and preparedness. Although pandemic influenza is at the top of the list when discussing possible future major infectious disease outbreaks, the truth is that the identity of the next major pandemic pathogen cannot be predicted with any accuracy. We can only hope that general preparedness and the lessons learned from previous outbreaks suffice.
Asunto(s)
Infecciones Comunitarias Adquiridas/epidemiología , Infecciones Comunitarias Adquiridas/historia , Cuidados Críticos/historia , Brotes de Enfermedades/historia , Enfermedades Endémicas/historia , Unidades de Cuidados Intensivos/historia , Adolescente , Adulto , Niño , Infecciones Comunitarias Adquiridas/terapia , Brotes de Enfermedades/prevención & control , Enfermedades Endémicas/prevención & control , Fascitis Necrotizante/historia , Fascitis Necrotizante/terapia , Femenino , Salud Global , Síndrome Pulmonar por Hantavirus/historia , Síndrome Pulmonar por Hantavirus/terapia , Historia del Siglo XX , Humanos , Gripe Humana/historia , Gripe Humana/terapia , Enfermedad de los Legionarios/historia , Enfermedad de los Legionarios/terapia , Masculino , Pneumocystis carinii , Neumonía por Pneumocystis/historia , Neumonía por Pneumocystis/terapia , Poliomielitis/historia , Poliomielitis/terapia , Síndrome Respiratorio Agudo Grave/historia , Síndrome Respiratorio Agudo Grave/terapia , Choque Séptico/historia , Choque Séptico/terapia , Infecciones Estafilocócicas/historia , Infecciones Estafilocócicas/terapia , Infecciones Estreptocócicas/historia , Infecciones Estreptocócicas/terapia , Adulto JovenRESUMEN
The topic of building related illness came into the public's eye as a major health issue in the mid 1970s, when several cases of pneumonia were found to be associated with an infectious agent in Philadelphia. This agent was subsequently found to be a gram-positive bacterium known as Legionella pneumoniae. During the ensuing 30 years, a myriad of symptom constellations, disorders, clinical syndromes and illnesses have been attributed to indoor living or working environments. Over time, there appeared to be no limit to claims of building related illness, and it was "reported" that almost any kind of clinical symptom, real or imaginary, could be blamed on indoor environments. As society became more and more litigious, many of these disorders were erroneously played out in courtrooms rather than medical offices, creating a circus atmosphere surrounding this class of disorders. With the advent of the internet, as well as other advances in telecommunications, these issues eventually became part of a media frenzy, and all truths could be thrown out the window as issues became more and more decided upon by emotions and unfounded beliefs, rather than scientific data and logical thinking.
Asunto(s)
Compensación y Reparación/historia , Enfermedad de los Legionarios/historia , Micosis/historia , Hongos , Historia del Siglo XX , Historia del Siglo XXI , Humanos , Enfermedad de los Legionarios/epidemiología , Micosis/epidemiología , Estados Unidos/epidemiologíaRESUMEN
The search for the cause of the large outbreak of severe pneumonia that affected attendees of a convention of war veterans in Philadelphia in 1976 was complicated by a number of factors. The 2-10 day incubation period meant that cases were dispersed across Pennsylvania at time of onset, and matters were further complicated by the lack of a centralised record of attendance of the convention. Known methods for culture, serology, tissue staining, and toxicology gave negative results. The reliance on a clinical case definition, and the need to coordinate local, state, and federal jurisdictions both hindered efforts. Intense public scrutiny, anxiety, and promotion of implausible theories, researchers' memories of prior unsolved major investigations, and the inherent difficulty of documenting airborne spread also had an impact. The novel bacterial agent Legionella pneumophila was identified and its spread defined by persistent application of basic epidemiological and laboratory principles, including the willingness to re-examine one's assumptions.
Asunto(s)
Brotes de Enfermedades/historia , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/historia , Centers for Disease Control and Prevention, U.S./historia , Historia del Siglo XX , Humanos , Enfermedad de los Legionarios/epidemiología , Enfermedad de los Legionarios/microbiología , Enfermedad de los Legionarios/transmisión , Masculino , Philadelphia/epidemiología , Estados UnidosAsunto(s)
Brotes de Enfermedades , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/historia , Infecciones del Sistema Respiratorio/epidemiología , Técnicas Bacteriológicas , Técnica del Anticuerpo Fluorescente Indirecta , Historia del Siglo XX , Humanos , Philadelphia/epidemiología , Neumonía/epidemiología , Neumonía/microbiología , Infecciones del Sistema Respiratorio/microbiologíaAsunto(s)
Enfermedad de los Legionarios/historia , Control de Enfermedades Transmisibles/historia , Salud Global , Historia del Siglo XX , Humanos , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/microbiología , Enfermedad de los Legionarios/prevención & control , EscociaAsunto(s)
Centers for Disease Control and Prevention, U.S./historia , Brotes de Enfermedades/historia , Enfermedad de los Legionarios/historia , Animales , Cobayas , Historia del Siglo XX , Humanos , Legionella pneumophila/aislamiento & purificación , Enfermedad de los Legionarios/epidemiología , Michigan/epidemiología , Philadelphia/epidemiología , Estados UnidosRESUMEN
In the summer of 1976, a mysterious epidemic of fatal respiratory disease in Philadelphia launched an intensive investigation that resulted in the definition of a new family of pathogenic bacteria, the Legionellaceae. In retrospect, members of the family had been isolated from clinical specimens as early as 1943. Unsolved epidemics of acute respiratory disease dating to the 1950s were subsequently attributed to the newly described pathogens. In the intervening years, the Legionellaceae have been firmly established as important causes of sporadic and epidemic respiratory disease. The sources of the infecting bacteria are environmental, and geographic variation in the frequency of infection has been documented. Airborne dissemination of bacteria from cooling towers and evaporative condensers has been responsible for some epidemics, but potable water systems are perhaps more important sources. The mode of transmission from drinking water is unclear. The Legionellaceae are gram-negative, facultative, intracellular pathogens. The resident alveolar macrophage, usually an effective antibacterial defense, is the primary site of growth. Cell-mediated immunity appears to be the most important immunological defense; the role of humoral immunity is less clear. Erythromycin remains the antibiotic of choice for therapy of infected patients, but identification and eradication of environmental sources are also essential for the control of infection.