Environmental surveillance of Pseudomonas aeruginosa in recreational waters in tourist facilities of the Balearic Islands, Spain (2016-2019).

BACKGROUND: Pseudomonas aeruginosa is a major opportunistic human pathogen commonly connected with recreational water activities. Spain is a tourist destination where most of the establishments have swimming pool. Nevertheless, the prevalence of P. aeruginosa in public swimming pools in our country is unknown. This works aimed to survey the P. aeruginosa presence in tourist Spanish recreational waters. METHOD: Tourist recreational water in hotels in the Balearic Islands were visited for four years (2016-2019). The levels of selected parameters were determined, and their correlation with P. aeruginosa contamination investigated. RESULTS: We evaluated 11,014 samples from 254 facilities. Unacceptable levels of at least one legislated parameter were detected in 30.7% of cases, implicating closure in 15.9%, being P. aeruginosa the leading cause of closure. The prevalence of the pathogen was 14.2%, with lower presence in outer swimming pools. Disinfectant levels influence P. aeruginosa contamination, and bromine-maintained pools were more often contaminated than those treated with chlorine. Prevalence remained constant over the years, although it increased in 2019. CONCLUSIONS: P. aeruginosa prevalence in our recreational waters is similar to other countries, and the contamination rates depend on the installations and type and disinfectant levels. Corrective measures are still needed to improve pathogen control.

Environmental surveillance of Legionella in tourist facilities of the Balearic Islands, Spain, 2006 to 2010 and 2015 to 2018.

BackgroundLegionnaires' disease is a respiratory illness often associated with hotels and travel. Spain is a major tourist destination and one of the European countries with most cases of Legionnaires' disease , both community- and travel-associated. However, the prevalence of Legionella in tourist facilities is unknown.AimThe present investigation aimed to survey the tourist facilities in the Balearic Islands, Spain, for Legionella prevalence.MethodsWe visited tourist facilities in the Balearic Islands in two different periods (2006-2010 and 2015-2018) and took water samples following national and international guidelines. Legionella was investigated by culture methods following international standards (ISO 11731:1998).ResultsWe evaluated 13,472 samples from 465 facilities. Bacteria of the Legionella genus were detected in 65.4% of the surveyed facilities. Contamination of the facilities was significantly higher during the second decade (54.5 vs 78.6%). The most frequent colonisers were L. pneumophila serogroup 2-14. We detected the pathogen in 15.9% and 6.9% of hot and cold water distribution systems samples, respectively. The Legionella contamination rate in cold water systems samples was higher when free chlorine levels were < 0.2 mg/L and at > 25 °C temperatures, while in the hot water systems samples, the contamination rate was higher at < 50 °C. Of the samples from hot tubs, 10.9% were contaminated.ConclusionLegionella prevalence in hotels in the Balearic Islands was high but the contamination rates depended on the installations. Corrective measures are still needed to improve Legionella control.

Determination of Legionella spp. prevalence in Spanish hotels in five years. Are tourists really at risk?

Legionella spp. is the etiological agent of the serious respiratory pneumonia known as Legionnaires' disease. This respiratory illness is frequently associated with travel and tourist resorts. Spain is an important tourist destination, and one of the top European countries concerning Legionnaires' disease cases, both community and travel associated. Still, the colonization of Legionella in our hotels remains scarce. Here, we surveyed 204 hotels in the Canary Islands, Spain, for five years (2015-2019), to determine the Legionella prevalence. Samples were obtained and analysed following national and international guidelines. We detected the pathogen in 140 of 2,318 samples (6.0%). The water distribution systems (WDS) were more colonized (7.4%) than the whirlpools (4.7%). Contamination levels were minimal (<3 log CFU L-1) in most of the cases, and only 3.6% of samples were highly contaminated minimal (>4 log CFU L-1). We isolated Legionella in 4.3% and 8.5% of cold and hot water distribution systems, respectively. The Legionella prevalence in cold water systems samples was higher when free chlorine levels were below 0.2 mg L-1, whereas in the hot water systems samples, the prevalence was higher at <50 °C. Legionella pneumophila was the most frequently isolated species, being the members of the serogroups 2-14 the most prevalent. The annual distribution showed a colonization pick in June, followed by the winter months. Regarding the geographical distribution, the presence of Legionella was more prevalent in the western islands. Our study concludes that Legionella contamination rates in samples from facilities of the Canary Islands is lower than most of the observed in other European studies. However, corrective measures are still needed to improve Legionella control.

Brote de gastroenteritis causado por norovirus en un hotel de Menorca, España / Norovirus outbreak causing gastroenteritis in a hotel in Menorca, Spain

OBJETIVO: Determinar el agente responsable de un brote de gastroenteritis ocurrido en un hotel de Menorca en septiembre de 2016. MÉTODOS: Se estudió la epidemiología de los casos y se investigaron muestras ambientales y clínicas para la presencia de microorganismos indicadores y patógenos. RESULTADOS: Se detectaron 151 casos: 123 afectaron a clientes y 28 a personal. Los análisis microbiológicos detectaron la presencia de norovirus genotipo II en heces de pacientes, así como en habitaciones y zonas comunes. El plan de control implementado permitió la erradicación del brote. CONCLUSIONES: Este estudio del brote causado por norovirus del genotipo II demuestra que una rápida actuación es crítica para controlar este tipo de brotes

OBJECTIVES: To establish the agent responsible for a gastroenteritis outbreak in a hotel in Menorca (Spain) in September 2016. METHODS: The study included epidemiological and laboratory analysis. Environmental and stool samples were examined for bacterial and viral pathogens. RESULTS: One hundred and fifty-one cases were detected, 123 among the tourists staying in the hotel and 28 affecting the staff. The presence of genotypeII norovirus was discovered in the microbiological studies of patient's faeces, as well as in the surface samples of rooms and common areas. The control plan implemented allowed for control of the outbreak. CONCLUSIONS: This study on a genotypeII norovirus outbreak reveals the importance of a rapid response for controlling these types of outbreaks

Norovirus outbreak causing gastroenteritis in a hotel in Menorca, Spain. / Brote de gastroenteritis causado por norovirus en un hotel de Menorca, España.

OBJECTIVES: To establish the agent responsible for a gastroenteritis outbreak in a hotel in Menorca (Spain) in September 2016. METHODS: The study included epidemiological and laboratory analysis. Environmental and stool samples were examined for bacterial and viral pathogens. RESULTS: One hundred and fifty-one cases were detected, 123 among the tourists staying in the hotel and 28 affecting the staff. The presence of genotypeII norovirus was discovered in the microbiological studies of patient's faeces, as well as in the surface samples of rooms and common areas. The control plan implemented allowed for control of the outbreak. CONCLUSIONS: This study on a genotypeII norovirus outbreak reveals the importance of a rapid response for controlling these types of outbreaks.

Efficient management of a norovirus outbreak causing gastroenteritis in two hotels in Spain, 2014 / Control de un brote de gastroenteritis causado por norovirus en 2 hoteles en España, 2014

OBJECTIVES: To determine the aetiological agent causing a gastroenteritis outbreak in two hotels in Majorca (Spain) on August and September 2014. METHODS: An epidemiological study was carried out. Environmental and stool samples were analyzed for different pathogens, including norovirus. RESULTS: Epidemiological analysis detected 79 cases among the tourists hosted in the affected hotels over the period 18th August to 3rd September. They included 52 (attack rate: 6.4%) and 27 (attack rate: 3.0%) cases in hotel A and B, respectively. Seven of the staff members were also affected. Microbiological analyses detected genotype 2 norovirus in patient's stool samples, in rooms and in common areas' surfaces. The specific control plan rapidly implemented at the beginning of the outbreak, and further adapted for norovirus elimination, allowed to control the outbreak. CONCLUSIONS: Our study demonstrates that the outbreak was caused by genotype 2 norovirus, and reflects the importance of a rapid analysis and response for its control

OBJETIVOS: Determinar el agente etiológico responsable del brote de gastroenteritis producido en 2 hoteles de Mallorca (España) en agosto y septiembre de 2014. MÉTODOS: Se realizó un estudio epidemiológico y se analizaron muestras ambientales y de heces para la presencia de patógenos, incluyendo norovirus. RESULTADOS: El análisis epidemiológico detectó 79 casos entre los clientes hospedados en los hoteles desde el 18 de agosto al 3 de septiembre: 52 en el hotel A (tasa de ataque: 6,4%) y 27 en el B (tasa de ataque: 3,0%), así como en 7 miembros del personal. Los análisis microbiológicos detectaron norovirus genotipo 2 en las heces de los pacientes y en las superficies de las habitaciones y zonas comunes. El plan específico implementado rápidamente y adaptado para la eliminación de norovirus permitió el control del brote. CONCLUSIONES: En este brote causado por norovirus del genotipo 2 se refleja la importancia de un análisis y una respuesta rápida para su control

Efficient management of a norovirus outbreak causing gastroenteritis in two hotels in Spain, 2014.

OBJECTIVES: To determine the aetiological agent causing a gastroenteritis outbreak in two hotels in Majorca (Spain) on August and September 2014. METHODS: An epidemiological study was carried out. Environmental and stool samples were analyzed for different pathogens, including norovirus. RESULTS: Epidemiological analysis detected 79 cases among the tourists hosted in the affected hotels over the period 18th August to 3rd September. They included 52 (attack rate: 6.4%) and 27 (attack rate: 3.0%) cases in hotel A and B, respectively. Seven of the staff members were also affected. Microbiological analyses detected genotype 2 norovirus in patient's stool samples, in rooms and in common areas' surfaces. The specific control plan rapidly implemented at the beginning of the outbreak, and further adapted for norovirus elimination, allowed to control the outbreak. CONCLUSIONS: Our study demonstrates that the outbreak was caused by genotype 2 norovirus, and reflects the importance of a rapid analysis and response for its control.

Microbiological levels of randomly selected food contact surfaces in hotels located in Spain during 2007-2009.

The aim of this study was to survey the microbial levels of food contact surfaces in hotels. Microbiological levels of 4611 surfaces (chopping machines, kitchenware, knives, worktops, and cutting boards) from 280 different facilities in Spain were determined in a 3-year period. The contact-plate technique was used throughout the survey. Overall, the mean of the log of total aerobic count cm(-2) was 0.62, better than those reported for child-care and assisted living facilities. Significant differences were detected among different types of surfaces, time of sampling, season, and year. The majority (74%) of food contact surfaces sampled in Spanish hotels was within the recommended standard of <1.3 log CFU cm(-2), and differences depend on several factors. Our results set a representative picture of the actual situation in our resorts and establish the basis for the development of educational programs to improve food handlers' knowledge of foodborne diseases and their transmission via food contact surfaces.

Emetic disease caused by Bacillus cereus after consumption of tuna fish in a beach club.

Several vomiting episodes were reported in December 2007 by the management of a beach club in Calvià. The subsequent case investigation confirmed tuna fish consumption a few hours before onset of emesis in all cases. Microbiological analyses detected high bacterial levels in ready-to-eat fish samples, indicating inappropriate cooking procedures. More important, elevated levels of Bacillus cereus were present both in raw and cooked fish. No other pathogens were detected, indicating B. cereus as the etiological agent. To our knowledge, this is the first case of emetic disease by B. cereus likely to be associated with fish consumption.