Three cases of legionnaires' disease in tourists who all stayed at the same hotel in Benidorm, Spain have been reported to the surveillance scheme of the European Working Group on Legionella Infections (EWGLI). Two of the cases were British and one was Dutch. The cases (one man and two women aged between 46 and 67 years) became ill on 20 December, 29 December 1997, and 3 January 1998. One case has died and the other two remain ill. Legionella pneumophila serogroup 1 has been diagnosed by culture from all three cases and also by urinary antigen detection from two of the cases... 

Four cases of Legionnaire`s disease reported in Brighton

Weeks after three Brighton High School students contracted mild cases of Legionnaire`s disease, a 68-year-old woman has been hospitalized with the disease, health officials said. The woman was in serious condition in an intensive care unit Friday at St. Joseph Mercy Hospital, A spokeswoman said, Her name was not released. Health officials are checking whether the woman is connected to the students or to the school, where parts of the water system were found last month to have the bacteria. It appears there is no connection between the woman's case and the three students.
The three student cases were so mild they aren't officially being considered Legionnaire`s, and health officials said the school is safe. This hasn't been clear cut, said.The Livingston County medical director. But it was compelling enough that we felt we had to take some action. All three students recovered quickly after being treated with antibiotics, Health officials tested 40 water samples at the high school and seven contained the Legionnaire`s bacteria. This week, officials flushed out the water system with hot water. Flushing the system should have eradicated any of the organisms that were there.

Source Media

Health officials are investigating an increase in reports of Legionnaires' Disease in Los Angeles County, especially in the Westside and South Bay. There have been 26 confirmed this year, compared to 12 cases confirmed in 1996, said Dr. James Haughton of the Department of Health Services. And Haughton added that the number of confirmed cases may not be the full story: "There may be cases we do not know about."

In addition to the usual source of the Legionnaire's bacterium, heating and cooling systems, Haughton said that the mist used by grocery stores to keep produce fresh may also be a source.

There have been no deaths reported in the California situation. 

This report appears to be describing an increased annual incidence of legionellosis in this location, rather than an ongoing outbreak. We would appreciate information about known links among the 26 patients and identities of enviromental source(s) of the etiologic agent.

ProMed December 1997

Legionnaires' outbreak kills 72-year-old man

LOS ANGELES (January 9, 1998 1:24 p.m. EST http://www.nando.net) -- An outbreak of Legionnaires' disease has killed a 72-year-old man and sickened at least seven other people in the Culver City area. Health officials are trying to trace the source of the outbreak.

The cases occurred between Nov. 8 and Dec. 8, said Dr. Laurene Mascola, chief of acute communicable disease control with the Los Angeles County Department of Health Services.

None of the victims knew each other, and "there was no unique restaurant, bank, car wash, hamburger stand" that all visited, Mascola said Thursday.

More than 70 water samples from water towers, fountains, car washes and other sources have turned up no clues.

Legionella blamed for four deaths

Health authorities have confirmed there has been an outbreak of legionella disease in Cairns, which it is suspected has killed four people over the past couple of months.

A spokesperson from the Tropical Public Health Unit in Cairns says two people have definitely died from the disease but says it will be impossible to determine if the other two died from legionella.

The disease is different from legionaires disease, which is carried through air conditioning systems.

The health unit says legionella disease is spread through potting mixes and soil. 

MORE than 1,500 Home Office civil servants are set to join the Whitehall exodus to new premises while their London headquarters are refurbished.

Opened in 1977 at the height of Whitehall expansionism and originally designed as commercial offices, Sir Basil Spence's building at Queen Anne's Gate is already in need of renovation. Staff have been instructed not to open windows in case the glass falls on passers-by below; the cabling is inadequate for modern computer systems and there was an Outbreak of Legionnaire's Disease several months ago.

Source Media

French tourists die from Legionnaire's disease:

Two French tourists died and another is in critical condition with Legionnaire's disease contracted during a visit to Turkey, the [French] Health Ministry said on Sunday. A ministry spokesman said the tourists had returned home from Istanbul earlier this month. 

Latest information on this outbreak
Wednesday 29th October 1997

Outbreak of legionnaires' disease among French tourists associated with Turkey

Three outbreaks of travel associated legionnaires’ disease have recently been reported to/detected by the European surveillance scheme for travel associated legionnaires’ disease, EWGLI. Further information on these outbreaks will be published as details are received.

Four confirmed cases and three suspected cases are linked to a hotel in Istanbul. All the cases are from France. They stayed at the hotel during September or October and became ill between 10 September and 17 October. Five of the cases are men and two are women (age range 49 to 77 years). Two cases are reported to have died.

The European Working Group on Legionella Infections (EWGLI) collaborator in Turkey and the Turkish health authorities have been informed of the outbreak. Tour operators in France have also been informed. Environmental investigations are underway. No other cases have been associated with this hotel since the EWGLI scheme began collecting data in 1987.

Reported by Carol Joseph (cjoseph@phls.co.uk) on behalf of the European Working Group on Legionella Infections (EWGLI)

Update 30 October 1997

October 28, 1997 - From the Nando net 

Turkish hotel defends itself after reported cases of Legionnaires' disease: 

The Istanbul hotel where two French tourists who died recently of Legionnaires' disease were staying, defended its health and safety record Monday, citing regular maintenance checks. "Regular checks are carried out, once a month and even more frequently in high season," affirmed an employee at the four-star Festival hotel, situated in the touristic Cemberlitas district of Istanbul in Turkey. The French health ministry reported Sunday the deaths of two French tourists, both of whom stayed at the hotel in early October. A third victim was in serious condition. Exact details were not given.

The management of Festival Hotel, which can accommodate 200 guests, defended the hotel's health and safety record, saying that the building's air-conditioning systems, heating systems and kitchens were regularly monitored. Further checks on the hotel, which is now practically empty, were being carried out Monday by the city's health department.

Update 15 November1997

Cases of legionellosis associated with stay at the Hotel Festival in Istanbul, Turkey: update on 6 November at 1200 hours

Further details have been received this week about the outbreak of legionnaires’ disease among French travellers to Istanbul, Turkey reported on 28 October in Eurosurveillance Weekly (1). Seventeen people, 3 women and 14 men aged from 49 to 82 years (median 65 years), have been reported to have developed respiratory symptoms after staying at the Hotel Festival in Istanbul since 10 September. Four people have died (69 to 77 years of age), seven people have recovered, and six are still in hospital.

Legionella infection has been confirmed in 13 people (Legionella pneumophila serogroup 1 was isolated from five), investigations are continuing for three, and one of the cases who died had shown clinical symptoms suggestive of legionellosis but laboratory confirmation could not be obtained. Three of the four cases who died had a bacteriologically confirmed diagnosis of legionellosis.

The epidemic curve shows that one case occurred at the beginning of September, and the remaining cases during the three weeks from 2 to 23 October (figure 1). All but the first case had stayed at the hotel between 23 September and 16 October (figure 2). To date, no cases who stayed at the hotel after 16 October (the date when the hotel was identified as the probable source of the infection) have been identified.

According to a tour operator, the hotel could have accommodated 3300 people between the 1 September and 22 October 1997, an average of 470 people each week. The 12 cases confirmed during a three week exposure period at the hotel imply an attack rate in the order of 1% (the attack rate in legionellosis epidemics is usually between 0.1% and 5% [2]).

Nine people who stayed at the hotel in September or October have reported nonspecific symptoms and are being followed up. The exact number of cases associated with this outbreak cannot be known precisely yet. Results of serological tests will be known within two weeks and the possibility that these will be positive and that further cases may come to light cannot be excluded.

This report is also available in French at the Réseau National de Santé Publique (http://www.b3e.jussieu.fr:80/rnsp/).

References:

1.Joseph C. Outbreak of legionnaires’ disease among French tourists associated with Turkey. Eurosurveillance Weekly 301097 2.AS Benenson, editor. Control of communicable diseases manual. (16th edition) Washington DC: American Public Health Association, 1995 

Reported by Dr Bruno Hubert (hubert@b3e.jussieu.fr), Dr Bénédicte Decludt (decludt@b3e.jussieu.fr) Réseau National de Santé Publique, Saint Maurice, France, and Prof Jérome Etienne, Centre de Référence des Legionella, Lyon, France

Five cases have been associated with an apartment hotel in Albufeira, Portugal. The cases, one reported from the Netherlands, two from Scotland, and two from England, became ill in May, July, August (2), and October. Three cases are men, two women (age range from 30 to 67 years). No deaths have been reported.

The EWGLI collaborator and the Ministry of Health in Portugal and the UK Federation of Tour Operators have all been informed. Investigations carried out by local health authorities in Portugal on the hotel’s air conditioning and water systems are reported to be negative for legionella.
1997

One dead, two ill after suffering Legionnaire`s Disease

Health authorities are investigating the Internal Revenue Service building where one person died and two others became ill with symptoms similar to Legionnaires' disease. a 59-year-old revenue officer, died earlier this month after suffering high fever and aches similar to Legionnaire`s Disease. As yet this has not been confirmed as the cause of her death. Two other worker reported similar illnesses . Water samples were taken at the building, and employees were asked to notify supervisors if they experience any flu-like symptoms. The building houses 600 workers . The Harris County Health Department and the federal Occupational Safety and Health Administration were investigating. The respiratory disease is caused by bacteria that thrive in , standing water such as cooling towers or airconditioning.
It was identified in 1976 after an outbreak at an American Legion convention in Philadelphia killed 29 people.

Tainted hot-water system may be source of disease 

Federal officials Thursday pinpointed a contaminated hot water system at the Alliance Tower, where a fatal case of Legionnaires' Disease may have originated. 

"The offending system is the hot water system that feeds most of the building," said the Internal Revenue Service spokesman .

Initial laboratory tests indicate enough bacteria were present in the hot water supply to cause the disease, the government said. 

About 600 IRS employees occupy part of the 12-story building in which at least two other suspected cases of Legionnaires' infecting revenue service workers are also being investigated. 

"We do not have to shut down the building, as the system is being treated," Yost said. 

The hot water system, previously kept on a temperature too cool to kill such Legionella bacteria as part of a national energy conservation policy, has remained turned off since last week, officials said. 

"The hot water system is maintained at 105 degrees, according to national policy," said Gil Bryant, real property manager for the General Services Administration, which oversees maintenance of federal buildings. 

But city of Houston Health Department spokeswoman said hot water temperature must be maintained between 122 and 140 degrees Fahrenheit to kill the Legionella bacteria. 

"The water needs to be purified through boiling, filtering or hyperchlorinating," she said. 

Legionnaires' is considered an environmental disease contracted when people have inhaled water vapor infected with Legionella bacteria, according to the Federal Centers for Disease Control and Prevention. 

The bacteria live in hot-water systems, showers, whirlpools and air-conditioning cooling towers, and may breed to deadly levels. 

Inside the lungs, Legionella multiply quickly. Symptoms, which come within 10 days, are headaches, nausea, high fever and diarrhea. The symptoms can develop into pneumonia. 

Ethromycin, an antibiotic, does not kill the Legionella, but prevents it from multiplying intracellularly, giving the immune system a chance to prevail. 

The longtime IRS employee ,died July 6 after experiencing a sudden and severe bout of pneumonia and high fever being characterized as "Legionnaires' symptoms," Yost said. 

At least two other IRS co-workers may be infected with the bacteria, he said. 

Officials eliminated as a possible source of contamination a now-defunct wastewater recycling system disconnected last fall at the Alliance Tower, 8701 S. Gessner, in Southwest Houston. 

Another source usually investigated in these cases are a building's cooling towers. 

Cooling towers in metropolitan areas are difficult to keep clean and usually operate at about 95 degrees. They receive hot water from condensers and spray it over a fill material through which air is forced in counterflow to the water. 

As condensation tends to occur around dust and particles, evaporative coolers have a filtering effect on the air and collect dirt in the water.

It was said "a hint of bacteria" was also found in the Alliance air-conditioning system. 

But further investigation is needed to tie in the Legionnaires' cases with the building's contamination, he said. 

In personal use, preventing the Legionella bacterial growth is relatively simple, said Jennifer Eppes of Royal Baths Manufacturing. 

She recommended a whirlpool system that uses rigid PVC piping rather than flex piping that can sag and not fully drain, allowing stagnant water and body oils to catch in the grooves and grow bacteria. 

A routine monthly cleaning is also recommended by using one cup of chlorine bleach or vinegar run through the system for five minutes with hot water, Eppes said. When drained, fill with cold water and run the system another five minutes. 

The Legionella bacteria was discovered in 1976 as the end result of the Legionnaires Disease outbreak in Philadelphia that caused 200 cases, and was found to have caused a similar outbreak the previous year at the same hotel. 

Four cases of Legionnaires' disease have been confirmed in northwest suburban Woodstock, and three more suspected cases are under study, health officials 

Two people with the disease are hospitalized and two others already have been released, 
said a spokesman for the Illinois Department of Public Health.

All seven people live in the north-central section of Woodstock and range in age from 47 to 84. The first case was confirmed July 22 and the most recent on Aug. 1, 

The McHenry County public health administrator, said the only known link between the cases is that all seven live in Woodstock.

The respiratory disease, an acute form of pneumonia, is caused by the bacterium Legionella, contracted by inhaling mist from a contaminated water source.

The bacteria is often in warm, stagnant water, such as air conditioning cooling towers, air-conditioner condensation pans, whirlpool spas, room humidifiers and hot water tanks turned to low temperatures, officials said. All seven people are believed to have been exposed to the bacteria between July 10 and July 29, The fact no more cases have been confirmed since then is good, but it complicates trying to identify sources of exposure,'' he said.

It usually takes two to 10 days for symptoms to occur. The disease cannot be contracted from another person, officials said. Investigators have taken water samples and asked victims and others to fill out questionnaires.

Most vulnerable are middle-aged and elderly people, heavy smokers, people with emphysema or other chronic respiratory ailments and those with weakened immune systems, Bacon said.

Symptoms include a cough, fever and chills and sometimes muscle aches, headaches, fatigue, loss of appetite or diarrhea, officials said. Erythromycin is the antibiotic of choice for treating the disease.

Statewide, from 1989 through 1996, there were 277 cases and 70 deaths from Legionnaires' disease.

Legionnaires' case called isolated

CHAMBERSBURG 

A Chambersburg man died of Legionnaire`s disease at Chambersburg Hospital , the second person in a month to be treated for the illness in what hospital officials say are isolated and unrelated cases.

The man died of the pneumonia-like illness after a month-long stay at the hospital, 

Chambersburg Hospital officials would not confirm the man died there of the disease.

Another patient was treated for the illness at the hospital early last month and released, according to a spokeswoman .

"It's not unusual to see a few isolated cases this time of year,"

Legionnaires' bacteria breeds in warm water and is contracted by inhaling bacteria transmitted in airborne water particles from a water source such as lakes and ponds or large air-conditioning systems or cooling towers, according to state health officials.

Chambersburg Hospital's hot water system and three air conditioning cooling towers are treated and tested weekly.

Tests have been negative for the Legionella bacteria for a year, it was said.

the man got sick on July 7 with aches and a high fever which progressed into other flu-like symptoms including vomiting and diarrhea, said a nurse at a Carlisle, Pa. nursing home.

He was admitted to Chambersburg Hospital on July 10 for dehydration and then took a turn for the worse a few weeks later with symptoms of pneumonia, 

Then he suffered kidney failure and damage to his liver and pancreas, 

This certainly represents no threat to the community. This is in no way close to being like the situation Chambersburg had in 1995," the deputy press secretary for the state Department of Health said.

The state averages about 120 Legionnaires' disease cases every year, the vast majority occurring as single, isolated cases not associated with any recognized outbreak, 

"There's no indication of an outbreak at Chambersburg Hospital," he added.

In the summer of 1995, Chambersburg Hospital was the source of the state's largest outbreak of Legionnaires' disease since 1976. In the 1995 outbreak, three Chambersburg area residents died and several others were infcted.

Tests showed the bacteria was present in the air and in two cooling towers on the roof of the hospital.

Legionnaires' Disease kills woman

Chambersburg Hospital officials say a 55-year-old woman died Monday evening from complications brought on by Legionnaires' disease. She is the second Chambersburg resident to die from the disease this month and the number of suspected and confirmed cases continued to grow Tuesday. 

Note:
THE 1976 OUTBREAK OF LEGIONNAIRE`S DISEASE AT THE BELLEVUE-STRATFORD HOTEL WAS NEVER PROVED THAT THE OUTBREAK WAS CAUSED BY THE HOTELS AIRCONDITIONING SYSTEM 
(Denis Green)

Seven cases of legionnaires’ disease have been confirmed since week 23 of 1997 by the Scottish Legionella Reference Laboratory, all of whom had travelled during the 10 days before becoming ill. These cases bring the 1997 total to the end of week 27 to 12 cases, 10 of whom were related to travel (table 1) and two acquired in hospital. Eleven cases were confirmed in the same period of 1996; 15 of the 24 cases in 1996 overall were associated with travel.

All the cases in 1997 thus far have been due to infection with Legionella pneumophila serogroup 1, and 10 have been patients aged over 50 years. Two of the patients are known to have died.

Table 1: Destinations of cases of travel associated legionnaires’ disease confirmed in Scotland to week 27 of 1997

Eurosurveillance Weekly 17 July 1997

International Investigation of an Outbreak of Legionnaires’ Disease at a Major Hotel Associated with Potable Water-Antigua, 1996 C. J. Hospedales, C. Joseph, J.Lee, K. Lewis-Belle, L. Michael and M. Francis Caribbean Epidemiology Centre, Port-of-Spain, Trinidad, Communicable Disease Surveillance Centre, London and Environemental Research Unit, Nottingham, England and the Ministry of Health, Antigua and Barbuda

On November 9, 1996, the Caribbean Epidemiology Centre and the UK Public Health Laboratory Service began an investigation of 3 cases of Legionnaires’ disease (LD) in English tourists staying in an Antiguan hotel in September and October, 1996. The medical records at the island’s two hospitals and the hotel’s nursing records were reviewed to identify any additional cases. A suspect case was defined as any guest or employee of the hotel since August 1, 1996 with fever and cough, and a confirmed case as one with clinical or radiological evidence of pneumonia plus laboratory evidence of recent Legionella pneumophila infection. Two cases were confirmed by high titre to Lp-1, and the third by culture of Lp-1 from sputum. Thirteen other suspected cases from four other countries were identified and are being followed up. Chlorine residual levels were satisfactory in the cold water. The hotel’s mains supply and hot and cold water distribution system contained L.pneumophila including Lp-1. Concentrations were highest in the hot water system, particularly the solar storage tanks, and in samples collected from rooms that had not been used for several days. Water samples from the rooms where the cases had stayed contained Lp-1 in high concentration. We concluded that the hotel’s hot water supply was the source of the outbreak and recommendations were made to prevent further cases from occurring. This outbreak has important implications for clinical practice and public health in the Caribbean, and the region’s hotel industry. 

Update
Legionnaire's outbreak on island

VISITORS to a hotel on the Caribbean island of Antigua have been offered alternative accommodation after three British holidaymakers who had stayed there contracted Legionnaire's Disease.

The three, whose names have not been released, visited the island in September but their illness was only recently revealed. All have now recovered and no further cases have been discovered, said a spokesman for the Antigua and Barbuda Tourist Board.

This week, specialists from the Communicable Disease Surveillance Centre and the Public Health Laboratory Service in London flew to Antigua to investigate the source of the infection. Their report is expected within two weeks.

Some holidaymakers at the St James's Club, where the three sufferers stayed, have moved to other hotels, but many decided to stay on.
The hotel's manager , said possible sources of the disease, including the water supplies, had been checked. The hotel does not have central air-conditioning, which is sometimes connected with the spread of Legionnaire's. 

Probe after Ninewells patient gets killer bug 

A FULL-SCALE investigation was launched last night into the source of an outbreak of potentially fatal Legionnaires' disease in Ninewells Hospital in Dundee.

A middle-aged man is seriously ill in intensive care after contracting the killer bug during a prolonged stay at the hospital.

Dundee Teaching Hospitals confirmed last night that they are investigating the source of what they believe is an "isolated" incident.

Although no details are being released by the hospital at the request of the family, it is believed that the man spent around five weeks in the coronary care department.

Hospital microbiologists are now trying to conclusively identify the organism, which was first detected in the man's respiratory tract during routine tests.

It is certain, however, that the bug - which has an incubation period of between two and 10 days - was contracted during his stay in the hospital.

A Ninewells spokesman said last night, "An organism which is possibly legionella has been grown from the respiratory tract of a patient being looked after in Dundee Teaching Hospitals.

"Rather than wait for confirmation of the findings from the reference laboratory, immediate steps have been taken to investigate the possibility that it may have been acquired during the patient's stay in hospital.

"At this stage we have no evidence of any other cases in the hospital, but the situation will be closely monitored and a search for a possible reservoir is under way."

While unable to say in which department the man had been detained, the hospital spokesman confirmed that no department has been closed.

He stressed that the bug could have been picked up from a wide variety of "individual" sources within the hospital but not related to the department itself.

Hospital staff are now backtracking through areas where the patient affected has been and checking for other cases in patients and staff. No outside agencies have been brought in.

The hospital spokesman said that the operation is well under way, although it is not yet clear when the results of the tests will be available.

He also stressed that they believe it to be an "isolated case" and that patients already admitted or preparing for a stay in the hospital have "no cause for anxiety."

Recent statistics reveal that Legionnaires' disease affects around 25 people in Scotland every year. The legionella bacterium lives in areas of undisturbed water, such as cooling towers, evaporative condensers and large water tanks.

Its name comes from the first identified cases, when 29 people fell ill with the bug at an American Legion convention in Philadelphia in 1976.

Hospitals in bug probe 

TWO HOSPITALS have been the source of an investigation this week after a Fife patient almost died when she was struck down by Legionnaire's disease.
Cardenden grandmother Agnes Brady (51) was taken to Victoria Hospital in Kirkcaldy last month suffering from angina.
Recognising a need to increase the blood flow to her heart, staff transferred her to the Western General Hospital in Edinburgh, where she was operated on.
But shortly after being discharged, Mrs Brady fell ill again, and doctors at the Western found that she had the legionella bacteria.

Since then, tests have been carried out at both the hospitals to find the source of the bug.

But a spokesman for the Victoria denied yesterday that it came from there.

"Tests at the Victoria have proved totally negative," he said.

"There is no evidence that she caught Legionnaire's disease at the Victoria Hospital."

A spokesman for the Western General said, "We are continuing to carry out our investigations to find the source of the bug."

Legionnaires Disease Found At New Jersey Bathroom tten sick...but they've closed two bathrooms at the New Jersey Highway Authority's Woodbridge headquarters because of the bacteria that causes Legionnaire's disease. m's been flushed....but the results of tests taken yesterday won't be available for two weeks. 

Woodbridge health officials closed a Motor Lodge on Route 9 yesterday, after state lab results indicated that a California man died last month from Legionnaire's disease he contracted at the motel. They also matched the bacterial strain taken from the victim with samples taken from three people who contracted the disease in the motel three years ago. 

IF ANYONE HAS INFORMATION ON ANY OF THIS, PLEASE EMAIL ME THE DETAILS....THANKS

Disease Death Shuts Motel 

TRENTON 
Health officials have closed a Woodbridge motel indefinitely after confirming that a California man who stayed there died last month of Legionnaires' disease. 

The pneumonia-like respiratory illness sickened three guests at the same motel in 1994. 

Water samples taken from the shower heads in the 44-year-old businessman's room and a second room at the Budget Motor Lodge on Route 9 last week contained legionella, the bacteria causing the disease, officials said yesterday. 

The legionella strain in the dead man's body matched the strain isolated in water samples taken from the Middlesex County motel after the 1994 cases, said Dr. Faye Sorhage of the state Department of Health and Senior Services. 

The victim, of Lemoore, Calif., was a consultant working temporarily at the Woodbridge Haagen-Dazs plant. He died May 23. 

Motel management is working with state and federal health officials to devise a strategy to eliminate the bacteria. Health workers have been contacting about 850 recent motel guests, but none of the 600 interviewed so far has reported illness.

Legionella in New Jersey

(6/20/97)

Rt. 9 motel closed as tests reveal bacteria

Woodbridge health officials closed a Motor Lodge on Route 9 yesterday, after state lab results indicated that a California man died last month from Legionnaire's disease he contracted at the motel.

State health inspectors found high concentrations of legionella, the bacterium that causes the pneumonia-like illnes on the shower head in the man's room.

They also matched the bacterial strain taken from the victim with samples taken from three people who contracted the disease in the motel three years ago...

After the 1994 disease "cluster," state and township officials ordered a complete flushing of the hotel's water system. An automatic chlorinating system also was installed and subsequent tests indicated that the bacterium was not present.

The township requested a list of all motel guests from May 1 to the present, a list of more than 700. The health department has called about half of the guests since then, and none has reported any symptoms of the disease.

The state official, described legionella as "ubiquitous." "It is found out in nature," the epidemiologist said. "You could grab some water from a puddle by your house and find it there."

The water-borne bacterium becomes a problem only when the liquid takes a mist form, or is "aerosolized." That can happen in an airconditioner or a shower head, he explained.

State officials will order the motel's water system to be superheated and flushed Monday to kill off the bacterium.

A resident of the state's home for the mentally disabled in Woodbridge was hospitalized with Legionnaire's disease last week.

Aug. 12 1997

An organism that causes Legionnaires' disease and other bacteria were found in a cooling system at the Occupational Safety and Health Administration building, prompting officials to send workers home.

Legionella premophilia, the bacterium that causes Legionnaires' disease, was found in water inside a cooling tower during a routine inspection Monday, 

All 18 OSHA workers were sent home about noon. 

About 65 employees of Shawnee Hills Inc., which shares the building, also were told to leave the building.

Legionnaires' disease got its name from an American Legion convention where it was first discovered in 1976. Symptoms include pneumonia, dry cough and muscular pain.

The Shawnee Hills spokesman said the building's owner is expected to have the air-conditioning water "debugged'' by Wednesday.

It was not known where the OSHA employees would work until the problem is corrected. The Charleston office is OSHA's only West Virginia facility.

Investigation of An Legionnaires' Disease Outbreak Associated with Contaminated Air-Conditioning System 

Ma Xiaoyan*,Wang Yuqin, Peng Xiaoming,et al. *
Department of Epidemiology ,Beijing Municipal Center for Hygiene and Epidemic Control, Beijing 
Abstract
An outbreak of upper respiratory infection (influenza-like syndrom) took place among the staff members of a large office building in Beijing,June, 1997.To understand the cause of the outbreak, with a case-control study with serological antibodies detection against serogroup 1 to 14 of Legionnaires' disease bacteria (LDB) and bacteriological test and culture on samples collected from the air-conditioning system of the office building was performed. The findings showed that the attack rates of tongillitis and upper respiratory infection were 61.86% and 34.62% respectively. The relation was statistically significant between the symptoms of fever and tonsillitis in the cases (¦Ö 2=77.88,P£¼0.01). The positive rates of LDB antibodies on serogroups 9, 10, 12,14 were 45.94% in the cases of upper respiratory infection and 3/15,6/17,0/15,1/16 respectively in the four controls groups. Condensied water samples from an air-conditioning system showed that Legionella Pneumophila was positive. Evidence showed that it was an outbreak resulting from LDB serogroup 9 and 12, accompanied by upper respiratory infection related to air-conditioning system contaminated by LDB. 

This was the first report Lp infection associated with an air-conditioning system in China.