Subject(s)
Disease Outbreaks/prevention & control , Immunization, Secondary/methods , Measles/epidemiology , Adult , Disease Outbreaks/economics , Female , Health Care Costs , Humans , Immunization Schedule , Incidence , Male , Measles/immunology , Measles Vaccine/administration & dosage , Middle Aged , Risk Factors , Universities/statistics & numerical data , Washington/epidemiologyABSTRACT
A multistate outbreak of Legionnaires' disease occurred among nine tour groups of senior citizens returning from stays at one of two lodges in a Vermont resort in October 1987. Interviews and serologic studies of 383 (85%) of the tour members revealed 17 individuals (attack rate, 4.4%) with radiologically documented pneumonia and laboratory evidence of legionellosis. A survey of tour groups staying at four nearby lodges and of Vermont-area medical facilities revealed no additional cases. Environmental investigation of common tour stops revealed no likely aerosol source of Legionella infection outside the lodges. Legionella pneumophila serogroup 1 was isolated from water sources at both implicated lodges, and the monoclonal antibody subtype matched those of the isolates from six patients from whom clinical isolates were obtained. The cultures reacted with monoclonal antibodies MAB1, MAB2, 33G2, and 144C2 to yield a 1,2,5,7 or a Benidorm 030E pattern. The strains were also identical by alloenzyme electrophoresis and DNA ribotyping techniques. The epidemiologic and laboratory data suggest that concurrent outbreaks occurred following exposures to the same L. pneumophila serogroup 1 strain at two separate lodges. Multiple molecular subtyping techniques can provide essential information for epidemiologic investigations of Legionnaires' disease.
Subject(s)
Disease Outbreaks , Legionella pneumophila/classification , Legionnaires' Disease/epidemiology , Adult , Aged , Aged, 80 and over , Antibodies, Monoclonal/immunology , Female , Humans , Legionella pneumophila/genetics , Legionella pneumophila/immunology , Legionnaires' Disease/etiology , Male , Middle Aged , Travel , Water MicrobiologyABSTRACT
An outbreak of "humidifier fever" affected 16 (57%) of 28 workers in a print shop. The most common symptoms were myalgia, chills or subjective fever, and cough. Illness began 5-13 hours after entering the workplace, and lasted 2-24 hours. A humidifier in use the day of the outbreak was found to be contaminated with fungi, amebae, and Gram-negative bacteria. The risk of illness was highest for those who had been on the job 3 months before the outbreak, a time when the humidifier was in constant use. Serologic studies of print shop workers showed positive reactions to extracts of organisms isolated from the humidifier, but could neither distinguish ill from well workers, nor identify causative organisms. The presence of endotoxin-producing bacteria and the clinical syndrome are consistent with an organic dust toxic syndrome. Previous exposure appeared to be the major risk factor for illness.
Subject(s)
Bacterial Infections/epidemiology , Book Industry , Disease Outbreaks , Fever/epidemiology , Humidity , Occupational Diseases/epidemiology , Printing , Water Microbiology , Acute Disease , Adult , Bacterial Infections/microbiology , Female , Fever/microbiology , Humans , Male , Middle Aged , Occupational Diseases/microbiology , Risk Factors , Time Factors , Vermont/epidemiologyABSTRACT
The Vermont Department of Health reviewed 2,035 reports of selected notifiable diseases received from January 1, 1986, through December 31, 1987. Laboratories provided 1,160, or 71 percent, of the initial reports on 1,636 confirmed cases. This demonstrates that laboratories, when required by law and when part of active surveillance, can make a significant contribution to surveillance of infectious disease. A survey of primary care physicians indicated that 18 percent always reported notifiable diseases. The most frequently mentioned reason for lack of reporting was an assumption that the laboratory would report the cases.
