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Chapter 57 : Cooling Towers and Legionellosis: a Large Urban Area Experience

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Cooling Towers and Legionellosis: a Large Urban Area Experience, Page 1 of 2

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Abstract:

In France, the risk of legionellosis associated with cooling systems had been underestimated for a long time because until 1998, no community outbreak had been related to these devices. The health risk was not taken into account and no risk assessment was developed to manage the cooling system. However, recommendations for prevention of legionellosis were provided in governmental guidelines published in 1997. The maintenance of cooling towers and control of were not mandated by law. Only compressors associated with cooling systems were submitted for regulation as detrimental devices for the environment. This chapter describes a Parisian experience, including two outbreaks, which should lead companies to improve the health aspects of managing cooling towers. and were determined in accordance with the French standard procedure XP T 90-431. The two patient isolates (, serogroup 1) had indistinguishable fingerprints using pulsed-field gel electrophoresis and arbitrarily primed PCR to strains isolated from water of one particular cooling tower. Legionella recovered from cooling towers examined during two outbreaks in Paris have been provided in the chapter.

Citation: Dubrou S, Challemel O, Carlier D, Lawrence C, Squinazi F, Guillotin L, Van Gastel B, Gabon S, Decludt B, Etienne J. 2002. Cooling Towers and Legionellosis: a Large Urban Area Experience, p 291-294. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch57

Key Concept Ranking

Pulsed-Field Gel Electrophoresis
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Legionella pneumophila
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Figures

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FIGURE 1

Distribution of counts in cooling systems.

Citation: Dubrou S, Challemel O, Carlier D, Lawrence C, Squinazi F, Guillotin L, Van Gastel B, Gabon S, Decludt B, Etienne J. 2002. Cooling Towers and Legionellosis: a Large Urban Area Experience, p 291-294. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch57
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Image of FIGURE 2
FIGURE 2

Areas associated with two outbreaks of Legionnaires' disease linked to cooling towers in Paris. First outbreak in June 1998 (insert image), 20 cases, 39 facilities with cooling systems, 3.2 km; ▲, incriminated cooling tower. Second outbreak in August 1999 (insert image), 8 cases, 20 facilities with cooling systems, 1.5 km; ▲, incriminated cooling tower.

Citation: Dubrou S, Challemel O, Carlier D, Lawrence C, Squinazi F, Guillotin L, Van Gastel B, Gabon S, Decludt B, Etienne J. 2002. Cooling Towers and Legionellosis: a Large Urban Area Experience, p 291-294. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch57
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References

/content/book/10.1128/9781555817985.chap57
1. Anonymous. 1993. Norme XP T 90-431. Essais des eaux. Recherche et denombrement des Legionella et Legionella pneumophila. Methode generale par ensemencement direct et filtration sur membrane. Association Francaise de Normalisation, Paris, France.
2. Decludt, B.,, L. Guillotin,, B. Van Gastel,, S. Dubrou,, S. Jarraud,, A. Perrocheau,, D. Carrier,, M. Reyrolle,, L. Capek,, M. Ledrans,, and J. Etienne. 1999. Epidemic cluster of Legionnaires' disease Paris, June 1998. Eurosurveillance 4:115118.
3. Fiore, A. E.,, J. P. Nuorti,, O. S. Levine,, A. Marx,, A. C. Weltman,, S. Yeager,, R. F. Benson,, J. Pruckler,, P. H. Edelstein,, P. Greer,, S. R. Zaki,, B. S. Fields,, and J. C. Butler. 1998. Epidemic legionnaires' disease two decades later: old sources, new diagnostic methods. Clin. Infect. Dis. 26:426433.
4. Keller, D. W.,, R. Hajjeh,, A. DeMaria, Jr.,, B. S. Fields,, J. M. Pruckler,., R. S. Benson,, P. A. Kludt,, S. M. Lett,, L. A. Mermel,, C. Giorgio,, and R. F. Breiman. 1996. Community outbreak of legionnaires' disease: an investigation confirming the potential for cooling towers to transmit Legionella species. Clin. Infect. Dis. 22: 257261.
5. Lawrence, C.,, M. Reyrolle,, S. Dubrou,, F. Forey,, B. Decludt,, C. Goulveste,, P. Matsiota-Bernard,, J. Etienne,, and C. Nauciel. 1999. Single clonal origin of high proportion of Legionella pneumophila serogroup 1 isolates from patients and the environment in the area of Paris over a 10-year period. J. Clin. Microbiol. 37:26522655.
6. Lawrence, C.,, E. Ronco,, S. Dubrou,, R. Leclercq,, C. Nauciel,, and P. Matsiota-Bernard. 1999. Molecular typing of Legionella pneumophila serogroup 1 isolates from patients and the nosocomial environment by arbitrarily primed PCR and pulsed-field gel electrophoresis. J. Med. Microbiol. 48:327333.
7. Nahapetian, K.,, and F. Squinazi. 1987. Modalités d'isolement des Legionella sp. dans les eaux et les boues residuaires, p. 165168. In Colloque Legionella des 6 et 7 max 1987. Collection Fondation Marcel, Merieux, France.
8. RifFard, S.,, F. Lo Presti,, F. Vandenessch,, F. Forey,, M. Reyrolle,, and J. Etienne. 1998. Comparative analysis of infrequent-restriction-site PCR and pulsed-field gel electrophoresis for epidemiological typing of Legionella pneumophila serogroup 1 strains. J. Clin. Miaobiol. 36:161167.
9. Shelton, B. G.,, W. D. Flanders,, and G. K. Morris. 1994. Legionnaires' disease outbreaks and cooling towers with amplified Legionella concentrations. Curr. Microbiol. 28:359363.

Tables

Generic image for table
TABLE 1

recovered from cooling towers examined during two outbreaks in Paris

Citation: Dubrou S, Challemel O, Carlier D, Lawrence C, Squinazi F, Guillotin L, Van Gastel B, Gabon S, Decludt B, Etienne J. 2002. Cooling Towers and Legionellosis: a Large Urban Area Experience, p 291-294. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch57

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