Legionellosis – New Zealand (03): (Auckland) Fatal
A ProMED-mail post, http://www.promedmail.org, ProMED-mail is a program of the International Society for Infectious Diseases http://www.isid.org
Date: Wed 25 Apr 2012
Source: The New Zealand Herald
Public health officials are bracing for more cases of legionnaires' disease in Auckland. 3 new cases were notified over the weekend [21-22 Apr 2012], bringing the total over the past 9 weeks to 15. One person has died.
Dr Simon Baker says the latest cases are in the Waitemata District Health Board area. "We're still very much looking for the source but the fact that the cases have been spread all over the [Auckland] region means it's probably more than one source and it's going to be extremely difficult to tie down."
Dr Baker says the only way to stop the spread of the legionellosis is for all building owners to shock-dose their cooling towers.
[When ProMED-mail last reported on this outbreak (Legionellosis - New Zealand (02): (AU) fatal 20120405.1091797), there were a total of 11 cases, with one fatality; all were caused by Legionella pneumophila serogroup 1. Now there are a total of 15 cases.
Contaminated water has been hypothesized as the source rather than contaminated potting mix, because _Legionella pneumophila_ serogroup 1, a waterborne pathogen, was incriminated in all cases rather than _Legionella longbeachae_, a species that is commonly found in potting mix, compost, and soil and cultured from the respiratory specimens in patients with community-acquired pneumonia associated with gardening and exposure to potting mix and compost, especially in Australia and New Zealand.
We still do not have information concerning genotyping of _L. pneumophila_ isolated from patients in the current outbreak. A single genotype would suggest a common source, and could be matched to any environmental isolates. Frequently, however, the diagnosis of legionnaires' disease is made only on the basis of urinary L.
pneumophila serogroup 1 antigen testing or serology, rather than isolation of the organism from cultures of respiratory tract specimens, in which case genotyping of clinical isolates is, of course, not possible.
The Auckland region is on the North Island; it is one of the 16 regions of New Zealand, with a population of almost 1.5 million (one third of the nation's residents) in 2011, and is the country's largest urban area, which encompasses the Auckland metropolitan area, smaller towns, rural areas, and the islands of the Hauraki Gulf (http://en.wikipedia.org/wiki/Auckland_Region). The Auckland Central Business District is densely built-up, with high-rise buildings mainly used for commercial and retail uses, although there are residential high-density buildings and a population of about 40 000 residents (http://en.wikipedia.org/wiki/Auckland_CBD).
The HealthMap/ProMED-mail interactive map of New Zealand can be accessed at http://healthmap.org/r/1VY-
Legionellosis - New Zealand (02): (AU) fatal 20120405.1091797 Legionellosis - New Zealand: (Auckland) 20120404.1090247
Legionellosis - New Zealand (04): increased incidence 20110805.2369 Legionellosis - New Zealand (03): (MA) 20110530.1658 Legionellosis - New Zealand (02): (MA) 20110525.1586 Legionellosis - New Zealand: (CA) potting soil, alert 20110116.0189
Legionellosis, fatal - UK (03): (Wales) 20101014.3725
Legionellosis, tourists - Malaysia 20061027.3064
Legionellosis, potting soil - New Zealand (South Island) 20051027.3126
Legionellosis - Australia (NSW) 20050216.0526 Legionellosis, fatal, potting soil - Australia (VIC): 2004 20050123.0250
Legionellosis, potting soil - New Zealand 2003 (02): background 20040104.0033
Legionellosis, potting soil - New Zealand 2003 20040102.0014
Legionellosis, potting soil - Australia (S.) (02): bkgrnd 20031230.3167
Legionellosis, potting soil - Australia (South) 20031229.3160
Legionellosis, potting soil - Australia (NSW) 20020808.4988
Legionellosis - Australia: background 20001226.2282 Legionellosis, potting soil - USA: May-Jun 2000 20000904.1503