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BMJ Case Reports 2013; doi:10.1136/bcr-2013-008713
  • CASE REPORT

Molecular diagnostics and the public health management of legionellosis

  1. Trish Mannes4
  1. 1Research Department of Infection and Population Health, University College London, London, UK
  2. 2Regional Laboratory of Public Health, Haarlem, Netherlands
  3. 3RVPBRU, HPA Microbiology Services Division, London, UK
  4. 4Thames Valley Health Protection Unit, Chilton, UK
  1. Correspondence to Dr Tom A Yates, t.yates{at}ucl.ac.uk

Summary

In 2009–2010, we investigated four legionella cases notified over an 8-month period in two adjacent villages in South East England. Molecular techniques enabled us to conclude that three of the cases had distinct infections. The absence of an adequate respiratory sample in one case necessitated epidemiological investigations to exclude a potential common environmental source of further infections. One of the cases had spent a part of their incubation period in a country in South East Asia. DNA-sequence-based typing of their isolate showed it to be of the Legionella pneumophila serogroup 1 (LP1) DNA-sequence type (ST) 481. Intriguingly, the only other two ST 481 isolates in the European Working Group for Legionella Infections database were among Dutch travellers to the same country in 2003 and 2006. This case makes clear the value of molecular diagnostics and the importance of obtaining adequate clinical specimens. The potential future uses for typing data are discussed.

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