Talk:Legionellosis

Grammatical errors are rampant in this article.
If you're going to take the time to write or rewrite it, please use proper English.66.26.95.207 (talk) 00:06, 13 July 2012 (UTC)

Public domain?
The text on this page began as a direct copy of a page from the US Center of Disease Control web site. I'm not marking it as a copyvio yet, because I *think* this is okay... I think that official US government information can't be copyrighted - is this correct? Even if there's no legal problem, I think there should be a disclaimer on the page citing its original source, and the section names shouldn't be questions. - Brian Kendig 07:11, 18 Jan 2005 (UTC)


 * Yes, info from US government pages are generally non-copyrighted (there are exceptions). Yes, please rewrite the headers.  RickK 07:16, Jan 18, 2005 (UTC)

Contracting bacteria from soil
I read the entire article and it doesn't mention anywhere that the bacterium can be contracted from soil. The bacteria also lives in soil worldwide. If someone doesn't want to edit this I will, but I have better things to do. -- 19:27, 18 Jan 2005 (UTC)


 * I did add a small section regarding Legionella Longbeachae, that is contracted from inhaling dust from soil or compost Hongkonger 07:22, 18 August 2006 (UTC)]


 * I guess the quote of the origin of the Legionaire Disease is missquoted.It started with the French Legion in North Africa in the begining of the 20th century.Check your facts please.[user](Georges,24,Dec.2010.London,England) —Preceding unsigned comment added by 86.166.63.5 (talk) 08:40, 24 December 2010 (UTC)

Second Norwegian outbreak
There is currently a second outbreak going on in Norway, 5 dead so far, 29 (93 suspected) confirmed infected, source is as of yet unknown. Dunno how often these outbreaks happen worldwide so it might not be worth mentioning, but I noticed the previous outbreak in Savanger was mentioned so I though I'd mention this one. Seeng as this is still "breaking news" I guess it's not wikipedia material yet, but once the dust settles it might be worth adding a paragraph about it. --Sherool 12:01, 25 May 2005 (UTC)
 * The source has now been found to be Borregaard Fabrikker in Sarpsborg.
 * sources: http://www.aftenposten.no/nyheter/iriks/article1055306.ece (in Norwegian)
 * http://www.aftenposten.no/english/local/article1055402.ece (in English)

Toronto Seniors' Home Case
It has been confirmed that 17 people have been killed by LD, it is believed that another 2 cases have appeared (October 12th, 2005)

Outbreaks
http://www.abc.net.au/science/news/stories/s1549987.htm France, 2004. 21 Dead, 65 with disease. --Copeland.James.H 21:31, 31 May 2006 (UTC)

http://www.hcinfo.com/outbreaks-news.htm#Return%20to%20list http://www.legionella.com/Documents/Fatal-legionnaires-outbr.pdf March 2006 One  85-year-old man died, and 9 people had legionnaires' disease. The outbreak A cooling tower caused the outbreak in Preston, near Melbourne Australia. --Copeland.James.H 21:16, 31 May 2006 (UTC)

Fountains, Weekly clean and disinfect: Ponds, Spray Heads, all wetted surfaces
Malta requires that Fountains (espcially indoors) have weekly cleaning and disinfection.Malta Dept. of Information Page 30 of 36 --Copeland.James.H 19:10, 30 June 2006 (UTC)

Major re-write and re-organization
I just finished about 8 hours of work on this article. I started out making some piece-meal changes. Then I decide to copy it into my Sandbox, re-work it completely and then install the re-worked version here. My changes included: copy editing, Wikifying the writing style, adding a few references, consolidating (i.e., merging) some of the sections), and re-arranging the order of some sections. In my opinion, the article is much more coherent now. It probably still needs some work (in particular, more source references). Also, I don't understand why the section entitled "Infections" is included ... I can't see what purpose it serves. Could it be deleted?? - mbeychok 03:58, 2 July 2006 (UTC)

Minor Alterations
I changed the Barrow outbreak source to cooling tower, the Bellevue Stratford Philly to unknown 1976

Added links to some outbreaks and added support and discussion groups, also added comments that it was never proved the Bellevue was the cause of the legionnaires disease outbreak

--Noigel2000 14:19, 5 July 2006 (UTC)


 * Noigel, thanks very much for your contributions here and also in the Legionella article.
 * I would like to point out that Wikipedia is an encyclopedia and comments like "It should be pointed out that it was never proved that the Bellevue Stratford Hotels Airconditioning was the cause of the Legionnaires' disease Outbreak, It is a shame that people never check their information when writng about LD and the Bellevue" is not the sort of comment to be in an encyclopedia. I don't know who wrote the original paragraph about the Bellevue, but it does include a verifiable source reference. I realize that you are new to Wikipedia ... as you get more familiar with Wikipedia, you find that it includes and strongly enforces what is called a "Neutral point of view" (NPOV) policy.  That means that Wikipedia does not want comments or contributions that are not balanced and which do not respect all points of view on any subject.


 * Accordingly, I am changing your comment to read: "It should be pointed out that there are some who do not believe that it was conclusively proven that the air conditioning conditioning was the cause of the outbreak." It would be very useful if you could furnish some source references in support of that point of view. If so, please do it here on the Talk page before altering the article itself. - mbeychok 16:37, 5 July 2006 (UTC)

Minor Alterations (more)
You should read my first outbreak page, these comments by Dr Yu

The disease is still being misdiagnosed as pneumonia in many cases, according to Dr. Victor L. Yu. Yu, one of the most zealous researchers of the disease nationwide, is the chief of the Oakland VA medical center's infectious disease section.

He is displeased that the public carries misperceptions about the 1976 outbreak. Some still believe the source of the bacterium to be the Bellevue-Stratford's air conditioning system when, in fact, the source has never been identified, Yu said. "It disturbs us because many of these people are physicians," Yu said. "This is one of the great modern myths."

Visit his site at

http://www.legionella.org/

--Noigel2000 21:31, 5 July 2006 (UTC)

Taken from the commemoration of CDC’s 50th anniversary, MMWR reprinted this historical article.

Reprinted is the initial report published August 6, 1976, on an outbreak of respiratory illness among persons who attended an American Legion convention in Philadelphia during the summer of 1976.

Following that report is the special issue of MMWR published January 18, 1977, which announced the identification of the bacterium that caused Legionnaires disease.

The source of the organism in the outbreak is not known, but the search should now be greatly facilitated. Reported by the Leprosy and Rickettsia Br, Virology Div, Bur of Laboratories, CDC.

A copy of the report is on my first outbreak page

http://www.q-net.net.au/~legion/Legionnaires_Disease_Worlds_First_Outbreak.htm

You can try searching the MMWR pages for the report

--Noigel2000 00:51, 6 July 2006 (UTC)


 * I have added a sentence about Dr.Yu's opinion that the Bellevue Hotel outbreak source is still unknown and a reference to your website where that opinion is quoted by your website. However, that is as far as I am willing to accept your website's information.


 * Noigel, I must point out that you simply must learn how to cite a reference more correctly and more specifically. You must do better than just say "You can try searching the MMWR pages for the report" ... you must spell out what the MMWR stands for and you must give a specific location (what book or journal or website), date, author, and exact title. Also, as to Dr. Yu's site, you cannot say simply "Visit his site". Since his site has a great many different pages, you should spell out very clearly where to look in his site.


 * The tabulation of suspected sources in this article is just that ... a list of suspected sources (it doesn't say proven sources). For that reason, I am reverting the suspected source in the Philadelphia outbreak (the Bellevue Hotel) back to "cooling tower" until such time as you can furnish some credible, legible and correctly cited sources to the contrary. After all, most of your comments above are taken from your own website and, even there, it is difficult to find any specific, correctly cited sources. - mbeychok 02:56, 6 July 2006 (UTC)

I wonder why you dont know what MMWR stands for its the official mag of the CDC

The Morbidity and Mortality Weekly Report, Department of Health and Human Services Centers for Disease Control and Prevention

A copy of this is on my first outbreak page, atr the time there was no link back to CDC for this item as it was a special presentation

I spend 16 hours aday on my comp, I cant look out for everyone, I search the net on the slightest piece of information I dont expect people to wet nurse me I check for myself, the link you have which states the cooling tower is really not a true article and written by students

I will put this link on the page and change the source to unknown

http://www.cdc.gov/mmwr/preview/mmwrhtml/00045731.htm --Noigel2000 07:10, 6 July 2006 (UTC)

I will add that i search the net on the slighted piece of information I get, I dont expect people to give me things on a plate, I cant see the point of me having a CDC article on my pages and then putting a link back to the source, whats the point of my pages if i do that

--Noigel2000 07:29, 6 July 2006 (UTC)

Same as this place its all click click click, no point really, spend a couple of hours on my pages and you will learn everything about LD

Forgot to say the official total of cases is 180 with 29 deaths

--Noigel2000 07:52, 6 July 2006 (UTC)


 * This is getting to be a little rediculous. Noige, you are citing the issue of MMWR from January 1977 as your source for the statements that the source of the Philadelphia Legionnella was never found.  That is the issue where they announced the identification of the causative bacterium, a mere 9 months after the disease cluster was identified, and some 29 years ago.  In my opinion, its only reasonable use as a citation regarding bacteria source is as an indication of what was known three decades ago.  I think we need a more current citation for a claim that the source has not been identified to this day.


 * I am going to make some changes in the hope that I can find some NPOV ground between you and Mbeychok


 * Pzavon 17:19, 6 July 2006 (UTC)


 * Pzavon, thanks for your input and I agree with your changes. I just want to clarify that I really had no POV one way or the other.  All I wanted was a coherently written contribution substantiated by a clearly stated and verifiable reference ... but it seems that I couldn't get that across to Noigel. Thanks again. - mbeychok 18:15, 6 July 2006 (UTC)


 * Noigel, it doesn't matter whether or not you or I knows what MMWR means. What does matter is that many Wikipedia readers may not know and it is our function to tell them what it means. It also doesn't matter if you think Wikipedia is all "click, click, click" or that your web site is better than Wikipedia as a source of Legionellosis data. What does matter is that a Wikipedia article should furnish coherently expressed information backed up by clearly and correctly stated verifiable references. - mbeychok 18:15, 6 July 2006 (UTC)

You need to show me a citation from the CDC who investigated the outbreak that says the cooling tower was at fault, which I know you cant do, you can point to citations written by Phd's and MD's that write about the outbreak saying the cooling tower was to blame, but you cant show me one thats official, The truth must be told here for people to read....so show me an official document that says the tower was to blame and I have not put MMWR up on the legionellose page, you avoid the issue, i said you should know what MMWR stands for

Now show me a document that blames the tower

--Noigel2000 00:17, 7 July 2006 (UTC)

Ghad! CDC is not the only source of valid conclusions regarding such an event, especially after some time has passed. CDC was primarily interested in identifying the agent. They did that and others went on to use that information both in evaluating the Philadelphia incident and in dealing with other clusters of this disease.

For Wikipedia one important item is the fact, which YOU acknowledge, that most people believe the cooling system was the source. I am confident that we are never going to have more definitive information on the source than we have now. Even 15 years ago too much time had passed to expect to get better information. So, many/most think it was the cooling system, as has been shown to be the case in many other clusters. Some, or perhaps just two, say the cooling system was not conclusively shown to be the source (but apparently don't offer an alternative suggestion). Both opinions are now represented in the article. The goal is a good article, not to express the "one true fact." Let's move on. Pzavon 02:09, 7 July 2006 (UTC)

Perhaps you could point me to the official findings on this were it states the cooling tower was at fault, most people only believe its the cooling tower because misinformed people keep writing that its the cooling tower. In early outbreaks after the bellevue there was a number of hospital outbreaks whos cooling towers were blamed when in fact it was the HWS. and anyhow where did you pop up from Pzavon

--Noigel2000 06:28, 7 July 2006 (UTC)

Noigel, please be more careful about your edits
Noigel, in your last edit,when you changed a link (at the bottom of the section on Philadelphia) to a reference you closed the reference with ,/ref> which is incorrect syntax. It should have been. As a result of that incorrect syntax, all of the article beyond that point was deleted. You really must be more careful of what you do and you should use the "Preview" button to check the whole article before you submit an edit concerning References. I have fixed it now. - mbeychok 17:10, 7 July 2006 (UTC)

I think that was my error, not Noigel's. Sorry. Pzavon 01:59, 8 July 2006 (UTC)


 * Pzavon, the History page of Legionellosis clearly shows that Noigel made that error at 07:40, 7 July 2006. Are we both on the same page? - mbeychok 02:44, 8 July 2006 (UTC)

Needs some clarification
First it says that legionellosis is "also known as" Legionnaires' disease, then it says legionellosis has two forms, one of which is Legionnaires' disease. Not logical!--BillFlis 12:04, 16 July 2006 (UTC)

Maybe that is a deleted reference to "pontiac disease"? The article starts talking about Pontiac disease with no introduction or explanation, or link./mjp (talk) 05:04, 16 December 2009 (UTC)

Reverting changes by Copeland back to last version by 72.155.218.238
James, this is an article about the disease Legionellosis and you are trying to turn it into a tedious, detailed maintenance manual on how to control Legionella in cooling towers. Everything you added is covered in even greater detail by the 11 external links prominently listed in the existing section "Gudelines for control of Legionella in cooling towers". Why clutter up this article with material covered in those referenced guidelines and maintenance manuals?

I am reverting your changes back to the last version of this article by 72.155.218.238. PLEASE don't start a reversion war. - mbeychok 22:08, 16 July 2006 (UTC)

Me thinks its you trying to start a war mbeychok, its you that keeps changing things, put james article back or i will

you had the sauce to rewrite everything without asking and then pat yourself on the back...good job mbeychok well done, stuff the rest..opps Mongo noigels at it again can we ban him, go back to your knitting mbeychok or pop over to the middle east seems they need a good chemical engineer not sure what for though could be target pratice--Noigel2000 07:51, 19 July 2006 (UTC)
 * Hey, mbeychok, get with the program. You need to ask Noigel's permission before you change anything on one of his pages. How rude of you to intrude! Didn't you smell his marking of his territory? Take a ball of chalk, or complain to your storm and strife. Go, Noigel! Noigel for benevolent dictator of all Wikipedia! (Not just the itty-bitty parts of legionella, legionellosis, and The Bellevue-Stratford Hotel.) All hail his private domain, his personal glory. And don't denigrate his personal pages, even if you don't know they're his, because it upsets him terribly. Fear his wrath!--BillFlis 03:32, 20 July 2006 (UTC)

Shucks not another clown on the page, seems you sll can alter the page other folks have msde alterations to, but i cant oh well will ask MONGO to ban you.... oppps thats mbeychok tune, sorry about that

'''If you study both legionella and legionellosis pages you have turned both of them into treatment for coolong towers and just reread the pages

take the following. people come to learn about legionella not cooling towers'''

Controlling potential sources of Legionella Common sources of Legionella include cooling towers used in industrial cooling water systems as well as in large central air conditioning systems, domestic hot water systems, fountains, and similar disseminators that draw upon a public water supply. Natural sources include freshwater ponds and creeks.

Recent research in the Journal of Infectious Diseases provides evidence that Legionella pneumophila, the causative agent of Legionnaires disease, can travel at least 6 km from its source by airborne spread. It was previously believed that transmission of the bacterium was restricted to much shorter distances. A team of French scientists reviewed the details of an epidemic of Legionnaires disease that took place in Pas-de-Calais in northern France in 2003–2004. There were 86 confirmed cases during the outbreak, of whom 18 perished. The source of infection was identified as a cooling tower in a petrochemical plant, and an analysis of those affected in the outbreak revealed that some infected people lived as far as 6–7 km from the plant.[3]

Several European countries established a working group known as the European Working Group for Legionella Infections (EWGLI)[4] to share knowledge and experience about monitoring potential sources of Legionella. That group has published guidelines about the actions to be taken to limit the number of colony forming units (i.e., the aerobic count) of micro-organisms per mL at 30°C (minimum 48 hours incubation):

Aerobic count Action required 10,000 or less System under control. more than 10,000 up to 100,000 Review program operation. The count should be confirmed by immediate re-sampling. If a similar count is found again, a review of the control measures and risk assessment should be carried out to identify any remedial actions. more than 100,000 Implement corrective action. The system should immediately be re-sampled. It should then be ‘shot dosed’ with an appropriate biocide, as a precaution. The risk assessment and control measures should be reviewed to identify remedial actions.

Temperature affects the survival of Legionellae as follows:

158 to 176 °F (70 to 80 °C): Disinfection range At 151 °F (66 °C): Legionellae die within 2 minutes At 140 °F (60 °C): Legionellae die within 32 minutes At 131 °F (55 °C): Legionellae die within 5 to 6 hours Above 122 °F (50 °C): They can survive but do not multiply 95 to 115 °F (35 to 46°C): Ideal growth range 68 to 122 °F (20 to 50°C): Legionellae growth range Below 68 °F: Legionellae can survive but are dormant The above data can be confirmed in an online article by Reliance World Wide.[5]

[edit] Guidelines for control of Legionella in cooling towers Many governmental agencies, cooling tower manufacturers and industrial trade organizations have developed design and maintenance guidelines for preventing or controlling the growth of Legionella in cooling towers. Below is a list of sources for such guidelines:

Centers for Disease Control and Prevention - Procedure for Cleaning Cooling Towers and Related Equipment (pages 239 and 240 of 249) Cooling Technology Institute - Best Practices for Control of Legionella Association of Water Technologies - Legionella 2003 California Energy Commission - Cooling Water Management Program Guidelines For Wet and Hybrid Cooling Towers at Power Plants Marley Cooling Technologies - Cooling Towers Maintenance Procedures Marley Cooling Technologies - ASHRAE Guideline 12-2000 - Minimizing the Risk of Legionellosis Marley Cooling Technologies - Cooling Tower Inspection Tips {especially page 3 of 7} Tower Tech Modular Cooling Towers - Legionella Control GE Infrastructure Water & Process Technologies Betz Dearborn - Chemical Water Treatment Recommendations For Reduction of Risks Associated with Legionella in Open Recirculating Cooling Water Systems

*****************************************************************************

NOW ON THE LEGIONELLOSIS YOU GOT THIS LOT

YOU CHANGED BACK TO LEGIONELLA, VERY CONFUSING, SO WHAT PAGE AM I ON BOSS LEGIONELLA OR LEGIONELLOSIS

SHIFT THE LOT ON COOLING TOWERS TO THE COOLING TOWER PAGE AND GIVE FOLKS THE INFORMATION ON THE DISEASE THEY ARE LOOKING FOR

BEFORE YOU GO RUNNING TO MONGO, I BEAT YOU THERE, TOLD HIM TO GET SOMEONE ELSE TO READ THE PAGES

BECAUSE IF YOU DONT LOOK AT WHAT YOU HAVE DONE, I'M THINKING OF A MAJOR REWRITE WITH A FEW FRIENDS

BYE FOR NOW, WHOOPPS YOUR OUT OF BREATH ALL READY RUNNING TO MONGO

--Noigel2000 15:10, 20 July 2006 (UTC)

''' Controlling the potential growth of Legionella in cooling towers Various studies have shown that some 40 to 60% of cooling towers tested contained Legionella.[5]

A recent research study provided evidence that Legionella pneumophila, the causative agent of Legionnaires' disease, can travel at least 6 km from its source by airborne spread. It was previously believed that transmission of the bacterium was restricted to much shorter distances. A team of French scientists reviewed the details of an epidemic of Legionnaires disease that took place in Pas-de-Calais in northern France in 2003–2004. There were 86 confirmed cases during the outbreak, of whom 18 perished. The source of infection was identified as a cooling tower in a petrochemical plant, and an analysis of those affected in the outbreak revealed that some infected people lived as far as 6–7 km from the plant.[6]

Several European countries established a working group known as the European Working Group for Legionella Infections (EWGLI)[7] to share knowledge and experience about monitoring potential sources of Legionella. That group has published guidelines about the actions to be taken to limit the number of colony forming units (i.e., the aerobic count) of micro-organisms per mL at 30°C (minimum 48 hours incubation):

Aerobic count Action required 10,000 or less System under control. more than 10,000 up to 100,000 Review program operation. The count should be confirmed by immediate re-sampling. If a similar count is found again, a review of the control measures and risk assessment should be carried out to identify any remedial actions. more than 100,000 Implement corrective action. The system should immediately be re-sampled. It should then be ‘shot dosed’ with an appropriate biocide, as a precaution. The risk assessment and control measures should be reviewed to identify remedial actions.

Temperature affects the survival of Legionellae as follows:[8]

158 to 176 °F (70 to 80 °C): Disinfection range At 151 °F (66 °C): Legionellae die within 2 minutes At 140 °F (60 °C): Legionellae die within 32 minutes At 131 °F (55 °C): Legionellae die within 5 to 6 hours Above 122 °F (50 °C): They can survive but do not multiply 95 to 115 °F (35 to 46°C): Ideal growth range 68 to 122 °F (20 to 50°C): Legionellae growth range Below 68 °F: Legionellae can survive but are dormant [edit] Guidelines for control of Legionella in cooling towers Many governmental agencies, cooling tower manufacturers and industrial trade organizations have developed design and maintenance guidelines for preventing or controlling the growth of Legionella in cooling towers. Below is a list of sources for such guidelines:

Centers for Disease Control and Prevention - Procedure for Cleaning Cooling Towers and Related Equipment (pages 239 and 240 of 249) Cooling Technology Institute - Best Practices for Control of Legionella OSHA page on Legionellosis Association of Water Technologies - Legionella 2003 California Energy Commission - Cooling Water Management Program Guidelines For Wet and Hybrid Cooling Towers at Power Plants Marley Cooling Technologies - Cooling Towers Maintenance Procedures Marley Cooling Technologies - ASHRAE Guideline 12-2000 - Minimizing the Risk of Legionellosis Marley Cooling Technologies - Cooling Tower Inspection Tips {especially page 3 of 7} Tower Tech Modular Cooling Towers - Legionella Control GE Infrastructure Water & Process Technologies Betz Dearborn - Chemical Water Treatment Recommendations For Reduction of Risks Associated with Legionella in Open Recirculating Cooling Water Systems Wisconsin Division of Health, Control of Legionella in Cooling Towers: Summary Guidelines, June 1987, Wisconsin Department of Health and Social Sciences. The guidance issued by the UK government's Health and Safety Executive (HSE) now recommends that microbiological monitoring for wet cooling systems, using a dip slide, should be performed weekly.[9]

Date of first outbreak
I'm reading this: "The first recognized outbreak occurred on July 27, 1976 at ... " which seems too precise; previously, it read "... in July 1976", which I thought was specific enough. If we're going to put an exact date, shouldn't it read "The first outbreak was first recognized on (date)"? or at most specific, "... was believed to start on (date)"? Does any reference clarify this?--BillFlis 00:39, 28 July 2006 (UTC)
 * I don't know an exact date and one isn't immediately obvious, primarily for the reason that you mention - there should be no exact date. The outbreak unfolds over time and is recognized at a certain date. Feel free to change it back, IMO - InvictaHOG 01:57, 28 July 2006 (UTC)


 * Just to muddy the waters a little, although the first case of illness emerged in July 76, nobody knew what was the cause of the illness. It wasn't until six months later, in Jan. 1977 (cant lookup the date if you wish) that CDC identified the caustitive agent and called a press conference to inform the public - Hongkonger 18-8-2006

New case in England
Hi there, I hope you all don't mind, I added another case of Legionnaires' disease that has recently occured in Bath, England. --207.174.142.110 16:00, 8 August 2006 (UTC)


 * I removed that material. One case does not make an "outbreak" and this part of the article has been a list of significant outbreaks in which large numbers of people were infected.  If we started listing all the single cases of infection the article would be nothing but a list of individual cases.  Pzavon 02:33, 9 August 2006 (UTC)

Australia, 2007
Removed the current event tag from the Australia 2007 outbreak. No changes since March and it's now late May.Niels Olson 01:27, 21 May 2007 (UTC)

Intro
I tagged this article as having a vague intro. It's way too hard to understand. The name is also bad. It should be Legionnaires' disease with a section on Pontiac fever (see here) I will do all this at about 7:00 tommorrow if no one objects - Pheonix 21:02, 9 August 2007 (UTC)


 * Please don't move the article. The consensus for medicine-related articles has been to use the scientific or recognised medical name to avoid ambiguity - see the Manual of Style (medicine-related articles) guideline. -- MarcoTolo 21:52, 9 August 2007 (UTC)


 * Ok, but the intro needs a rewrite - Pheonix 19:42, 10 August 2007 (UTC)


 * I tried to do it but it wasn't satisfactory as I don't know much about it - Pheonix 19:50, 10 August 2007 (UTC)


 * I did not think the intro was vague at all, just a bit too wordy. I've made several changes (mostly deleting words).  Some deletions were made because the terms were highly specific terms that were addressed more clearly in the Legionella article, to which the introduction includes links at appropriate places.  Pzavon 02:11, 11 August 2007 (UTC)

General: tidy this page
this page needs to be tidied cleared Hongkonger (talk) 04:39, 13 December 2007 (UTC)

New York 2007 outbreak ?
No such outbreak and no source or citation, if real where is CDC MMWR? Also quotes some nonsense about infection from a "radiator system" which is in fact impossible. needs to be deleted Hongkonger (talk) 04:40, 13 December 2007 (UTC)

Common name or scientific name?
I thought that we generally put pages like this at the common name (Legionnaire's Disease) not the scientific name (Legionellosis) ? Regards, Ben Aveling 00:11, 13 March 2008 (UTC)

Endless lists lead to wikipedian mess
as much as this is an encyclopedia it is not an index, I don't think it's resourceful to list every case of legionaires disease ever reported. Notable cases e.g. Philidelphia, Murcia fine, but when the local media reports two cases (here exaggerated to four in Dublin see http://www.rte.ie/news/2008/0708/legionnaires.html) it is not very noteworthy and should be ommitted. Otherwise we are endager of biasing English language Wikipedia towards English speaking nations (well it is already biased but we must stop the rot).

IF YOU ARE INTERESTING IN EDITING FOR THE SAKE OF HAVING EDITED ON WIKIPDIA MIGHT I SUGGEST YOU TIDY UP THE LIST BY CHECKING PAST CASES AND MAKING AN EDITORIAL DECISION ON THEIR WORTH AN EDITING OUT THOSE DEEMED TO BE UN WORTHY, RATHER THAN POINTLESSLY MAKING MEANINGLESS ADDITIONS.

Two people in Dublin contracted the disease, nobody died, there's over six billion of us left. It's not a big deal. —Preceding unsigned comment added by 195.128.2.68 (talk) 15:21, 8 July 2008 (UTC)

Notable outbreaks
As the above commentator noted, legionellosis is not an uncommon disease - the CDC estimates that 8-18,000 cases occur annually in the US alone. Wikipedia is not a list of legionellosis outbreaks. I've removed the following reports from the main article:


 * United Kingdom, 1985: A large outbreak of Legionnaires' disease was associated with Stafford District General Hospital. A total of 68 confirmed cases were treated in hospital and 22 of these patients died. A further 35 patients, 14 of whom were treated at home, were suspected cases of Legionnaires' disease. All these patients had visited the hospital during April 1985. The BBC reported these statistics as 101 infected with 28 deaths resulting.


 * No source cited. Moderate size for an early outbreak; might be relevant if this was the "first UK outbreak".


 * Norway, 2001: The first known case of the disease in Norway occurred in 2001 when 28 people were infected in the city of Stavanger, and seven died. At first the authorities were puzzled as several of the victims lived in other locations, including one in Germany and another in England. After a massive investigation a fountain in the small lake of Breiavatnet, in the city centre, was suspected as the source of the outbreak. But the fountain had not sprayed the bacteria into the air, the source was a cooling tower at the nearby SAS Radisson hotel. Only three of the infected had stayed at the hotel, but the exit vent of the cooling tower was at ground level next to a public bus stop, explaining the other victims.


 * No citation. Small-ish outbreak. Relevance unclear.


 * North Wales, PA, 2002: The Abramson Center, a nursing home outbreak where 11 people got ill and 2 died. The facility was only 9 months old at the time of the outbreak.  Ten days prior to the outbreak there was a municipal water interruption which resulted in turbid water in the facility for several hours.


 * Very small outbreak, no source cited.


 * France, 2004: Researchers found that the Legionnaires' disease bacteria spread through the air up to 6 kilometers from a large contaminated cooling tower at a petrochemical plant in Pas-de-Calais in northern France. That outbreak killed 21 of the 86 people with laboratory-confirmed infection.Norox Pas-de-Calais


 * Interesing airbone spread info, but the event itself does not appear particularly notable.


 * New Zealand, 2005: An outbreak of Legionnaires' disease hit the New Zealand city of Christchurch in mid-2005, with 20 reported cases (three fatal) between late April and August. A cooling tower at the city's Ravensdown Fertiliser Plant was implicated in the outbreak. The outbreak led to plans by the city council to create a registry of all air-conditioning cooling towers within the city.Television New Zealand report


 * Very small outbreak.


 * Norway, 2005: In May 2005 there was a second&mdash;greater&mdash;outbreak in Norway, this time originating in the southeastern town of Fredrikstad. As of 8 June 2005, 52 patients were confirmed infected and ten people were dead. The dead were all from Fredrikstad or nearby cities, in age ranging from 68 to early 90's. The source of the outbreak unexpectedly came from an air scrubber (an industrial air purification facility; this particular one operated by Borregaard Industries in Sarpsborg). Such an installation has never before been reported as a source of Legionellosis anywhere in the world. Although the source was finally identified by DNA matching, it was also fairly well identified by analysing risk increases from people living near suspected sources.Borregaard Sarpsborg plant in Norway The first case was a truck driver that delivered sludge from a waste treatment plant at another facility to the one at Borregaard Industries. Because of this the first facility inspected by the health authority was Borregaard Industires however the water was not tested because this type of facility had never been associated with an outbreak.


 * Another small outbreak.


 * Toronto, 2005: In October 2005 at least 21 people died and over 100 fell ill during an outbreak at the Seven Oaks Home for the Aged in Toronto, Ontario, Canada. Legionnaire's disease was originally ruled out as being the cause, but post-mortem examinations confirmed that victims had Legionella bacteria in their lungs. The outbreak is still being investigated, and researchers believe this particular outbreak may be related to a new strain of the bacteria.


 * Modest outbreak, but, again, relevance beyond local area seems minimal....


 * Australia, 2007: The outbreak is believed to have started during New Year's Eve celebrations at Circular Quay, on Sydney's harbour. Thought to have started from a cooling tower (where 1,400 cfu/ml Legionella was found) from an adjacent office building, four cases were initially confirmed, but there were concerns due to the fact that Circular Quay is one of the most populated areas in Sydney on New Year's Eve.  As a result, there could have been potentially many more cases. On Saturday, January 20 the NSW Health Authority reported that three more cases had developed overnight, bringing the total reported cases to 7.


 * Vague assertations without reliable sources. Small outbreak.


 * New York, 2007: A Legionnaires' disease was confirmed in six residents of New York City nursing homes, all of whom were hospitalized and recovered. It was believed to have spread through the heating radiators located at the facilities. In the upstate community of Rochester, New York, two cases have been confirmed at Rochester General Hospital in 2008.


 * No sources. Bordenline "outbreak".


 * Orlando, Florida, 2008: It was reported on March 14 by the Orange County Health Department that two people who were staying at a Quality Suites, contracted Legionnaires' disease, possibly from a pool and spa that did not have adequate chlorine.Legionnaires' Disease Found At Local Hotel


 * Again, vague. Strains outbreak definition to limit.


 * Syracuse, New York, 2008: An outbreak infecting 11 people was confirmed in Syracuse, New York in July 2008, and was traced to an air conditioning cooling tower at Community General Hospital. One infected person died. In the same month, the health department discovered Legionella bacteria in the water system of the Van Duyn nursing home. They don't believe this is related to the outbreak at Community General Hospital.


 * Elmira, New York, 2008: An outbreak in Elmira, New York occurred in August 2008 and resulted in 13 confirmed cases and caused the death of two people. The outbreak occurred at the Edward Flannery Apartments, which is overseen by the Elmira Housing Authority.  The outbreak occurred one month after a municipal water main break at the edge of the buildings' driveway. Elmira Housing Authority


 * New Brunswick, New Jersey, 2008: An outbreak in New Brunswick, New Jersey occurred in September 2008. There are 8 confirmed cases and three deaths caused by the infection as of October 6, 2008.  The outbreak occurred at Saint Peters University Hospital.  Appropriate action is being taken to investigate the water supply as the source.


 * Galway, Ireland, 2008: In October, 2008 The Health Service Executive in Ireland announced an outbreak of Legionnaires Disease at University College Hospital in Galway.


 * Las Vegas, Nevada, 2008: The Clark County Health Department has announced that four guests of the Polo Towers in Las Vegas, Nevada have confirmed cases and is urging anyone who stayed at the hotel between during August and September 2008 to recieve a medical check-up. It has also been confirmed that the disease was traced to the hotel's water system.


 * More tiny and sporadic events; do not fit "notable outbreak" concept


 * None of the above outbreaks seem to reach notability on anything other than a local level (the 1985 UK event may be an exception). While there isn't (to my knowledge) a Wikipedia-wide notability standard for disease outbreaks, the MEDMOS standard for individual cases seems like a good starting point. -- MarcoTolo (talk) 20:38, 19 October 2008 (UTC)


 * Discussion also beginning here on the larger question of infectious outbreak notability. -- MarcoTolo (talk) 20:51, 19 October 2008 (UTC)


 * Although the subject of an article on Wikipedia needs to be notable to be in Wikipedia, it is not true that every sentence'= in the article needs to be individually notable. Stating that the individual outbreaks do not "seem to reach notability" only indicates that not all of the individual outbreaks need their own entry-- not that they should not be mentioned into this article.  Geoffrey.landis (talk) 15:41, 24 January 2011 (UTC)


 * I agree, and I am going to restore ones with deaths. Article notability and list notability are different and the number of cases per year is not relevant. What makes it notable is the coverage and that is when there is a cluster and if someone dies. --Richard Arthur Norton (1958- ) (talk) 16:05, 8 October 2011 (UTC)

Merger proposal
I believe that Legionella Risk assessment should be deleted or merged into this one. Comments? 12:52, 15 January 2009 (UTC) —Preceding unsigned comment added by Power.corrupts (talk • contribs)
 * I believe that Legionella Risk assessment should be redirected to this page, as this page already contains all of the references that that page does, except for the spammy ones to the author's own testing company site. WikiDan61 ChatMe!ReadMe!! 12:57, 15 January 2009 (UTC)

Nosocomial
"When the disease is caused by contact with the organism in a hospital, it is called a "nosocomial infection."" - I don't see this as helpful. Any infection contracted in a hospital is called nosocomial just like any health issue caused by a doctor is called iatrogenic. This isn't explanatory of Legionellosis; it's explanatory of nosocomial. /mjp (talk) 05:08, 16 December 2009 (UTC)

Inconsistent data
The data in this article seems to be inconsistent from section to section.

In the list of outbreaks, the fatality rates range from 1.3% (Spain outbreak, using only the "confirmed" cases-- lower if the "estimated" number is used) to 18% (Norway outbreak, 10 out of 56).
 * Lead: "The fatality rate of Legionnaires' disease has ranged from 5% to 30% during various outbreaks."

But in the "Prognosis" section: (I will note that it's a little confusing to see how the death rate can be "especially" close to 50% when antibiotics are started late. This means it's only "approximately" close to 50% otherwise?)Geoffrey.landis (talk) 15:41, 24 January 2011 (UTC)
 * "The death rate for patients who develop Legionnaire's disease while in the hospital is close to 50%, especially when antibiotics are started late", according to the NIH and U.S. National Library of Medicine service's MedlinePlus"''
 * "According to the journal Infection Control and Hospital Epidemiology, hospital-acquired Legionella pneumonia has a fatality rate of 28%"

Update to Edinburgh outbreak stats
I live in the affected area of Edinburgh and have been following the story closely. I've updated the figures in line with the press release shown on BBC news 15:00 — Preceding unsigned comment added by 157.203.43.103 (talk) 14:42, 6 June 2012 (UTC)


 * Yes you have but some of the facts that you added are incorrect. The gentleman who died did not die of legionnaires, he had underlying health concerns too which you did not add. The citation you offered does not state 40 infected, it states 17 confirmed and 15 suspected. Please fix values and citations using the correct format. If you are unsure how to do this I will be more than happy to assist. — Preceding unsigned comment added by 212.20.247.136 (talk) 16:16, 6 June 2012 (UTC)

Cause
This section currently says "Surface organelles are made up from at least forty various protein components reconcile motile bacteria." (revision http://en.wikipedia.org/w/index.php?title=Legionellosis&diff=462816453&oldid=462813733) which doesn't appear to make any sense at all. The cited paper says "Bacterial flagella are highly complex molecular machines. They are surface organelles assembled from over 40 different protein components that mediate bacterial motility." which at least is clear. I assume the rewrite was an attempt to not just copy text verbatim. However I'm not convinced this information is specific enough to this disease to warrant inclusion here, a link to flagella would probably do. In any case it's out of place in the middle of the first paragraph which isn't otherwise discussing the role of legionella flagella - the second paragraph appears to be trying to do that, but also in a particularly unclear/word-soup way. 81.134.152.4 (talk) 18:05, 8 June 2012 (UTC)

Notable cases table : too much in notes column
See heading basically. As it is now, it looks like some of the notes in the table are more like an entire section rather then just notes. Because they are subsequently elongated, the table cells in some places are about 30 lines tall. It generally looks untidy as it is. Any objections to shortening the notes in an effort to get it looking more like... a table. Maybe even the remote chance of fitting it into one screen is on the cards? MrZoolook (talk) 16:31, 19 June 2012 (UTC)

split page
I moved the table of outbreaks to a separate article List of Legionellosis outbreaks and included the action tables, etc., to show governmental efforts to control outbreaks. That section seemed to go well with it. I also ordered the table by year. Before that it had no logical order. The page still needs a lot of work. The transmission and cause sections are redundant and the lede needs to be rewritten with citations. I'll do what I can over the weekend. Malke 2010 (talk) 06:08, 23 March 2013 (UTC)