PUBLIC HEALTH
INFORMATION
Issued by the Communicable Disease Control
Branch of the Department of Health
Date 28/04/2000
This notice is for the attention of all doctors
Legionella
outbreak in Melbourne, Victoria
Many South Australians visited Melbourne
during the recent Easter holiday break.
The Victorian Department of Human
Services is investigating an outbreak of Legionnaires’ disease in the
vicinity of the Melbourne Aquarium on the Yarra River.
Four cases have been notified in Victoria
since 26th April 2000. All cases have been diagnosed by
urinary antigen testing for Legionella pneumophila serogroup 1.
Please consider the diagnosis in any
patient who has visited the Aquarium or its vicinity, presenting with
pneumonia particularly when the following features are present:
- Dyspnoea but in the absence of
significant cough
- Extensive bilateral pneumonia
- Upper lobe pneumonia
- Renal impairment or hyponatremia
- Liver function abnormalities.
Cases also often report diarrhoea.
Rapid confirmation (within 24 hours) of
the diagnosis can be obtained through urinary antigen testing. However,
sputum for culture should be sought in all cases. A four-fold rise in
titre between acute and convalescent sera is diagnostic. However, a rise
in titre may take 2 to 4 weeks to develop. A single high titre of 512 in
a serum sample is also very suggestive of Legionnaires' disease in the
appropriate clinical setting.
The antibiotic of choice is IV
erythromycin; rifampicin may be a useful adjunct but should not be used
alone.
Legionnaires’ disease is a notifiable
condition, and must be reported within 24 hours. Please notify the
Communicable Diseases Control Branch on clinical suspicion of
Legionnaires’ disease, particularly if the case has visited the
Aquarium or its vicinity.
To notify Legionnaires’ disease contact
the South Australian Communicable Disease Control Branch:
Telephone:
8226-7177
Facsimile: 8226-7187
For advice contact the South Australian
Communicable Disease Control Branch
Telephone 8226-7177 (24 hours/7 days) or 0417-812-052
(after hours)
Contact person: Dr Rod Givney, Medical Consultant, Communicable Disease
Control Branch, South Australia |
