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Clinical and Vaccine Immunology, April 2009, p. 528-534, Vol. 16, No. 4
1071-412X/09/$08.00+0     doi:10.1128/CVI.00458-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.

Seroepidemiological Study after a Long-Distance Industrial Outbreak of Legionnaires' Disease{triangledown}

E. Wedege,1* T. Bergdal,2 K. Bolstad,1 D. A. Caugant,1 J. Efskind,3 H. E. Heier,4 A. Kanestrøm,2 B. H. Strand,1 and I. S. Aaberge1

Norwegian Institute of Public Health, Oslo, Norway,1 Østfold Hospital Trust, Fredrikstad, Norway,2 Borregaard Industries Ltd., Sarpsborg, Norway,3 Ullevaal University Hospital, Oslo, Norway4

Received 5 December 2008/ Returned for modification 2 January 2009/ Accepted 10 February 2009

Following a long-distance outbreak of Legionnaires' disease from an industrial air scrubber in Norway in 2005, a seroepidemiological study measuring levels of immunoglobulin G (IgG) and IgM antibodies to Legionella pneumophila was performed with a polyvalent enzyme-linked immunosorbent assay. One year after the outbreak, IgG levels in employees (n = 213) at the industrial plant harboring the scrubber and in blood donors (n = 398) from the outbreak county were low but significantly higher (P ≤ 0.002) than those in blood donors (n = 406) from a nonexposed county. No differences in IgM levels among the three groups were found after adjustment for gender and age. Home addresses of the seroresponders in the exposed county clustered to the city of the outbreak, in contrast to the scattering of addresses of the seroresponding donors in the nonexposed county. Factory employees who operated at an open biological treatment plant had significantly higher IgG and IgM levels (P ≤ 0.034) than those working >200 m away. Most of the healthy seroresponders among the factory employees worked near this exposure source. Immunoblotting showed that IgG and IgM antibodies in 82.1% of all seroresponders were directed to the lipopolysaccharide of the L. pneumophila serogroup 1 outbreak strain. In conclusion, 1 year after the long-distance industrial outbreak a small increase in IgG levels of the exposed population was observed. The open biological treatment plant within the industrial premises, however, constituted a short-distance exposure source of L. pneumophila for factory employees working nearby.

* Corresponding author. Mailing address: Division of Infectious Disease Control, Norwegian Institute of Public Health, P.O. Box 4404 Nydalen, NO-0403 Oslo, Norway. Phone: 47 21 07 66 99. Fax: 47 21 07 65 18. E-mail: elisabeth.wedege{at}fhi.no

{triangledown} Published ahead of print on 18 February 2009.

Clinical and Vaccine Immunology, April 2009, p. 528-534, Vol. 16, No. 4
1071-412X/09/$08.00+0     doi:10.1128/CVI.00458-08
Copyright © 2009, American Society for Microbiology. All Rights Reserved.





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