[CH] Legionnaires' Disease Associated With Potting Soil
Mary & Riley (uGuys@ChileGarden.com)
Tue, 05 Sep 2000 12:38:20 -0700
Greetings,
Some of you might find this of interest. If you wade through all of it you
find at the end fairly high positive rates for the bacteria in potting soil
in Australia. No US testing has been done.
A dust mask might be in order--I know I got a good dose of potting dust
yesterday.
Riley
Date: Mon, 4 Sep 2000 09:55:17 -0400 (EDT)
From: ProMED-mail <promed@promed.isid.harvard.edu>
Subject: PRO/EDR> Legionellosis, potting soil - USA: May-Jun 2000
LEGIONELLOSIS, POTTING SOIL - USA: MAY-JUN 2000
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A ProMED-mail post
<http://www.promedmail.org>
[see also:
1999
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Legionellosis, flower show - Netherlands (02) 19990315.0385
Legionellosis, flower show - Netherlands (10) 19990421.0665
Legionellosis, flower show - Netherlands: background 19990317.0403
Legionellosis, flower show - Netherlands: RFI 19990315.0384
Legionellosis, trade fair - Belgium (02) 19991118.2052
Legionellosis, trade fair - Belgium: alert 19991114.2028
1996
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Legionellosis - Spain (02) 19961014.1734
Legionellosis - Spain (03) 19961016.1739
Legionellosis - Spain (8) 19961215.2080
Legionellosis - Spain: RFI 19961012.1728]
Date: 31 Aug 2000 20:23:12 -0400
From: Marjorie P. Pollack <pollackmp@mindspring.com>
Source: MMWR, 1 Sep 2000 / 49(34);777-8
<http://www.cdc.gov/epo/mmwr/preview/mmwrhtml/mm4934a1.htm>
Legionnaires' Disease Associated With Potting Soil -- California, Oregon,
and Washington, May-Jun 2000
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Since Legionnaires' Disease (LD) was first reported in 1976, outbreaks have
been associated with airborne transmission of _Legionella bacteria_ through
cooling towers, showers, and other aerosolizing devices (1). However, most
LD cases are sporadic, and the source and mode of infection in many cases
are unknown. Infections with one species, _Legionella longbeachae_, have
been associated with gardening and use of potting soil in Australia and
Japan (2,3). This report summarizes the findings of LD investigations in
California, Oregon, and Washington, that suggest that transmission from
potting soil has occurred for the first time in the United States, and that
active surveillance and case finding are warranted to explore this
association.
On 13 Jun 2000, CDC was alerted by a county health official in Washington
of _L. longbeachae_ infection in a 46-year-old woman who had been
hospitalized with pneumonia. The patient reported that she had been potting
plants during the 10 days before her symptoms began in May. An isolate from
the patient's sputum was sent to CDC for species confirmation, and 2
samples of potting soil and one of compost from the original packages
obtained from the patient's residence were sent for analysis. _L.
longbeachae_ was isolated from one potting soil sample. The compost
contained other _Legionella_ species but not _longbeachae_.
In May, 2 _L. longbeachae_ isolates had been received at CDC from bronchial
wash samples taken from both a 77-year-old Oregon woman and a 45-year-old
California man who were both diagnosed with legionellosis. The California
patient died and his house was cleaned before an investigation could be
undertaken. State and local health officials determined that the Oregon
patient had been potting plants using commercial potting soil mixtures and
had been working in a home garden during the 10 days before her symptoms
began in Apr 2000. Two potting soil samples taken from her residence were
tested for _Legionella_ at CDC; one was positive for _L. longbeachae_.
Isolates of _L. longbeachae_ from the patients and soils will be compared
using amplified fragment length polymorphism typing.
Reported by: JS Duchin, MD, J Koehler, DVM, Public Health--Seattle & King
County, Seattle; JM Kobayashi, MD, State Epidemiologist, Washington State
Dept of Health; RM Rakita, MD, K Olson, MD, NB Hampson, MD, Virginia Mason
Medical Center, Seattle. DN Gilbert, MD, JM Jackson, Providence Portland
Medical Center, Portland; KR Stefonek, MPH, MA Kohn, MD, State
Epidemiologist, Oregon Dept of Human Svcs, Health Div. J Rosenberg, MD, D
Vugia, MD, Acting State Epidemiologist, California Dept of Health Svcs. M
Marchione-Mastroianni, CDC Foundation, Atlanta, Georgia. Respiratory
Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for
Infectious Diseases; and EIS officers, CDC.
Editorial Note:
The findings in this report illustrate the importance of reporting cases of
LD to local and state health officials and of culturing patient specimens
for _Legionella_. Although urine antigen tests provide rapid and accurate
diagnosis of _Legionella pneumophila_ serogroup 1, these tests are not
sensitive for other serogroups or species. Microbiologic and epidemiologic
investigations are needed to identify less common species and may reveal
risk factors and novel modes of disease transmission.
_L. pneumophila_ serogroup 1 accounts for most legionellosis cases in the
United States; _L. longbeachae_ is reported less frequently. During
1990--1999, 37 cases of _L. longbeachae_ were reported to CDC's
_Legionella_ reporting system. It is likely that legionellosis is
underreported to CDC because of failure to obtain the appropriate
diagnostic tests in cases of pneumonia of unknown etiology, difficulty of
culturing _Legionella_ from clinical specimens, and because legionellosis
is not reportable in all states.
Soil surveys for _Legionella_ have not been conducted in the United States;
however, in a soil survey in Australia, 33 (73%) of 45 potting soil samples
tested positive for _Legionella_; 26 (79%) of the 33 contained _L.
longbeachae_ (4). Nineteen (100%) soil samples in Europe and the United
Kingdom were negative for _L. longbeachae_. A survey of 17 soil samples in
Japan in 1998 yielded 31 different strains of _Legionella_; 8 of the 17
samples (47%) contained _L. longbeachae_ (3).
Health-care providers should report legionellosis cases to local or state
health departments, and state health departments should report
legionellosis cases, particularly _L. longbeachae_ to CDC. Risk factors and
behaviors associated with transmission of _L. longbeachae_ are unknown;
therefore, to better define the extent of disease, modes of transmission,
and to develop prevention strategies, CDC urges state health departments to
send _Legionella_ cultures yielding non-pneumophila isolates to CDC's
_Legionella_ laboratory for speciation, telephone (404) 639-3563. Cases of
_L. longbeachae_ infection that have occurred during the previous 12 months
should be reported to CDC's National Center for Infectious Diseases,
Division of Bacterial and Mycotic Diseases, Respiratory Diseases Branch,
telephone (404) 639-2215. For local and state use, a case report form may
be obtained from the World-Wide Web,
<http://www.cdc.gov/ncidod/dbmd/diseaseinfo>, and faxed to (404) 639-3970.
References:
1. Fiore AE, Nuorti JP, Levine OS, et al. Epidemic Legionnaires' disease
two decades later: old sources, new diagnostic methods. Clin Infect Dis
1998;26:426--33.
2. Steele TW, Lanser J, Sangster N. Isolation of _Legionella longbeachae_
serogroup 1 from potting mixes. Appl Environ Microbiol 1990;56:49--53.
3. Koide M, Saito A, Okazaki M, et al. Isolation of _Legionella
longbeachae_ serogroup 1 from potting soils in Japan. Clin Infect Dis
1999;29:943--4.
4. Steele TW, Moore CV, Sangster N. Distribution of _Legionella
longbeachae_ serogroup 1 and other _Legionella_ in potting soils in
Australia. Appl Environ Microbiol 1990;56:2984--8.
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