1. Management of the 2012 Legionella crisis in Quebec City: need for a better communication between resources and knowledge transfer
- Author
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Caroline eDuchaine, Laetitia eBonifait, Luc eTrudel, and Marc eVeillette
- Subjects
Microbiology (medical) ,Operations research ,Legionella ,Population ,lcsh:QR1-502 ,Water supply ,cooling towers ,Legionella pneumophila ,Microbiology ,lcsh:Microbiology ,Environmental protection ,water sampling ,Faecal pollution ,Cooling tower ,education ,education.field_of_study ,Legionellosis ,biology ,outbreak ,business.industry ,Opinion Article ,biology.organism_classification ,respiratory tract diseases ,Fresh water ,business ,Tower - Abstract
Legionella pneumophila is one of the few bacteria that can be considered as a genuine environmental pathogen. Whilst most infections of hydric origins result from the faecal pollution of a stream or ground water, it is indeed not the case for Legionella pneumophila since this bacterium can be found in an ubiquitous manner in fresh water where it can survive temperature variations from 5.7 to 63°C (Fliermans et al., 1981). Consequently, any machinery or device using a water supply can be colonized with Legionellae, especially if the water temperature is high as it favor its growth: cooling towers, plumbing, water-heaters and hot tubs are few examples. Between July 18th and October 8th, 2012, 181 cases of legionellosis have been reported in the Quebec City area, 14 of which being sadly fatal. The investigation done by the Direction de la sante publique (DSP) (public health management office) assisted by the Ministere du Developpement durable, de l'Environnement, de la Faune et des Parcs (MDDEFP) (Ministry of sustainable development, environment, fauna and parks) and the Institut de recherche Robert Sauve en sante et securite du travail du Quebec (IRSST) (Robert Sauve occupational health and safety research institute) has been long and tedious for various reasons that will be discussed later on. This extended delay between first case notification and resolution of crisis has enticed the media to spread messages, sometimes contradictory, and to give the floor to pseudo-experts who, by proposing, for example, source of outbreak that were totally improbable in these circumstances, needlessly alarmed and increase the panic response of the population (Pelchat et al., 2012). It was people living in or frequently visiting the St-Roch and Limoilou districts (lower part of the city) that were contaminated by this strain of Legionella and, from the first notified cases, the cooling towers found in the area were suspected of harboring the pathogenic strain (Isabelle Goupil Sormany, 2012). These towers are essentially heat exchangers between the water and ambient air. The water to be cooled, the temperature of which usually varies between 25 and 40°C, is pulverized upward in the cooling tower using forced ventilation, loading the air released by the tower with steam created by the evaporation stream and tiny droplets which are the preferred conveyers for this pulmonary pathogen (Keller et al., 1996). The factors known to favor the proliferation of legionellae are the temperature (25–40°C), stagnancy, presence of sediments, scale, biofilms and corrosion, as well as the presence of amoebas and ciliate protozoans that could support the Legionella intracellular growth, all conditions found in cooling towers during summertime (Buse et al., 2012).
- Published
- 2014
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