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A wake up call for continued vigilance
| The first 150 words of the full text of this article appear below. |
In the past 25 years an extensive knowledge base has
been established about legionnaires' disease, and the measures needed for control and prevention from environmental sources of infection are
now legally enforced in most industrialised countries.1 Yet in spite of these advances in public health knowledge and practice,
four major community outbreaks around the world have occurred in the
past three years, the most recent in England.2 This
outbreak and those in the Netherlands3 and
Australia4 are the largest ever in their countries, and
the one in Spain last year ranks as the world's largest.5
These four outbreaks alone account for almost 1000 cases of pneumonia
and around 40 deaths. They are an uncomfortable but timely reminder of
how breakdowns in control or maintenance procedures can have
catastrophic consequences for many people. They also raise interesting
questions
namely, why were they so large in comparison with other
outbreaks, why did fewer deaths
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