{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,31]],"date-time":"2025-10-31T06:54:59Z","timestamp":1761893699805},"reference-count":0,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2001,3,1]],"date-time":"2001-03-01T00:00:00Z","timestamp":983404800000},"content-version":"unspecified","delay-in-days":90,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2000,12]]},"abstract":"<jats:p>An epidemiological and microbiological investigation of a cluster of eight cases of \nLegionnaires' disease in Los Angeles County in November 1997 yielded conflicting results. The \nepidemiological part of the investigation implicated one of several mobile cooling towers used \nby a film studio in the centre of the outbreak area. However, water sampled from these cooling \ntowers contained <jats:italic>L. pneumophila<\/jats:italic> serogroup 1 of another subtype than the strain that was \nrecovered from case-patients in the outbreak. Samples from two cooling towers located \ndownwind from all of the case-patients contained a <jats:italic>Legionella<\/jats:italic> strain that was indistinguishable \nfrom the outbreak strain by four subtyping techniques (AP-PCR, PFGE, MAb, and MLEE). It \nis unlikely that these cooling towers were the source of infection for all the case-patients, and \nthey were not associated with risk of disease in the case-control study. The outbreak strain also \nwas not distinguishable, by three subtyping techniques (AP-PCR, PFGE, and MAb), from a \n<jats:italic>L. pneumophila<\/jats:italic> strain that had caused an outbreak in Providence, RI, in 1993. Laboratory \ncross-contamination was unlikely because the initial subtyping was done in different \nlaboratories.<\/jats:p><jats:p>In this investigation, microbiology was helpful for distinguishing the outbreak cluster from \nunrelated cases of Legionnaires' disease occurring elsewhere. However, multiple subtyping \ntechniques failed to distinguish environmental sources that were probably not associated with \nthe outbreak. Persons investigating Legionnaires' disease outbreaks should be aware that \nmicrobiological subtyping does not always identify a source with absolute certainty.<\/jats:p>","DOI":"10.1017\/s095026880000474x","type":"journal-article","created":{"date-parts":[[2002,7,27]],"date-time":"2002-07-27T09:23:42Z","timestamp":1027761822000},"page":"599-608","source":"Crossref","is-referenced-by-count":22,"title":["Strengths and limitations of molecular subtyping in a community outbreak of Legionnaires' disease"],"prefix":"10.1017","volume":"125","author":[{"given":"J. L.","family":"KOOL","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"U.","family":"BUCHHOLZ","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C.","family":"PETERSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E. W.","family":"BROWN","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R. F.","family":"BENSON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. M.","family":"PRUCKLER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"B. S.","family":"FIELDS","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J.","family":"STURGEON","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"LEHNKERING","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"R.","family":"CORDOVA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. M.","family":"MASCOLA","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"J. C.","family":"BUTLER","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2001,3,1]]},"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S095026880000474X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,5,8]],"date-time":"2019-05-08T15:48:42Z","timestamp":1557330522000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S095026880000474X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2000,12]]},"references-count":0,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2000,12]]}},"alternative-id":["S095026880000474X"],"URL":"https:\/\/doi.org\/10.1017\/s095026880000474x","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2000,12]]}}}