{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T00:45:39Z","timestamp":1794271539061,"version":"4.9.0"},"reference-count":19,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2006,11,17]],"date-time":"2006-11-17T00:00:00Z","timestamp":1163721600000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Eight cases of Legionnaires' disease were identified among the 215 German passengers after a cruise to the Nordic Sea in August 2003. An unmatched case-control study was conducted to identify risk factors and the source of infection. In total, eight passengers fulfilled the case definition, one of these died. Forty-two passengers served as controls. The attack rate was 4%. The mean age was 60 years for cases and 62 years for controls. Prolonged exposure to the spa pool seemed to be a risk factor of infection (OR 4\u00b785,<jats:italic>P<\/jats:italic>=0\u00b709).<jats:italic>Legionella pneumophila<\/jats:italic>serogroup 1, monoclonal antibody (mAb) subgroup \u2018Knoxville\u2019 was isolated from clinical and environmental samples. DNA sequence-based typing revealed that these isolates were indistinguishable from each other. The investigation showed the importance of an interdisciplinary approach of microbiology and epidemiology as not all sites on the ship that tested positive for<jats:italic>L. pneumophila<\/jats:italic>actually posed a relevant risk for the passengers.<\/jats:p>","DOI":"10.1017\/s0950268806007473","type":"journal-article","created":{"date-parts":[[2006,11,17]],"date-time":"2006-11-17T08:31:14Z","timestamp":1163752274000},"page":"802-810","source":"Crossref","is-referenced-by-count":34,"title":["Legionnaires' disease outbreak associated with a cruise liner, August 2003: epidemiological and microbiological findings"],"prefix":"10.1017","volume":"135","author":[{"given":"K.","family":"BEYRER","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"LAI","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.","family":"DREESMAN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u00a0V.","family":"LEE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"JOSEPH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"T.","family":"HARRISON","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"SURMAN-LEE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"L\u00dcCK","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.","family":"BRODHUN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"U.","family":"BUCHHOLZ","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"WINDORFER","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2006,11,17]]},"reference":[{"key":"S0950268806007473_ref011","unstructured":"11.\u00a0 Joseph C , European guidelines for control and prevention of travel associated Legionnaires' Disease. European Commission, 2003 (http:\/\/www.ewgli.org\/data\/european_guidelines\/european_guidelines_jan05.pdf). Accessed 25 October 2006."},{"key":"S0950268806007473_ref010","unstructured":"10.\u00a0EWGLI. European Working Group for Legionella Infections (www.ewgli.org). Accessed 25 October 2006."},{"key":"S0950268806007473_ref012","first-page":"174","article-title":"Epidemiology and laboratory diagnosis of Legionella infections","volume":"26","author":"L\u00fcck","year":"2002","journal-title":"Journal of Laboratory Medicine"},{"key":"S0950268806007473_ref005","first-page":"146","article-title":"Legionellosis associated with ships: 1977 to 1997","volume":"3","author":"Rowbotham","year":"1998","journal-title":"Communicable Disease and Public Health"},{"key":"S0950268806007473_ref009","doi-asserted-by":"publisher","DOI":"10.1086\/515083"},{"key":"S0950268806007473_ref018","volume-title":"Management of Spa Pools: Controlling the risk of infection","year":"2006"},{"key":"S0950268806007473_ref017","doi-asserted-by":"crossref","first-page":"187","DOI":"10.2166\/wst.2000.0312","article-title":"Controlling biofilm formation by hydrogen peroxide and silver combined disinfectant","volume":"42","author":"Armon","year":"2000","journal-title":"Water Science and Technology"},{"key":"S0950268806007473_ref007","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880500508X"},{"key":"S0950268806007473_ref015","doi-asserted-by":"crossref","first-page":"2841","DOI":"10.1128\/JCM.35.11.2841-2845.1997","article-title":"Antigenic lipopolysaccharide components of Legionella pneumophila recognized by monoclonal antibodies: possibilities and limitations for division of the species into serogroups","volume":"35","author":"Helbig","year":"1997","journal-title":"Journal of Clinical Microbiology"},{"key":"S0950268806007473_ref019","doi-asserted-by":"publisher","DOI":"10.3201\/eid0801.010176"},{"key":"S0950268806007473_ref003","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91137-X"},{"key":"S0950268806007473_ref008","doi-asserted-by":"publisher","DOI":"10.1086\/515084"},{"key":"S0950268806007473_ref001","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197712012972201"},{"key":"S0950268806007473_ref014","unstructured":"14.\u00a0International Organization for Standardization (ISO). Water quality\u00a0\u2013\u00a0detection and enumeration of Legionella. ISO 11731. Geneva, 1998."},{"key":"S0950268806007473_ref013","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.41.2.838-840.2003"},{"key":"S0950268806007473_ref016","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.43.5.2047-2052.2005"},{"key":"S0950268806007473_ref006","first-page":"152","article-title":"Outbreak of Legionnaires' disease on a cruise ship: lessons for international surveillance and control","volume":"2","author":"Regan","year":"2003","journal-title":"Communicable Disease and Public Health"},{"key":"S0950268806007473_ref004","first-page":"237","article-title":"Legionella on board a cruise ship [Editorial]","volume":"27","year":"1998","journal-title":"CDR Weekly"},{"key":"S0950268806007473_ref002","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268804002018"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268806007473","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,4,19]],"date-time":"2020-04-19T01:05:52Z","timestamp":1587258352000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268806007473\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2006,11,17]]},"references-count":19,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2007,7]]}},"alternative-id":["S0950268806007473"],"URL":"https:\/\/doi.org\/10.1017\/s0950268806007473","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2006,11,17]]}}}