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Hundreds of water samples were collected for<jats:italic>Legionella<\/jats:italic>isolation but only two clinical samples were obtained. Clinical strains were ST23 as were environmental isolates detected in most<jats:italic>Legionella<\/jats:italic>-positive patients' homes and those from a public fountain. Although no<jats:italic>Legionella<\/jats:italic>was found in the municipal water mains, a continuous chlorination was applied in 2008. This action resulted in a halving of cases, although incidence remained tenfold higher than the Italian average incidence until the end of 2013, when it dropped to the expected rate. Retrospective analyses of prevalent wind direction suggested that a hidden cooling tower could have been the main cause of this uncommon outbreak, highlighting the importance of implementation of cooling tower registers in supporting LD investigations.<\/jats:p>","DOI":"10.1017\/s0950268814003094","type":"journal-article","created":{"date-parts":[[2014,11,27]],"date-time":"2014-11-27T12:09:08Z","timestamp":1417090148000},"page":"2416-2425","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":17,"title":["An unusually long-lasting outbreak of community-acquired Legionnaires' disease, 2005\u20132008, Italy"],"prefix":"10.1017","volume":"143","author":[{"given":"M.","family":"SCATURRO","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"FONTANA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"CRIPPA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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