{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,9]],"date-time":"2026-06-09T13:50:29Z","timestamp":1781013029528,"version":"3.54.1"},"reference-count":19,"publisher":"MDPI AG","issue":"13","license":[{"start":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T00:00:00Z","timestamp":1624838400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["IJERPH"],"abstract":"<jats:p>Legionnaires\u2019 disease (LD) is a severe pneumonia caused by bacteria belonging to the genus Legionella. This is a major public health concern and infections are steadily increasing worldwide. Several sources of infection have been identified, but they have not always been linked to human isolates by molecular match. The well-known Legionella contamination of private homes has rarely been associated with the acquisition of the disease, although some patients never left their homes during the incubation period. This study demonstrated by genomic matching between clinical and environmental Legionella isolates that the source of an LD cluster was a private building. Monoclonal antibodies and sequence-based typing were used to type the isolates, and the results clearly demonstrated the molecular relationship between the strains highlighting the risk of contracting LD at home. To contain this risk, the new European directive on the quality of water intended for human consumption has introduced for the first time Legionella as a microbiological parameter to be investigated in domestic water systems. This should lead to a greater attention to prevention and control measures for domestic Legionella contamination and, consequently, to a possible reduction in community acquired LD cases.<\/jats:p>","DOI":"10.3390\/ijerph18136922","type":"journal-article","created":{"date-parts":[[2021,6,28]],"date-time":"2021-06-28T11:45:40Z","timestamp":1624880740000},"page":"6922","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["A Legionnaires\u2019 Disease Cluster in a Private Building in Italy"],"prefix":"10.3390","volume":"18","author":[{"given":"Maria Luisa","family":"Ricci","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9861-446X","authenticated-orcid":false,"given":"Maria Cristina","family":"Rota","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Grazia","family":"Caporali","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonietta","family":"Girolamo","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Scaturro","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Istituto Superiore di Sanit\u00e0, 00161 Rome, Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,28]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1011","DOI":"10.1016\/S1473-3099(14)70713-3","article-title":"Epidemiology and clinical management of Legionnaires\u2019 disease","volume":"14","author":"Phin","year":"2014","journal-title":"Lancet Infect. Dis."},{"key":"ref_2","unstructured":"European Centre for Disease Prevention and Control (2020). Legionnaires\u2019 disease. ECDC. Annual Epidemiological Report for 2018, ECDC."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1177\/0033354916689620","article-title":"A Large Community Outbreak of Legionnaires\u2019 Disease Associated with a Cooling Tower in New York City, 2015","volume":"132","author":"Weiss","year":"2017","journal-title":"Public Health Rep."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"642","DOI":"10.1111\/j.1469-0691.2006.01447.x","article-title":"A community outbreak of Legionnaires\u2019 disease: Evidence of a cooling tower as the source","volume":"12","author":"Sabria","year":"2006","journal-title":"Clin. Microbiol. Infect."},{"key":"ref_5","first-page":"32","article-title":"Il sistema di sorveglianza della legionellosi in Italia: I risultati del 2019","volume":"1","author":"Rota","year":"2020","journal-title":"Boll. Epidemiol. Naz."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"207","DOI":"10.15585\/mmwr.mm6908a2","article-title":"Fatal Case of Legionnaires\u2019 Disease after Home Exposure to Legionella pneumophila Serogroup 3\u2014Wisconsin, 2018","volume":"69","author":"Schumacher","year":"2020","journal-title":"MMWR Morb. Mortal. Wkly. Rep."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"172","DOI":"10.1017\/S0950268811000355","article-title":"Sporadic Legionnaires\u2019 disease: The role of domestic electric hot-water tanks","volume":"140","author":"Dufresne","year":"2011","journal-title":"Epidemiol. Infect."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"457","DOI":"10.3201\/eid1003.020707","article-title":"Legionella Infection Risk from Domestic Hot Water","volume":"10","author":"Borella","year":"2004","journal-title":"Emerg. Infect. 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Dis."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"e00016-18","DOI":"10.1128\/mBio.00016-18","article-title":"Prevalence of Infection-Competent Serogroup 6 Legionella pneumophila within Premise Plumbing in Southeast Michigan","volume":"9","author":"Byrne","year":"2018","journal-title":"mBio"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"1900523","DOI":"10.2807\/1560-7917.ES.2020.25.20.1900523","article-title":"Large community-acquired Legionnaires\u2019 disease outbreak caused by Legionella pneumophila serogroup 1, Italy, July to August 2018","volume":"25","author":"Faccini","year":"2020","journal-title":"Eurosurveillance"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"2416","DOI":"10.1017\/S0950268814003094","article-title":"An unusually long-lasting outbreak of community-acquired Legionnaires\u2019 disease, 2005\u20132008, Italy","volume":"143","author":"Scaturro","year":"2015","journal-title":"Epidemiol. 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