NOSOCOMIAL LEGIONNAIRES-DISEASE IN ENGLAND AND WALES, 1980-92

Two hundred and eighteen nosocomial cases of Legionnaires' disease wit h 68 deaths were reported to the National Surveillance Scheme for Legi onnaires Disease between 1980 and 1992, representing 15% of the report ed infections acquired in England and Wales, Twenty-two nosocomial out breaks accounted for 135 (62%) of these cases, the remainder occurring as single cases either in hospitals where other single cases or outbr eaks had been reported in different years or as 'sporadic' cases in ho spitals from which no other cases were reported. A clinical history pr ior to onset of Legionnaires' disease was available for 124 patients, 61 of whom had undergone recent transplant therapy or were immunosuppr essed for other reasons. Sixty cases (27%) were diagnosed by culture o f the organism and isolates from 58 patients were typed; 25 (42%) were non L. pneumophila serogroup 1 infections. Methods for prevention and control of nosocomial outbreaks are discussed, in particular the susc eptibility to Legionnaires' disease of certain groups of hospital pati ents.