Large community-acquired Legionnaires’ disease outbreak caused by Legionella pneumophila Italy, July to August 2018

In the case-crossover study, extreme precipitation 5–6 days before symptom onset was associated with increased Legionnaires’ disease risk. The aerosol dispersion model showed that the fountain matched the case distribution best. The case control study demonstrated a significant eightfold increase in risk for cases residing near the public fountain. The three studies and the matching of clinical and environmental Lp1 strains identified the fountain as the source responsible for the epidemic. Eurosurveillance

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