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首页> 外文期刊>感染症学雑誌 >An outbreak of legionellosis in a new facility of hot spring bath in Hiuga City
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An outbreak of legionellosis in a new facility of hot spring bath in Hiuga City

机译：日向市新温泉浴场爆发军团菌病

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Following cerebrating ceremony in 20 June 2002, for the completion of Hiuga Sun-Park Hot Spring Bath "Ofunade-no-Yu" facilities, Miyazaki Prefecture, Kyushu Island, 200 neighbors were invited each day to experience bathing on 20 and 21 June. The Bath "Ofunade-no-Yu" officially opened on 1 July 2002. On 18 July, Hiuga Health Center was informed that 3 suspected Legionella pneumonia patients in a hospital and all of them have bathing history of "Ofunade-no-Yu". Health Center officers notified Hiuga City, the main proprietor of the Bath business, that on-site inspection on sanitary managements will be done next day and requested the City to keep the bath facilities as they are. On 19 July, Health Center officers collected bath water from seven places and recommended voluntary-closing of "Ofunade-no-Yu" business. Because of various reasons, Hiuga City did not accept the recommendation and continued business up to 23 July. Because Legionella pneumophila serogroup 1 strains from 4 patients' sputa and severalbath water specimens were determined genetically similar by Pulsed Field Gel Electrophoresis of Sfi I-cut DNA. "Ofunede-no-Yu" was regarded as the source of infection of this outbreak. On 24 July, Ofunade-no-Yu 19,773 persons who took the bath during the period from 20 June to 23 July, 295 became ill, and 7 died. Among them, 34 were definitely diagnosed as Legionella pneumonia due to L. pneumophila SG 1, by either one or two tests of positive sputum culture, Legionella-specific urinary antigen, and significant rise of serum antibody titer against L. pneumophila SG 1. In addition to the 8 items shown by Miyazaki-Prefecture Investigation Committee as the cause of infection. Hiuga City Investigation Committee pointed out following 3 items: 1) Insufficient knowledge and understanding of stuffs on Legionella and legionellosis; 2) Residual water in tubing system after trial runs might lead multiplication of legionellae in it; and 3) Inadequate disinfection and washing for whole circulation system prior the experience bathing. The Hiuga City Committee directed 24 measures to improve the sanitary condition of the facility including following 5 items. 1) Fix the manual for maintenance and management of the bath. 2) Keep sufficient overflow of bath water. 3) Put disinfection of filters into practice. 4) Precise measurement and control of the residual chlorine concentration in bath water. 5) Replacement of filtrating material from crushed porous ceramic into natural sand.
机译：在2002年6月20日举行的庆祝仪式之后，为完成位于九州岛宫崎县的日向太阳公园温泉浴场的“ Ofunade-no-Yu”设施，每天都邀请200名邻居在6月20日至21日进行沐浴。 “ Ofunade-no-Yu”浴场于2002年7月1日正式开放。在7月18日，日向保健中心获悉，医院中有3名疑似军团菌肺炎患者，他们都有“ Ofunade-no-Yu”浴场的病史。卫生中心官员通知浴室业务的主要所有者日向市第二天将进行卫生管理现场检查，并要求纽约市保持浴室设施不变。 7月19日，卫生中心人员从七个地方收集了浴水，并建议自愿关闭“ Ofunade-no-Yu”业务。由于种种原因，日向市没有接受该建议，直到7月23日仍继续营业。因为通过Sfi I切割DNA的脉冲场凝胶电泳确定了来自4位患者的痰液和几个浴水标本的嗜肺军团菌血清群1菌株在遗传上相似。 “ Ofunede-no-Yu”被认为是这次疫情的传染源。 7月24日，在6月20日至7月23日期间洗澡的Ofunade-no-Yu浴场有19,773人，病倒295人，死亡7人。其中，通过一项或两项阳性痰培养检测，军团菌特异性尿抗原和针对肺炎链球菌SG 1的血清抗体滴度的显着升高，确定有34例确诊为肺炎链球菌SG 1的军团菌肺炎。除了宫崎县调查委员会显示的8个感染原因。日向市调查委员会指出了以下3个方面：1）对军团菌和军团菌病的知识了解不足; 2）试运行后管道系统中残留的水可能导致军团菌繁殖。 3）洗澡之前，对整个循环系统的消毒和清洗不足。日向市委员会指示了24项改善设施卫生状况的措施，包括以下5项。 1）维修手册，以维护和管理浴缸。 2）保持充足的沐浴水溢出。 3）实行过滤器消毒。 4）精确测量和控制浴水中残留氯的浓度。 5）将过滤材料从破碎的多孔陶瓷中替换成天然沙子。

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