Emerging Infectious Disease ISSN: 1080-6059

A Large Outbreak of Legionnaires’ Disease at a Flower Show, the Netherlands, 1999

Jeroen W. Den Boer*†

, Ed P.F. Yzerman‡, Joop Schellekens*, Kamilla D. Lettinga§, Hendriek C. Boshuizen*, Jim E. Van Steenbergen¶, Arnold Bosman*, Susan Van den Hof*, Hans A. Van Vliet*, Marcel F. Peeters#, Ruud J. Van Ketel§, Peter Speelman§, Jacob L. Kool*, and Marina A.E. Conyn Van Spaendonck*

Author affiliations: *National Institute of Public Health and the Environment, Bilthoven, the Netherlands; †Municipal Health Service Zuid-Kennemerland, Haarlem, the Netherlands; ‡Regional Laboratory of Public Health Haarlem, Haarlem, the Netherlands; §Academic Medical Center, Amsterdam, the Netherlands; ¶National Outbreak Structure for Infectious Diseases, Den Haag, the Netherlands; #Regional Laboratory of Public Health Tilburg, Tilburg, the Netherlands

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Figure 3

a. Smoothed mean geometric immunoglobulin (Ig) M antibody titers to Legionella pneumophila of nearest 35 exhibitors in Halls 3 and 4 per 63 cm2 of exhibition area; confirmed and probable cases among exhibitors in halls 3 and 4. ● = confirmed case in exhibitor; ○ = probable case in exhibitor; Bu = bubblemat; W = whirlpool spa. b. Smoothed mean geometric IgG antibody titers to L. pneumophila of 35 exhibitors nearest to whirlpool in halls 3 and 4 per 63 cm2 of exhibition area; exhibitors ill with c

Figure 3. . a. Smoothed mean geometric immunoglobulin (Ig) M antibody titers to Legionella pneumophila of nearest 35 exhibitors in Halls 3 and 4 per 63 cm2 of exhibition area; confirmed and probable cases among exhibitors in halls 3 and 4. ● = confirmed case in exhibitor; ○ = probable case in exhibitor; Bu = bubblemat; W = whirlpool spa. b. Smoothed mean geometric IgG antibody titers to L. pneumophila of 35 exhibitors nearest to whirlpool in halls 3 and 4 per 63 cm2 of exhibition area; exhibitors ill with confirmed and probable cases in halls 3 and 4. ●= confirmed case in exhibitor; ○ = probable case in exhibitor; Bu = bubblemat; W = whirlpool spa.

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¹A bubblemat is an inflatable rubber mat that causes a whirlpool-like effect when placed in a normal bathtub.

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