![]() Two weeks after the interview, environmental inspectors from PHAB sampled the fluid that remained in the windshield wiper tank of the truck. No other cases of Legionnaires’ disease reported during the same period were related to his residence or driving areas. He reported that the vehicle had been unused for several months before the purchase and denied using screen wash in the windshield wiper fluid. The truck used for work was self-owned the patient had purchased it secondhand ≈1.5 years before illness. He worked as a commercial truck driver, and his driving route included merchandise pickup at an industrial area once a day. The patient smoked and had a medical history of hypertension and type 2 diabetes. After discharge, he completed the remaining course of antimicrobial drug therapy and proceeded favorably to cure.Īfter the case was reported, public health nurses contacted the patient to complete a structured epidemiologic questionnaire that included demographic data, personal risk factors, activities, and potential exposures during the 14 days before illness onset. The patient was hospitalized briefly, and his clinical course was unremarkable. ![]() A respiratory sample was not available because of the lack of productive secretions. On December 13, the patient sought care at a hospital, and a diagnosis of Legionnaires’ disease was made by UAT. Onset of symptoms had begun a week before diagnosis. In December 2019, the Public Health Agency of Barcelona (PHAB) received a case report of Legionnaires’ disease in a 59-year-old man. We report 2 cases of Legionnaires’ disease cases diagnosed by urine antigen testing (UAT) linked to detection of the bacteria in the windshield wiper fluid. However, no studies have epidemiologically confirmed the fluid as the source of infection ( 8). can grow in windshield wiper fluid that does not contain screen wash. Using windshield wiper fluid without added screen wash has been identified as a risk factor for Legionnaires’ disease in commercial drivers in a previous case‒control study ( 4). Exposures related to the vehicle are usually considered secondary to outside sources in industrial areas, such as cooling towers, and are seldomly investigated, despite some studies suggesting them as potential sources ( 4). However, in most sporadic cases, the source of infection remains unknown ( 3).Ĭommercial truck drivers are at increased risk for Legionnaires’ disease ( 4– 7). Cooling towers, warm water systems, and whirlpool spas are well-established sources of infection ( 2). Systems with warm water (35☌), stagnation, and lack of disinfection and maintenance can lead to proliferation of Legionella spp. Most Legionella infections are related to contaminated artificial water systems. Legionnaires’ disease is a severe form of acute pneumonia caused by inhalation of aerosols containing Legionella bacteria.
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