TY - JOUR T1 - Hot tub <em>Legionella</em> pneumonia outbreak JF - European Respiratory Journal JO - Eur Respir J SP - 1379 LP - 1381 DO - 10.1183/09031936.00005114 VL - 44 IS - 5 AU - Maryam Ahmed AU - Naveed Mustfa Y1 - 2014/11/01 UR - http://erj.ersjournals.com/content/44/5/1379.abstract N2 - To the Editor:We read with interest the article on legionnaires’ disease in Europe by Beauté et al. [1]. As highlighted in that paper, larger outbreaks of legionnaires’ disease tend to gain more attention although smaller outbreaks occur, which also have implications on public health.Such an outbreak occurred in the Stoke-on-Trent area of North Staffordshire, UK, in July 2012, the first case presenting on July 18, 2012 with symptoms of a pneumonic illness. A positive urine Legionella antigen test was reported 5 days later (Legionella pneumophila serogroup 1). A number of similar presentations were admitted in the days that followed and 13 cases of Legionella pneumonia were confirmed by July 23, at which stage it was evident an outbreak was emerging. By the end of the outbreak at the beginning of August, a total of 20 cases had been confirmed.The reported cases were all from the local area of Stoke; 13 were male. Age ranged from 48 to 79 years (mean 65 years). 50% were ex-smokers. Three patients were immunosuppressed by long-term oral steroid use (for Crohn’s disease, polymyalgia rheumatica and gall bladder malignancy). One patient reported foreign travel in the month preceding the outbreak (Mallorca, Spain). The clinical features observed in the group were consistent with those reported for Legionella pneumonia. 14 patients … ER -