The Bovenkarspel legionellosis outbreak ( nl, Legionellaramp; Legionella disaster) began on 25 February 1999 in
Bovenkarspel
Bovenkarspel is a town in the municipality of Stede Broec in the Dutch province of North Holland. Until 1979, it was a separate municipality.
Legionella outbreak
In March 1999 an outbreak of Legionnaires' disease occurred during a flower exhibit ...
, the
Netherlands
)
, anthem = ( en, "William of Nassau")
, image_map =
, map_caption =
, subdivision_type = Sovereign state
, subdivision_name = Kingdom of the Netherlands
, established_title = Before independence
, established_date = Spanish Netherl ...
, and was one of the largest outbreaks of
legionellosis
Legionnaires' disease is a form of atypical pneumonia caused by any species of '' Legionella'' bacteria, quite often ''Legionella pneumophila''. Signs and symptoms include cough, shortness of breath, high fever, muscle pains, and headaches. Na ...
in history. With at least 32 dead and 206 severe infections, it was the deadliest legionellosis outbreak since the original
1976 outbreak in
Philadelphia
Philadelphia, often called Philly, is the List of municipalities in Pennsylvania#Municipalities, largest city in the Commonwealth (U.S. state), Commonwealth of Pennsylvania, the List of United States cities by population, sixth-largest city i ...
, United States.
Between 19 and 28 February 1999, the Westfriese Flora took place in Bovenkarspel, one of the largest indoor flower exhibitions in the world (later the Holland Flowers Festival). A vendor had several recreational
hot tubs on display, with one of them filled from a long-inactive firehose and heated to 37 degrees Celsius (98.6 degrees Fahrenheit). In the water that had previously stagnated inside the hose, a very aggressive type of ''
legionella pneumophila'' bacterium had developed.
The vendor did not add
chlorine
Chlorine is a chemical element with the symbol Cl and atomic number 17. The second-lightest of the halogens, it appears between fluorine and bromine in the periodic table and its properties are mostly intermediate between them. Chlorine i ...
to the tubs, since customers were not permitted in them.
From 7 March, 13 patients were admitted to the Westfries Gasthuis in
Hoorn. Unable to diagnose the patients, hospital staff called the
Academic Medical Center
An academic medical centre (AMC), variously also known as academic health science centre, academic health science system, or academic health science partnership, is an educational and healthcare institute formed by the grouping of a health profes ...
(AMC) in
Amsterdam
Amsterdam ( , , , lit. ''The Dam on the River Amstel'') is the capital and most populous city of the Netherlands, with The Hague being the seat of government. It has a population of 907,976 within the city proper, 1,558,755 in the urban ar ...
. The AMC initially diagnosed six patients with legionellosis and a link with the Westfriese Flora was soon made. On 12 March, the
(RIVM) issued an epidemic warning to all doctors and hospitals, alerting them to Flora visitors and people with pneumonia-like symptoms. In the following weeks, 318 cases throughout the Netherlands were reported to the RIVM. All patients had visited the Westfriese Flora after 22 February and had become ill between 25 February and 16 March. It is known that 32 people died of the infection, one of them in 2001 after prolonged illness. A further 206 people became severely ill and many developed permanent health problems after visiting the Flora.
The 318 cases exceeds the 221 in the 1976 Philadelphia outbreak. While the Philadelphia outbreak had two more fatalities (34 versus 32), there is a possibility that others died in the 1999 Bovenkarspel outbreak, but were
interred
Burial, also known as interment or inhumation, is a method of final disposition whereby a dead body is placed into the ground, sometimes with objects. This is usually accomplished by excavating a pit or trench, placing the deceased and objec ...
before the infection was recognized.
References
External links
A Large Outbreak of Legionnaires’ Disease at a Flower Show, the Netherlands, 1999 Jeroen W. Den Boer, Ed P.F. Yzerman, Joop Schellekens et al.,
Emerging Infectious Diseases
''Emerging Infectious Diseases'' (EID) is an open-access, peer-reviewed journal published by the Centers for Disease Control and Prevention (CDC). EID is a public domain journal and covers global instances of new and reemerging infectious diseas ...
, Volume 8, Number 1—January 2002
The Westfriese Flora flower exhibition and fair Legionnaires` Disease website
Zwaailichten disaster website (archive)
{{DEFAULTSORT:Bovenkarspel legionellosis outbreak
Legionellosis
1999 in the Netherlands
1999 disease outbreaks
February 1999 events in Europe
March 1999 events in Europe
Disease outbreaks in the Netherlands
History of North Holland
1999 Bovenkarspel legionellosis outbreak
The Bovenkarspel legionellosis outbreak ( nl, Legionellaramp; Legionella disaster) began on 25 February 1999 in Bovenkarspel, the Netherlands, and was one of the largest outbreaks of legionellosis in history. With at least 32 dead and 206 seve ...
1999 disasters in the Netherlands