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The compulsory National Reported Diseases (DDO) (Law No. 2036 of
09 August 1949, laying the foundation for the fight against transmittable
diseases) is one of the main instruments of epidemiological surveillance
of transmittable diseases. It is a tool used by Public Health Services to
monitor trends, assess extent of spreading and help make decisions about
intervention strategies. From day 1 of January 1999, Legionnaires’ disease
integrated the list of reported diseases following the decree No. 1071/98 of
31 December.
Apart from isolated cases, Portugal had in recent years some epidemic
outbreaks of Legionnaires’ disease.
In 1994, a nosocomial outbreak occurred at the Hospital of Santa Cruz,
in Carnaxide, were 16 confirmed cases of contamination by
Legionella
pneumophila
serogroup 1 occurred in hospitalized patients. The source
of contamination was never identified. However, it was suspected that
the contamination was related to the water supply (Marques, Bornstein;
Fleurette, 1995).
In 1997, five tourists were contaminated in a hotel in Albufeira. In this
case the showers were thought to be the source but this was never confirmed
(Silva - Afonso; Lança, undated).
During September of 2000, in Vizela, a city in the north of Portugal,
eleven cases of Legionnaires’ disease were detected in inhabitants of the
municipality. The
Legionella pneumophila
bacterium was never isolated
from any of the suspected sources. However, a case-control suggested that
aerosols produced by a decorative fountain during a rock concert, were the
most likely route of transmission.
