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Another case of probable contamination of the water supply network
and engaged equipment occurred in the Spa of Caldas da Rainha (aerosols,
Vichy and therapeutic baths), fromsulphurous hot springs, with temperatures
higher than 20 °C. This situation persisted between August 2004 and January
2006. The installations were closed until there was a guarantee that the water
sources and distribution network of the Caldas da Rainha Hospital was been
decontaminated. (Silva - Afonso; Lança, undated).
During the year of 2006 another three outbreaks were identified in
Portugal, one in the north, one in the center and another in the region of
Lisbon and Tagus Valley.
Also, in the years of 2012 and 2013 at least one outbreak in the North
region of Portugal took place.
Integrated surveillance system in Portugal
Despite being integrated in the list of DDO’s since 1999, Legionnaires’
disease is considered an under–reported disease. For this reason,
the Directorate General of Health created in 2004, the Program for
Integrated Epidemiological Surveillance of Legionnaires ‘Disease (VigLab
- Legionnaires’ Disease), which associates the clinic, laboratory and
epidemiological components. From this date onwards, the data from this
system became integrated with the DDO system, aiming to reinforce the
epidemiological surveillance of Legionnaires’ disease through:
• Efficacy in diagnosis and notification;
• Optimization of laboratory diagnosis;
• Increasing the number of isolates of
Legionella
from clinical cases;
