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During June and July 2008, five cases of Legionnaires' disease (LD) were reported to the local health authorities and the Norwegian Institute of Public Health (NIPH). The patients all lived in the industrial twin cities Sarpsborg and Fredrikstad in southeast Norway. In the same area, a large outbreak of LD with 56 cases and 10 deaths had occurred in 2005. The source at the time had been traced to an industrial air scrubber at the factory of one of the world's leading suppliers of wood-based chemicals (company A). During this outbreak patients were infected up to 10km away from the source [1]. .


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