Potable water as a cause of sporadic cases of community-acquired legionnaires' disease

1992 ◽  
Vol 11 (10) ◽  
pp. 79-80
Keyword(s):  
Potable Water ◽  
Sporadic Cases ◽  
Legionnaires Disease

Potable Water as a Cause of Sporadic Cases of Community-Acquired Legionnaires' Disease

1992 ◽  
Vol 326 (3) ◽  
pp. 151-155 ◽  
Author(s):  
Janet E. Stout ◽  
Victor L. Yu ◽  
Paul Muraca ◽  
Jean Joly ◽  
Nancy Troup ◽  
...  
Keyword(s):  
Potable Water ◽  
Sporadic Cases ◽  
Legionnaires Disease

Potable water as a source of legionnaires' disease

1985 ◽  
Vol 13 (6) ◽  
pp. 286 ◽  
Author(s):  
K.N. Shands ◽  
J.L. Ho ◽  
R.D. Meyer ◽  
G.W. Gorman
Keyword(s):  
Potable Water ◽  
Legionnaires Disease

scholarly journals Legionnaires' Disease Outbreak at a Resort in Cozumel, Mexico

2016 ◽  
Vol 3 (3) ◽  
Author(s):  
Lee M. Hampton ◽  
Laurel Garrison ◽  
Jessica Kattan ◽  
Ellen Brown ◽  
Natalia A. Kozak-Muiznieks ◽  
...  
Keyword(s):  
United States ◽  
Potable Water ◽  
Water System ◽  
Disease Outbreak ◽  
Community Acquired Pneumonia ◽  
Health Departments ◽  
Medical Providers ◽  
Cozumel Island ◽  
European Working ◽  
Legionnaires Disease

Abstract Background.  A Legionnaires' disease (LD) outbreak at a resort on Cozumel Island in Mexico was investigated by a joint Mexico-United States team in 2010. This is the first reported LD outbreak in Mexico, where LD is not a reportable disease. Methods.  Reports of LD among travelers were solicited from US health departments and the European Working Group for Legionella Infections. Records from the resort and Cozumel Island health facilities were searched for possible LD cases. In April 2010, the resort was searched for possible Legionella exposure sources. The temperature and total chlorine of the water at 38 sites in the resort were measured, and samples from those sites were tested for Legionella. Results.  Nine travelers became ill with laboratory-confirmed LD within 2 weeks of staying at the resort between May 2008 and April 2010. The resort and its potable water system were the only common exposures. No possible LD cases were identified among resort workers. Legionellae were found to have extensively colonized the resort's potable water system. Legionellae matching a case isolate were found in the resort's potable water system. Conclusions.  Medical providers should test for LD when treating community-acquired pneumonia that is severe or affecting patients who traveled in the 2 weeks before the onset of symptoms. When an LD outbreak is detected, the source should be identified and then aggressively remediated. Because LD can occur in tropical and temperate areas, all countries should consider making LD a reportable disease if they have not already done so.

Eight years of Legionnaires' disease transmission in travellers to a condominium complex in Las Vegas, Nevada

2012 ◽  
Vol 140 (11) ◽  
pp. 1993-2002 ◽  
Author(s):  
B. J. SILK ◽  
M. R. MOORE ◽  
M. BERGTHOLDT ◽  
R. J. GORWITZ ◽  
N. A. KOZAK ◽  
...  
Keyword(s):  
Disease Transmission ◽  
Potable Water ◽  
Las Vegas ◽  
Case Series ◽  
Case Control ◽  
Case Finding ◽  
Sequence Type ◽  
Retrospective Case ◽  
Legionnaires Disease ◽  
Matched Case

SUMMARYTravel is a risk factor for Legionnaires' disease. In 2008, two cases were reported in condominium guests where we investigated a 2001 outbreak. We reinvestigated to identify additional cases and determine whether ongoing transmission resulted from persistent colonization of potable water. Exposures were assessed by matched case-control analyses (2001) and case-series interviews (2008). We sampled potable water and other water sources. Isolates were compared using sequence-based typing. From 2001 to 2008, 35 cases were identified. Confirmed cases reported after the cluster in 2001–2002 were initially considered sporadic, but retrospective case-finding identified five additional cases. Cases were more likely than controls to stay in tower 2 of the condominium [matched odds ratio (mOR) 6·1, 95% confidence interval (CI) 1·6–22·9]; transmission was associated with showering duration (mOR 23·0, 95% CI 1·4–384). We characterized a clinical isolate as sequence type 35 (ST35) and detected ST35 in samples of tower 2's potable water in 2001, 2002, and 2008. This prolonged outbreak illustrates the importance of striving for permanent Legionella eradication from potable water.

Legionella and Public Water Supplies

1988 ◽  
Vol 20 (11-12) ◽  
pp. 5-10 ◽  
Author(s):  
J. S. Colbourne ◽  
P. J. Dennis ◽  
R. M. Trew ◽  
C. Berry ◽  
G. Vesey
Keyword(s):  
Surface Water ◽  
Heat Shock ◽  
Distribution Systems ◽  
Potable Water ◽  
Water Sources ◽  
Water Supplies ◽  
Indirect Immunofluorescent Assay ◽  
Water Mains ◽  
Legionnaires Disease ◽  
Indirect Immunofluorescent

A survey for legionella in public water supplies in England failed to detect culturable L.pneumophila in all but samples from taps in buildings; however, the organism was detected in underground and surface water sources and distribution systems using an indirect immunofluorescent assay (IFA) to L.pneumophila serogroup 1. Culturability was related to water temperatures above 20°C. In water mains L.pneumophila was associated with biofilms or sediment. Non-culturable L.pneumophila detected in potable waters by IFA were recovered by heat shock experiments demonstrating their viability. Although the strain found in potable water is rarely asociated with disease, monoclonal expression, a virulence marker, was altered by heat shock. These findings have implications for the prevention of legionellosis and may explain the sporadic nature of legionnaires disease in the community.

scholarly journals Lessons From an Outbreak of Legionnaires’ Disease on a Hematology-Oncology Unit

2016 ◽  
Vol 38 (3) ◽  
pp. 306-313 ◽  
Author(s):  
Louise K. Francois Watkins ◽  
Karrie-Ann E. Toews ◽  
Aaron M. Harris ◽  
Sherri Davidson ◽  
Stephanie Ayers-Millsap ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Potable Water ◽  
Single Case ◽  
Healthcare Providers ◽  
Water System ◽  
Positive Sequence ◽  
Environmental Isolates ◽  
Legionnaires Disease ◽  
Oncology Unit ◽  
Healthcare Associated

OBJECTIVESTo define the scope of an outbreak of Legionnaires’ disease (LD), to identify the source, and to stop transmission.DESIGN AND SETTINGEpidemiologic investigation of an LD outbreak among patients and a visitor exposed to a newly constructed hematology-oncology unit.METHODSAn LD case was defined as radiographically confirmed pneumonia in a person with positive urinary antigen testing and/or respiratory culture forLegionellaand exposure to the hematology-oncology unit after February 20, 2014. Cases were classified as definitely or probably healthcare-associated based on whether they were exposed to the unit for all or part of the incubation period (2–10 days). We conducted an environmental assessment and collected water samples for culture. Clinical and environmental isolates were compared by monoclonal antibody (MAb) and sequence-based typing.RESULTSOver a 12-week period, 10 cases were identified, including 6 definite and 4 probable cases. Environmental sampling revealedLegionella pneumophilaserogroup 1 (Lp1) in the potable water at 9 of 10 unit sites (90%), including all patient rooms tested. The 3 clinical isolates were identical to environmental isolates from the unit (MAb2-positive, sequence type ST36). No cases occurred with exposure after the implementation of water restrictions followed by point-of-use filters.CONCLUSIONSContamination of the unit’s potable water system with Lp1 strain ST36 was the likely source of this outbreak. Healthcare providers should routinely test patients who develop pneumonia at least 2 days after hospital admission for LD. A single case of LD that is definitely healthcare associated should prompt a full investigation.Infect Control Hosp Epidemiol2017;38:306–313

Legionnaires' Disease in a Child with Cancer

PEDIATRICS ◽  
1979 ◽  
Vol 64 (6) ◽  
pp. 951-953
Author(s):  
Michael E. Ryan ◽  
Sandor Feldman ◽  
Bonnie Pruitt ◽  
David W. Fraser
Keyword(s):  
Childhood Cancer ◽  
Immunosuppressive Therapy ◽  
Geographic Distribution ◽  
Acute Lymphocytic Leukemia ◽  
Lymphocytic Leukemia ◽  
Clinical Entity ◽  
Elderly Persons ◽  
Respiratory Illnesses ◽  
Sporadic Cases ◽  
Legionnaires Disease

Although Legionnaires' disease has only recently been recognized as a distinct clinical entity, serologic surveys of localized outbreaks of respiratory illnesses have indicated that its geographic distribution is wide.1-5 Most cases have occurred in clusters, but reports of sporadic cases are increasing.6 The disease appears to be most prevalent among elderly persons or adults undergoing immunosuppressive therapy; it has seldom been documented in children.1,7,8 We report a previously undetected case of Legionnaires' disease in a child with acute lymphocytic leukemia in remission. MATERIALS AND METHODS To determine whether Legionnaires' disease had occurred in a childhood cancer population with pneumonia, we reviewed the records of patients between 1 and 18 years of age for whom percutaneous transthoracic lung aspirates had been obtained between April 1970 and December 1977.

scholarly journals Nosocomial Legionnaires' disease in England and Wales, 1980–92

1994 ◽  
Vol 112 (2) ◽  
pp. 329-346 ◽  
Author(s):  
C. A. Joseph ◽  
J. M. Watson ◽  
T. G. Harrison ◽  
C. L. R. Bartlett
Keyword(s):  
Prevention And Control ◽  
Clinical History ◽  
National Surveillance ◽  
England And Wales ◽  
Hospital Patients ◽  
Sporadic Cases ◽  
Legionnaires Disease ◽  
And Control ◽  
Surveillance Scheme

SUMMARYTwo hundred and eighteen nosocomial cases of Legionnaires' disease with 68 deaths were reported to the National Surveillance Scheme for Legionnaires Disease between 1980 and 1992, representing 15% of the reported infections acquired in England and Wales. Twenty–two nosocomial outbreaks accounted for 135 (62%) of these cases, the remainder occurring as single cases either in hospitals where other single cases or outbreaks had been reported in different years or as ‘sporadic’ cases in hospitals from which no other cases were reported. A clinical history prior to onset of Legionnaires' disease was available for 124 patients, 61 of whom had undergone recent transplant therapy or were immunosuppressed for other reasons.Sixty cases (27%) were diagnosed by culture of the organism and isolates from 56 patients were typed; 25 (42%) were nonL. pneumophilaserogroup 1 infections.Methods for prevention and control of nosocomial outbreaks are discussed, in particular the susceptibility to Legionnaires' disease of certain groups of hospital patients.

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