K A Hamilton1, A J Prussin2, W Ahmed3, C N Haas4. 1. Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA. kh495@drexel.edu. 2. Virginia Polytechnic Institute and State University, Blacksburg, VA, 24061, USA. 3. CSIRO Land and Water, Ecosciences Precinct, 41 Boggo Road, Brisbane, QLD, 4102, Australia. 4. Drexel University, 3141 Chestnut Street, Philadelphia, PA, 19104, USA.
Abstract
PURPOSE OF REVIEW: The global importance of Legionnaires' disease (LD) and Pontiac fever (PF) has grown in recent years. While sporadic cases of LD and PF do not always provide contextual information for evaluating causes and drivers of Legionella risks, analysis of outbreaks provides an opportunity to assess these factors. RECENT FINDINGS: A review was performed and provides a summary of LD and PF outbreaks between 2006 and 2017. Of the 136 outbreaks, 115 were LD outbreaks, 4 were PF outbreaks, and 17 were mixed outbreaks of LD and PF. Cooling towers were implicated or suspected in the a large portion of LD or PF outbreaks (30% total outbreaks, 50% confirmed outbreak-associated cases, and 60% outbreak-associated deaths) over this period of time, while building water systems and pools/spas were also important contributors. Potable water/building water system outbreaks seldom identify specific building water system or fixture deficiencies. The outbreak data summarized here provides information for prioritizing and targeting risk analysis and mitigation strategies.
PURPOSE OF REVIEW: The global importance of Legionnaires' disease (LD) and Pontiac fever (PF) has grown in recent years. While sporadic cases of LD and PF do not always provide contextual information for evaluating causes and drivers of Legionella risks, analysis of outbreaks provides an opportunity to assess these factors. RECENT FINDINGS: A review was performed and provides a summary of LD and PF outbreaks between 2006 and 2017. Of the 136 outbreaks, 115 were LD outbreaks, 4 were PF outbreaks, and 17 were mixed outbreaks of LD and PF. Cooling towers were implicated or suspected in the a large portion of LD or PF outbreaks (30% total outbreaks, 50% confirmed outbreak-associated cases, and 60% outbreak-associated deaths) over this period of time, while building water systems and pools/spas were also important contributors. Potable water/building water system outbreaks seldom identify specific building water system or fixture deficiencies. The outbreak data summarized here provides information for prioritizing and targeting risk analysis and mitigation strategies.
Authors: Alicia Demirjian; Claressa E Lucas; Laurel E Garrison; Natalia A Kozak-Muiznieks; Stanley States; Ellen W Brown; Jonathan M Wortham; Amanda Beaudoin; Megan L Casey; Chandra Marriott; Alison M Ludwig; Ali F Sonel; Robert R Muder; Lauri A Hicks Journal: Clin Infect Dis Date: 2015-02-25 Impact factor: 9.079
Authors: Ed P F Yzerman; Jeroen W den Boer; Kamilla D Lettinga; Arnoud J Schel; Joop Schellekens; Marcel Peeters Journal: J Med Microbiol Date: 2006-05 Impact factor: 2.472
Authors: Stephanie A Hines; Daniel J Chappie; Robert A Lordo; Brian D Miller; Robert J Janke; H Alan Lindquist; Kim R Fox; Hiba S Ernst; Sarah C Taft Journal: Water Res Date: 2014-02-26 Impact factor: 11.236
Authors: Kerry A Hamilton; Mark T Hamilton; William Johnson; Patrick Jjemba; Zia Bukhari; Mark LeChevallier; Charles N Haas Journal: Water Res Date: 2017-12-13 Impact factor: 11.236
Authors: L A Hicks; C E Rose; B S Fields; M L Drees; J P Engel; P R Jenkins; B S Rouse; D Blythe; A P Khalifah; D R Feikin; C G Whitney Journal: Epidemiol Infect Date: 2006-11-23 Impact factor: 2.451
Authors: A Potts; M Donaghy; M Marley; R Othieno; J Stevenson; J Hyland; K G Pollock; D Lindsay; G Edwards; M F Hanson; K O Helgason Journal: Euro Surveill Date: 2013-12-12
Authors: Maria A Kyritsi; Varvara A Mouchtouri; Antonis Katsioulis; Elina Kostara; Vasileios Nakoulas; Marina Hatzinikou; Christos Hadjichristodoulou Journal: Int J Environ Res Public Health Date: 2018-11-30 Impact factor: 3.390