1. Incorporating Novel Methods Into a Standard Environmental Legionnaires' Disease Investigation and Identifying the Exposure Source of an Outbreak in New York
- Author
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Morse, Matthew, Savage, Braden, Lauper, Ursula, Dziewulski, David, Mingle, Lisa, Wanjugi, Pauline, Blumerman, Seth, Zartarian, Martin, and Wroblewski, Danielle
- Subjects
Epidemics -- Control -- Environmental aspects -- United States ,Legionellosis -- Distribution -- Control -- Genetic aspects ,Legionnaires' disease -- Distribution -- Control -- Genetic aspects ,Company distribution practices ,Environmental issues ,Health - Abstract
A total of 17 Legionnaires' disease cases were identified in an outbreak in a western town in New York. The cases had symptom onset dates ranging from August 1, 2019, to July 1, 2021. Staff from the New York State Department of Health and Chemung County Health Department employed numerous environmental investigation techniques. Environmental health program staff collected 74 environmental samples, including samples from cooling towers, residences, and a wastewater treatment plant. Wind direction was analyzed to determine the potential for the dispersion of aerosolized Legionella. In total, five cases were found to be genetically related by whole genome sequencing. Further testing revealed that isolates recovered from a cooling tower at an industrial facility were genetically related to four of the 2019 cases. Excessive iron was found in the tower and might have suppressed the oxidizing biocide residual and interfered with the evaluation of routine culture and other testing methods. In 2021, clinical and environmental samples from a private hot tub were found to be genetically related to the four matching cases and cooling tower samples recovered in 2019. Keywords: Legionnaires' disease, Legionella, cooling tower, outbreak, investigation, Introduction Infections from Legionella are a leading cause of waterborne disease outbreaks in the U.S. (Weiss et al., 2017). Legionnaires' disease (LD) is a type of pneumonia caused by inhaling [...]
- Published
- 2024