Nosocomial legionnaires' disease: epidemiologic demonstration of cooling towers as a source. [Legionella pneumophila]

Journal Article · Fri Jul 26 00:00:00 EDT 1985 · JAMA, J. Am. Med. Assoc.; (United States)

DOI:https://doi.org/10.1001/jama.1985.03360040075028· OSTI ID:6030976

Garbe, P L; Davis, B J; Weisfeld, J S; Markowitz, L; Barbaree, J M; Reingold, A L

Investigation of a recent outbreak of nosocomial legionnaires' disease - initially thought to be due to the documented presence of Legionella pneumophila in the hospital potable water - showed that aerosols from one or more cooling towers were the actual source of infection. From June 27 to Aug 25, 1983, nosocomial legionnaires' disease developed in 15 persons at a hospital in Rhode Island. Twelve (80%) of 15 case-patients occupied rooms in building 1, unit B, compared with eight (28%) of 29 control patients (odds ratio = 10.8; 95% confidence interval = 1.4 to 85.6). Subsequent investigation demonstrated that water in a cooling tower located 100 ft upwind of unit B was heavily contaminated with L. pneumophila, serogroup 1, subgroup 1, 2, 4, 5. The same strain was isolated from nine of the patients and from the make-up water for the tower. Active surveillance during the ten months following decontamination of the cooling tower identified no additional cases of nosocomial legionnaires' disease, although the hospital potable water had not been treated. While recommendations have been made for controlling nosocomial legionnaires' disease by heating or hyperchlorination of hospital potable water, this outbreak demonstrates the importance of an adequate epidemiologic-environmental investigation in choosing the appropriate control strategy.

• Research Organization: Centers for Disease Control, Atlanta, GA
• OSTI ID: 6030976
• Journal Information: JAMA, J. Am. Med. Assoc.; (United States), Journal Name: JAMA, J. Am. Med. Assoc.; (United States) Vol. 254:4; ISSN JAMAA
• Country of Publication: United States
• Language: English

Related Subjects

500200 -- Environment
Atmospheric-- Chemicals Monitoring & Transport-- (-1989)
54 ENVIRONMENTAL SCIENCES
560306* -- Chemicals Metabolism & Toxicology-- Man-- (-1987)
63 RADIATION, THERMAL, AND OTHER ENVIRON. POLLUTANT EFFECTS ON LIVING ORGS. AND BIOL. MAT.
AEROSOLS
AIR POLLUTION CONTROL
BACTERIA
BACTERIAL DISEASES
BUILDINGS
CLEANING
COLLOIDS
CONTROL
COOLING TOWERS
DECONTAMINATION
DISEASES
DISPERSIONS
ENVIRONMENTAL EXPOSURE PATHWAY
ETIOLOGY
HOSPITALS
INFECTIOUS DISEASES
INFECTIVITY
LEGIONELLA PNEUMOPHILA
MECHANICAL STRUCTURES
MEDICAL ESTABLISHMENTS
MICROORGANISMS
PATIENTS
POLLUTION CONTROL
SOLS
TOWERS