Recent Legionnaires’ Disease Outbreaks

Bresso, Italy • July 2018
As of July 26, an outbreak of Legionnaires’ disease in Bresso, Italy, near Milan, has affected 26 people, including 3 elderly individuals who have died. Water testing and remediation is ongoing. In the first round of testing, Legionella was found in one sample from the home of a patient and in one from a public fountain. The town mayor closed 4 public fountains as a precaution. A city swimming pool and sports center were included in the second testing round, the results for which have not been reported.

New York City (Washington Heights) • July 2018
An outbreak of Legionnaires’ disease in the Upper Manhattan neighborhood Washington Heights sickened 27 individuals, 25 of whom were hospitalized. 1 has died. According to news reports, New York City health officials said on Tuesday, August 14, that no new cases had been diagnosed in the previous three weeks. The first cases were reported July 11. The health department suspects a cooling tower located near the neighborhood was likely the source based on a Legionella strain match between the cooling tower and 6 of the case-patients. That cooling tower had been cleaned and disinfected on July 13.

Cleveland, OH • July 2018
11 parishioners of a church in Parma, a suburb of Cleveland, were diagnosed with Legionnaires’ disease between early June and mid-July. 10 of those individuals were hospitalized and one, a 93-year-old Parma woman, has died. Legionella was not found in samples collected by the health department from the church’s cooling tower on July 23 and from the plumbing system on July 26. Health officials have not confirmed the church as the source but are not investigating other potential sources.

Palm Springs, CA • July 2018
On July 4, the Riverside County (California) Department of Environmental Health closed swimming pools at a retirement community in Palm Springs after test results came back positive for Legionella. The health department had received confirmation of Legionnaires’ disease among two of the residents 12 days prior. The pools remained closed until sometime in August.

Detroit, MI • May-July 2018
3 cases of Legionnaires’ disease were reported among people on a college campus in Detroit, MI. The first case, a university employee, was confirmed in May. The university then tested 16 buildings and found Legionella in three cooling tower systems and in 3 bathrooms. Two more cases were confirmed in July, among workers on a campus construction project.

McHenry County, IL • June 2018
On July 10, the McHenry County Department of Health (MCDH) issued an announcement that Legionnaires’ disease had been diagnosed in 9 county residents between June 7 and July 1. The cases occurred among people ranging from 46 to 82 years of age and residing in various areas of the county. MCDH warned residents experiencing Legionnaires’ disease symptoms to see a doctor.

Columbus, Ohio • June 2018
Two veterans were diagnosed with Legionnaires’ disease in Columbus, OH after having both visited the primary care area of a VA ambulatory care center in Whitehall. 5 additional patients presented symptoms of the disease. The clinic disabled 26 drinking fountains, notified employees, and tested the water for Legionella.

Honolulu, HI • June 2018
Legionnaires’ disease was diagnosed in 4 patients of a Honolulu hospital in June. One of the patients has died. After the cases were reported, the hospital implemented water restrictions, had its water systems tested for Legionella, chlorinated, and began a faucet flushing program.

Laughlin, NV • March 2018
Legionnaires’ disease was confirmed in two guests who stayed at the same casino resort in Laughlin, NV. The cases occurred November of 2017 and March of this year but the hotel apparently was not notified by health officials until mid-June. At the request of the Southern Nevada Health District, the hotel provided guest information dating back to October 2017, posted a survey on its website to ask about any symptoms experienced among guests, disinfected water systems, and updated its water management plan.

Sarasota County, Florida • February 2018
Florida health officials investigated Legionnaires’ disease diagnosed in late February in approximately 13 people, all of whom had been in the spa and pool area of a single-family home community in North Port (Sarasota County). Although the investigators found Legionella in the water heater for the pool area fitness center, but not in the pool or spa, they suspected the pool or spa as the more likely source, probably because Legionella tests had not been conducted prior to disinfection.

San Antonio, TX • February 2018
A staff member at Brooke Army Medical Center in San Antonio was diagnosed with Legionnaires’ disease on February 6. Based on the Texas Department of State Health Services “Emerging and Acute Infectious ‎Disease Guidelines” (https://www.dshs.texas.gov/foodestablishments/pdf/GuidanceDocs/The-Emerging-and-Acute-Infectious-Disease-Guidelines-2016.pdf), the case was considered part of an outbreak that affected two other staff members last summer. After identifying a water heater as the suspected source, the building in which it was located was evacuated.

Sydney, Australia • February 2018
Onset of Legionnaires’ symptoms occurred around the same time, between February 3 and 5, for three men who spent time in the Castle Hill area (near Sydney). News reports indicated that the health officials focused their investigation on cooling towers in the area.

Lisbon • January 2018
Health officials said a Lisbon hospital’s domestic water system was the most likely source of Legionella that caused infections in 9 women and 4 men in late January, 3 of whom were still in intensive care when the outbreak was reported.

Christchurch, New Zealand • November 2017
Potting mix the suspected source of 10 cases. Ten people in Christchurch, New Zealand were hospitalized with Legionnaires’ disease earlier this month. Potting mix was reported as the suspected source. In New Zealand and Australia, Legionella longbeachae in potting mix is a major source of Legionnaires’ disease, accounting for approximately half of reported cases.

Majorca, Spain • October 2017
Health officials identified a whirlpool spa at a hotel in the Balearic Islands (Majorca, Spain) as the source of Legionella that infected 19 British tourists who stayed there between mid-August and mid-October. One of the tourists, a 70-year-old man who had underlying illness, died in October.

Lisbon, Portugal • October 2017
Forty-Six Legionella infections have been diagnosed among patients of a hospital in the Lisbon area of Portugal since October 31. Four of the patients have died. Portuguese health officials suspect the source of the outbreak was the hospital’s domestic (potable) plumbing system.

Flushing, New York • October 2017
Fifteen cases of Legionnaires’ disease were identified in Flushing, NY (New York City area) in October. NYC Health investigators tested several cooling towers and ordered disinfection of the ones in which Legionella was found.

New York City • October 2017
Five residents of an assisted living facility in the Bronx (New York City) Riverdale neighborhood were diagnosed with Legionnaires’ disease last month. All five recovered without hospitalization. Little information about the investigation or response was found in news reports except that additional chemicals were added to the facility’s cooling towers.

Round Rock, TX • October 2017
Legionnaires’ disease has been confirmed in four guests and one employee of a hotel in Round Rock, Texas (near Austin). The hotel was shut down on Wednesday, October 4 for disinfection of the water systems.

Disneyland, CA • September 2017
Twelve people who spent time in Anaheim, California in September were diagnosed with Legionnaires’ disease. After Orange County health officials saw that 9 of the 12 had visited Disneyland, the park shut down and disinfected two cooling towers. Most of the 12 who contracted the disease were hospitalized. One of the three persons who did not visit Disneyland in the days before onset of infection has died. Information about the environmental and epidemiologic investigation has not been reported.

Spain • September 2017
12 cases of Legionnaires’ disease, including one death, have been reported among guests of a resort in northern Spain (Cantabria) since August. Part of the facility was closed for remediation.

England • September 2017
Public Health England closed a hotel in Burton, England (near Birmingham) after a guest was diagnosed with Legionnaires’ disease in September and Legionella bacteria was found in the hotel’s plumbing system. Another guest of the hotel was diagnosed with the disease in January. Both patients have recovered.

Maple Grove, MN • September 2017
Legionnaires’ disease was identified in two residents of an assisted living facility in Maple Grove, MN, the first in late August and another in mid-September. Minnesota health officials investigated the building water systems. The facility closed its pools and advised residents to not shower or use tap water for drinking or brushing teeth.

Valencia, Spain • August 2017
The water supply to a housing development in Valencia, Spain was chlorinated on August 16 in response to 7 cases of Legionnaires’ disease.

San Antonio, TX • August 2017
Brooke Army Medical Center in San Antonio confirmed that Legionnaires’ disease had been identified in two staff members during the last week in July and tests were pending for a third. According to an August 10 news report, 200 employees had been relocated and water testing initiated.

Seattle, WA • August 2017
Two University of Washington Medical Center patients were diagnosed with Legionnaires’ disease. One of the two, a woman in her 20s with underlying medical conditions, died on August 25. Approximately one year ago, Legionnaires’ disease was diagnosed in five patients of the same hospital building, two of whom died. The hospital said it is treating a third Legionnaires’ case it believes was contracted elsewhere.

Ohio • July 2017
An Ohio prison restricted showers, distributed bottled water, and installed filters on faucets in July after two inmates were diagnosed with Legionnaires’ disease.

Washington • July 2017
The Washington Department of Health is investigating two cases of Legionnaires’ disease diagnosed in two members of the same gym in Kennewick. The health department found no other common link between the two patients. The gym’s pool and hot tub were to be disinfected prior to reopening.

Memphis, TN • June 2017
Nine cases of Legionnaires’ disease have been identified in guests who stayed at a hotel in Memphis between May 15 and June 26. The Shelby County Health Department allowed the pools and hot tubs to be reopened after finding no Legionella in water samples collected from them following remediation.

Manhattan • June 2017
NYC Health collected samples for Legionella testing from more than 100 cooling towers in the vicinity of Lenox Hill in June in an effort to identify the source of seven cases of Legionnaires’ disease. Six persons were hospitalized. A woman in her 90s has died.

Ohio • May 2017
Five residents of a Reynoldsburg, Ohio senior apartment complex were diagnosed with Legionnaires’ disease in April and early May. Legionella was found in the building’s potable (plumbing) water system. Hyperchlorination was performed to temporarily disinfect the system.

Australia • May 2017
Two outbreaks of Legionnaires’ disease in Australia were under investigation in early May, one in Melbourne and the other in Adelaide. A total of 7 people were hospitalized. The patients ranged from 45 to 78 years of age. The investigation apparently focused on cooling towers.

California • May 2017
A community pool and spa in Orange County, California was closed on May 12 after two cases of Legionnaires’ disease were diagnosed among residents that used it. Health agency officials notified residents in the area to call their doctors if symptoms indicated a possible Legionella infection. The pool and spa were to remain closed pending acceptable test results.

Dubai • May 2017
The European Centres for Disease Prevention and Control (ECDC) identified 60 cases of Legionnaires’ disease among travelers to Dubai between Oct 2016 and May 2017, most of whom had stayed in hotels. The number of cases is higher than normal.

Orlando • April 2017
A fitness center in Orlando notified its members by email on April 18th that three people who had recently used the gym contracted Legionnaires’ disease. The fitness center decontaminated its hot tub and installed filtered shower heads per health department recommendations.

Macau, Hong Kong • March 2017
Three Hong Kong men who had stayed at or visited a new 3000-room casino resort in Macau between December and March were diagnosed with Legionnaires’ disease. All three men were hospitalized – one in critical and two in serious condition – were treated, and recovered. Health authorities inspected the property’s fountains, whirlpool spas, swimming pools, and plumbing systems, collected samples, and ordered disinfection of the spas and plumbing systems.

Mihara, Japan • March 2017
Legionella was detected in 39 people who complained of pneumonia-like symptoms after visiting an onsen in Mihara, Japan. 37 were hospitalized, including a man in his 50s who has died. The onsen has indoor and outdoor bathing facilities supplied by hot spring water at approximately 45 degrees C (113 degrees F) and an adjoining inn with hot spring baths in each guest room. It was closed on March 21.

Melbourne • March 2017
Three men and two women ranging from 51 to 71 years of age were hospitalized with Legionnaires’ disease in late March to early April. All five reported spending time in the eastern end of Melbourne’s central business district in the days before onset of illness. One of the patients required life support in intensive care but all have been discharged. Authorities are sampling in search for the source and have disinfected several systems and warned people experiencing pneumonia or flu-like symptoms to see their physician.

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