Recent Legionnaires’ Disease Outbreaks
New York City • January 2015
In January the New York City Department of Health investigated 12 cases of Legionnaires’ disease diagnosed among Bronx residents since December, eight of whom live in the same residential complex. Cooling towers identified as a suspected source were disinfected by the operators.
Retirement Home in Spain • November 2014
Eight cases of Legionnaires’ disease were reported among residents of a retirement home in the northwest region of Spain in November. All eight were hospitalized but no deaths were reported. Around the same time, at least three cases of Legionnaires’ were reported at another nursing home about 21 kilometers away.
Rhode Island Hospital • November 2014
Two patients at Rhode Island Hospital were diagnosed with Legionnaires’ disease in November. Details about the number of days the case patients had been in the hospital and their exposure to water were not reported. In response to the cases, the hospital provided bottled water for drinking and performed “superheating and flushing” of the plumbing system in at least one building.
Major Outbreak in Portugal • November 2014
As of 13 November, the case count in an outbreak of Legionnaires’ disease near Lisbon had risen to 311, with 7 deaths, according to Portuguese health officials. The World Health Organization has called the outbreak a “major public health emergency.” Evidence of a possible source has not been reported but officials suspect the cooling towers at a fertilizer plant.
Four Retirement Home Residents in Lugo, Spain • November 2014
Four residents of the same retirement home in Lugo, Spain were diagnosed with Legionnaires’ disease in earlier November. All four were hospitalized. The Department of Health disinfected the building’s plumbing system.
Eight Legionnaires’ Cases in Alcoy, Spain • October-November 2014
Eight cases of Legionnaires’ disease were reported in the city of Alcoy over a 10-day period in late October and early November. As of November 3rd, six persons who required hospitalization had been discharged and the other four were recovering well. Health officials are attempting to identify the source of Legionella that caused the infections. Alcoy is located in the eastern part of Spain.
North Carolina Health Facility • September 2014
In late September, the North Carolina Department of Health and Human Services reported that Legionnaires’ disease had been diagnosed in two patients of a 327-bed facility for intellectual and developmental disabilities. The second case was identified after the first case prompted increased patient surveillance. The facility suspended admissions and restricted visitation while investigating and remediating the water systems. As of September 26th, one patient had recovered and the other was still receiving treatment.
Eight Deaths in Spain • September 2014
More than 40 cases of Legionnaires’ disease were identified in September in the Spanish towns of Sabadell and Ripollet, located only about 10 kilometers (6 miles) apart, near Barcelona. Eight of the patients have died. Health officials, believing the cases are part of two separate outbreaks, said the source of the Ripollet outbreak has not been established but the source of the Sabadell outbreak is likely a particular company’s cooling tower. According to news reports, if the cooling tower is confirmed to be the source of the Sabadell outbreak and is not in compliance with every cleaning and maintenance regulation, the company could be fined up to 600,000 Euros (US$751,000). No new cases have been identified since late September.
North Carolina Nursing Home • August-September 2014
Legionnaires’ disease has been reported in three residents of a nursing home in Hoke County, North Carolina. The first case was diagnosed on August 28th and the other two after all the residents were tested for Legionella.
Cooling Towers Investigated in German Outbreak • August-September 2014
Cooling towers at a power plant, research center, and metalworking and plastics plants are under investigation as possible sources of 60 suspected and 23 confirmed cases of Legionnaires’ disease identified in the German town of Juelich in August and September. Two of the patients have died.
Three Guests of a Hotel in California • August 2014
Three people who had stayed at a hotel in Ukiah, CA were hospitalized with Legionnaires’ disease in early August. County health officials suspected the hotel’s water systems were the source.
Four Cases in Grimsby, UK • July 2014
Four people diagnosed with Legionnaires’ disease in late July had all been in the area around Freeman Street in Grimsby in the days before onset of illness. As of early August news reports, no common source had been identified and all four patients were recovering.
Travelers to a Softball Tournament in Alabama • July 2014
The Alabama Department of Public Health launched an outbreak investigation after receiving phone calls about illness in several children and adults who had traveled to a softball tournament in early to mid July. Among the group of 40 who traveled to the event, 16 reported symptoms of fever, cough, nausea, diarrhea, or vomiting, three of whom tested positive for Legionella and were hospitalized. The state health department said a hotel in Elmore County was the common link among the three who tested positive for Legionella.
Veterans Health Facility Near Orlando • July 2014
Three veterans receiving care at a new VA health facility in Lake Nona, Florida were diagnosed with Legionnaires’ disease in July. One has since died.
Hotel in Ocean City, Maryland • Summer 2014
Legionnaires’ disease has been reported among hotel guests in Ocean City, Maryland yet again, this time in two people who stayed at the same hotel this summer. Both guests recovered after seeking treatment elsewhere in Maryland.
Three North Carolina Nursing Homes • June-July 2014
Since mid June, Legionnaires’ disease has been reported at three nursing homes in North Carolina, two in Wilson County and one in Forsyth County. Five residents and three visitors of a nursing home in Wilson County were diagnosed with the disease and have recovered. Three additional cases were linked to another nursing home in Wilson County, at a state-operated facility. Six cases of Legionnaires’ disease were identified among residents of a nursing home in Forsyth County, all of whom have recovered. No new cases have been reported in Wilson County homes since July 10th or in Forsyth County home since July 24th.
Baby Contracts Legionnaires’ Disease During Birth in Pool • June 2014
Public Health England has advised against the use of home birthing pools. It issued a temporary warning in June after a case of Legionnaires’ disease was identified in a baby born in a home pool and confirmed the advice earlier this month after investigating the pools and finding unsatisfactory risk control procedures. The alert pertains only to birthing pools with heaters and circulation as opposed to pools that are filled from the home’s hot water system and do not incorporate heaters or circulation pumps. The full press release is at https://www.gov.uk/government/news/public-health-england-advice-on-home-birthing-pools.
Eight Cases at an Alabama Hospital • May 2014
Two patients in the hematology/oncology unit of an Alabama hospital died In late May after laboratory tests confirmed a Legionella infection. Six other patients in the same unit tested positive for Legionella. After the cases were identified, the hospital installed filters on showers and faucets, flushed superheated water through the hot water piping in part of the hospital, and asked patients to temporarily wear masks when flushing the toilet. The news articles did not state the hospital’s longer term plan, if any, for controlling Legionella.
Melbourne, Australia • April-May 2014
Two men and a woman were hospitalized with Legionnaires’ disease after spending time in the same area of Melbourne late April and early May. Health officials have focused their investigation on cooling towers in the area.
Senior Living Facility in Florida • April 2014
On April 18th, the Duval County Health Department in Jacksonville, Florida issued a health advisory after Legionnaires’ disease was identified in three residents of an elder care facility. Health officials collected water samples from the facility’s water systems. Source: First Coast News
Indianapolis Hospital • January 2014
An Indianapolis (USA) hospital restricted patient showers and baths and provided bottled water for drinking after two patients contracted Legionnaires’ disease. Both patients have died. Legionella was found in the hospital plumbing water after the cases were identified. The hospital implemented procedures to temporarily disinfect its plumbing system. Source: indystar.com