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3. Legionnaires' Disease Outbreak at a Long-Term Care Facility Caused by a Cooling Tower Using an Automated Disinfection System--Ohio, 2013.

Author

Quinn C, Demirjian A, Watkins LF, Tomczyk S, Lucas C, Brown E, Kozak-Muiznieks N, Benitez A, Garrison LE, Kunz J, Brewer S, Eitniear S, and DiOrio M

Subjects
Aged, Aged, 80 and over, Air Conditioning, Disinfectants administration & dosage, Disinfection instrumentation, Female, Humans, Legionella pneumophila classification, Legionella pneumophila isolation & purification, Legionnaires' Disease microbiology, Legionnaires' Disease mortality, Long-Term Care, Male, Middle Aged, Ohio epidemiology, Disease Outbreaks, Disinfection methods, Legionella pneumophila physiology, Legionnaires' Disease epidemiology, Nursing Homes, Water Microbiology
Abstract

On July 9, 2013, an outbreak of Legionnaires' disease (LD) was identified at Long-Term Care Facility A in central Ohio. This article describes the investigation of the outbreak and identification of the outbreak source, a cooling tower using an automated biocide delivery system. In total, 39 outbreak LD cases were identified; among these, six patients died. Water samples from a cooling tower were positive for Legionella pneumophila serogroup 1, reactive to monoclonal antibody 2, with matching sequence type to a patient isolate. An electronic control system turned off cooling tower pumps during low-demand periods, preventing delivery of disinfectant by a timed-release system, and leading to amplification of Legionella in the cooling tower. Guidelines for tower maintenance should address optimal disinfection when using automated systems.

Published
2015

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