Legionnaires’ Disease Outbreaks and Cooling Towers, New York City, New York, USA

Fitzhenry, Robert; Weiss, Don; Cimini, D; Balter, Sharon; Boyd, Christopher; Alleyne, Lisa; Stewart, R. G.; McIntosh, Natasha; Econome, Andrea; Lin, Ying; Rubinstein, Inessa; Passaretti, Teresa; Kidney, Anna; Lapierre, Pascal; Kass, Daniel; Varma, Jay K.

doi:10.3201/eid2311.161584

Cited by 50 publications

(47 citation statements)

References 24 publications

(21 reference statements)

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“…ABD Hastalık Kontrol Merkezi (CDC) risk gruplarını aşağıdaki başlıklarda sıralamaktadır (9) : Lejyoner hastalığı olgu sayılarında yıllar içerisinde artış dikkati çektiği, olgu insidansının 2000 yılından günümüze ABD'de yaklaşık 4 kat, 1995 yılından bu yana Avrupa'da da yaklaşık 3 kat arttığı belirtilmekte ve ABD'de yılda 8-18 bin kişinin LH nedeniyle hastaneye yattığı tahmin edilmektedir (10,11) .…”

Section: Lejyoner Hastaliğiunclassified

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As a Waterborne Disease Legionnaıre's Disease and Environmental Survey

Yavuz¹

2018

TMCD

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Lejyoner hastalığı, Legionella pneumophila'nın neden olduğu, sık görülmeyen ancak belirli risk grupları için tehlikeli, ağırlıklı olarak pnömoni ile seyreden bir hastalıktır. Hastalık, suda bulunan Legionella bekterisinin aerosolize olması ve kontamine aeresollerin solunmasıyla bulaşır. Legionella suda ve toprakta doğal olarak bulunabilir. Çok farklı çevresel koşullara dayanıklıdır ve bu koşullarda yaşamını sürdürebilir. Sucul ortamlarda bulunur ve suda belirli şartlarda çoğalır. Hastalıktan korunmada temel strateji, binalarda su sistemlerinde ve suyla ilgili alanlarda önlemler alınmasıdır. Hastalığın kontrolünde çevresel sürveyans önemli bir yer tutmaktadır. Ülkemizde Sağlık Bakanlığı tarafından yapılan yasal düzenlemeler ve Hastalık Kontrol Programı başta hastaneler olmak üzere birçok kuruluşa çeşitli yükümlülükler getirmektedir. Bu makalede, Lejyoner hastalığı bulaş yolu ve çevresel sürveyansın özellikleri hakkında bilgi aktarılması amaçlanmıştır.

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Section: Lejyoner Hastaliğiunclassified

“…Bu üç kategori toplum kökenli LH, seyahat ilişkili LH ve nozokomiyal LH'dir (1) . Bu üç kategoriden LH olgularının yaklaşık %70'inin toplum kökenli, yaklaşık %20'sinin seyahat ilişkili, yaklaşık %10'unun ise nazokomiyal olduğu belirtilmektedir (10) :…”

Section: Lejyoner Hastaliğiunclassified

As a Waterborne Disease Legionnaıre's Disease and Environmental Survey

Yavuz¹

2018

TMCD

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“…Temperatures in the range of 20 °C to 45 °C together with stagnancy, sediment, sludge, scale, rust and microbial multispecies biofilms with protozoa within the water system provide favorable conditions for Legionella growing [1]. Free-living thermo-tolerant amoebae play a crucial role in the lifecycle of Legionella species as they provide a habitat for Legionella environmental survival and replication and also this intra-cel-nella transmission and cause either LD or Pontiac fever [6,10,14]. Reported legionellosis outbreaks with both LD and PF are relatively rare [10].…”

Section: Introductionmentioning

confidence: 99%

“…They include mostly open-circuit cooling towers that can range in size from small towers used in air conditioning to large towers for heavy industrial applications [15]. Aerosols generated from open cooling towers can through water droplets transmit legionellae over large distances to susceptible hosts [16] and cause legionellosis in community [10,14] as well as in hospitals [17]. It is imperative that CT are managed to prevent legionella colonization and the potential release of contaminated aerosols.…”

Section: Introductionmentioning

confidence: 99%

“…Therefore disinfection by biocides, control of quality of recirculating water in storage tanks/ponds of CT and monitoring of legionellae, biological and chemical conditions favorable for legionellae are most important preventive measures [1,15,18]. Control and registration of cooling towers can prevent some legionella community acquired and nosocomial outbreaks, of special concern are industrial CT [1,14,19,20].…”

Section: Introductionmentioning

confidence: 99%

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Risk of Legionellosis from Exposure to Water Aerosol from Industrial Cooling Tower

Spaleková¹,

Kotrbancová²,

Fulová³

et al. 2019

Int Arch Public Health Community Med

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Background: Community-acquired cases of Legionella infection or even outbreaks can be attributed to inhalation of aerosols from devices such as hot water system, cooling towers, hot tubs, industrial equipment and indoor fountains. Legionellae survive in water in temperatures between 20 °C and 50 °C and tend to colonize particularly water systems rich of sludge, rust, biofilms and amoebae where they can multiply. Cooling towers (CT) in industry are used as heat-transfer devices in which warm water is cooled by evaporation in atmospheric air. Aerosols can transmit Legionellae to susceptible hosts, who can contract either Legionnaires´ disease (elderly with many risk factors) or Pontiac fever (young or middle-aged people relatively healthy without any risk factors). Aim: Aim of the study was risk assessment of legionellosis for workers in contact with contaminated water aerosol from industrial cooling towers. Methods: Water samples from industrial cooling towers and air samples were processed by standard manner (EN ISO 11731) and plated on special buffered charcoal yeast extract agar with 0.1% ketoglutarate and L-cysteine (BCYα medium) containing glycine, vancomycin, polymyxin B, cycloheximide (GVPC medium) for Legionella isolation. Exposure of workers to water aerosols was evaluated by interview, questionnaire, serological testing (agglutination test), cultivation of sputum on BMPA (BCYα medium with cefamandole, polymyxin B, anisomycin), detection of Legionella antigen in urine by ELISA and DNA Legionella in sera by PCR. Results: Sampling water from 6 cooling towers revealed isolates of Legionella pneumophila (L.p.) serogroups 1, 5, 10 from four of them (1,6 × 10 2-1,49 × 10 4 /200 ml). Investigation of air around three CT showed contamination by L. p. serogroup 12 in one of them. Antibodies only against this L. p. serogroup 12 were detected in single sera (1:128-1:256) in 13 workers, i.e. in two external workers working directly inside CT (diving) and 11 internal workers, who attended instruction meeting lasting several hours close to this tower. The workers contracted non-pneumonic infection-Pontiac fever with mild clinical symptoms. Conclusion: Exposure to water aerosols produced by the industrial cooling tower led to the cluster of non-pneumonic professional Legionella infection in workers. Results of the study were used for recommendation of repressive (disinfection, operating regimen of towers) and preventive (respiratory protective equipment, monitoring of Legionella colonization, etc.) measures.

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Examining the efficacy of copper‐silver ionization for management of Legionella: Recommendations for optimal use

LeChevallier¹

2023

AWWA Water Science

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Although copper‐silver ionization (CSI) has been used for 30 years to inactivate Legionella bacteria and other opportunistic pathogens in water, the literature is a mix of both successes and failures. This paper reviews the technology and case studies to help improve the success of CSI installations. Important is a properly designed system capable of consistent delivery of copper/silver ions at their target levels. However, even the most advanced system will fail if not properly operated and maintained. Water chemistry can impact the performance of CSI systems and attention should be on conductivity, temperature, oxygen, flow, pH, chloride, sulfate, alkalinity, hardness, phosphate and dissolved organic carbon levels. Several case studies are provided to demonstrate the effectiveness of CSI treatment even at high pH levels. The report concludes that the use of CSI to control Legionella and other opportunistic pathogens is highly effective when the units are properly designed, maintained, and operated.

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Legionnaires’ Disease Outbreaks and Cooling Towers, New York City, New York, USA

Abstract: Surveillance will determine whether a new law regulating cooling towers reduces the incidence of Legionnaires’ disease.

Cited by 50 publications

References 24 publications

As a Waterborne Disease Legionnaıre's Disease and Environmental Survey

As a Waterborne Disease Legionnaıre's Disease and Environmental Survey

Risk of Legionellosis from Exposure to Water Aerosol from Industrial Cooling Tower

Examining the efficacy of copper‐silver ionization for management of Legionella: Recommendations for optimal use

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