Severe neonatal legionellosis associated with use of home humidifiers – A case report

Mitting, Rebecca; Rajagopal, Veena; Grossman, Thalita; Whittaker, Elizabeth; Chalker, Victoria J.; Lai, Sandra; Hoffman, Peter; Atkin, Sara; Qureshi, Sabeena; Hatcher, James

doi:10.1016/j.clinpr.2020.100050

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…These bacteria can be aerosolized in the tap water which may cause respiratory illness when the aerosolized water vapors are inhaled by people who are older, current or former smokers, or who have weakened immune systems. Reports of pulmonary disease and exposure to opportunistic human pathogens, such as non-tuberculous mycobacteria and Legionella through home showerheads is an emerging area of concern ( Falkinham et al 2008 ; Schoen & Ashbolt 2011 ; Thomson et al 2013 ; Mitting et al 2020 ; Schumacher et al 2020 ). An estimated 7.2 million waterborne illnesses occur annually in the US, with hospitalizations and deaths predominantly caused by biofilm-associated pathogens ( Collieret al 2021 ).…”

Section: Discussionmentioning

confidence: 99%

“…Manufacturers’ instructions for some devices (i.e., CPAPs) warn against using tap water, but instructions for humidifiers generally do not. However, humidifiers in the home have been linked to illnesses such as hypersensitivity pneumonitis ( Ando et al 2017 ), cavitary Pseudomonas pneumonia ( Woods et al 2017 ), and Legionnaires’ disease ( Mitting et al 2020 ). Following the manufacturer’s instructions for emptying the water tanks of water-aerosolizing devices to allow for proper cleaning and drying can help reduce exposure to waterborne pathogens at home ( Centers for Disease Control and Prevention 2021b ).…”

Section: Discussionmentioning

confidence: 99%

“…Inhalation of aerosolized tap water that contains these pathogens may cause illness in certain populations, such as older age groups or people with weakened immune systems ( Centers for Disease Control and Prevention 2021a ). Water-aerosolizing devices in the home that have been attributed to human illness include humidifiers ( Ando et al 2017 ; Woods et al 2017 ; Mitting et al 2020 ) and showerheads ( Falkinham et al 2008 ; Schoen & Ashbolt 2011 ; Thomson et al 2013 ). Demographic data on household use of water through such devices has not previously been collected.…”

Section: Introductionmentioning

confidence: 99%

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Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019

Esschert

Barrett

Collier

et al. 2021

Journal of Water and Health

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Tap water that is safe to consume may cause respiratory illness (e.g., Legionnaires’ disease) when water conditions allow for proliferation and aerosolization of biofilm-associated pathogens. This study assessed household tap water consumption, exposure to aerosolized tap water, and associated demographics. A nationally representative FallStyles survey administered by Porter Novelli Public Services was sent to 4,677 US adult panelists in October 2019. There were 3,624 adults who completed the survey (77.5% response rate). Respondents were asked about self-reported use of household tap water for consumption (i.e., drinking, rinsing produce, or making ice) and use through water-aerosolizing devices (e.g., showerheads, humidifiers). Demographics included gender, age, race/ethnicity, education, income, region, and health status. Weighted analyses using complex sample survey procedures were used to assess tap water exposure by route and demographics. Most US adults are exposed to aerosolized tap water through showering (80.6%), and one in five are exposed through other water-aerosolizing devices (20.3%). Consumption and showering were greatest among older, White, higher educated, and higher-income adults. Aerosolized tap water can transmit waterborne pathogens and cause respiratory illness, especially among older age groups and people with weakened immune systems. These results will help target health messages for using water-aerosolizing devices safely.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019

Esschert

Barrett

Collier

et al. 2021

Journal of Water and Health

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Improved biosensing of Legionella by integrating filtration and immunomagnetic separation of the bacteria retained in filters

Mesas Gómez,

Molina-Moya,

de Araujo Souza

et al. 2024

Microchim Acta

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A novel approach is presented that combines filtration and the direct immunomagnetic separation of the retained bacteria Legionella in filters, for further electrochemical immunosensing. This strategy allows for the separation and preconcentration of the water-borne pathogen from high-volume samples, up to 1000 mL. The limit of detection of the electrochemical immunosensor resulted in 100 CFU mL−1 and improved up to 0.1 CFU mL−1 when the preconcentration strategy was applied in 1 L of sample (103-fold improvement). Remarkably, the immunosensor achieves the limit of detection in less than 2.5 h and simplified the analytical procedure. This represents the lowest concentration reported to date for electrochemical immunosensing of Legionella cells without the need for pre-enrichment or DNA amplification. Furthermore, the study successfully demonstrates the extraction of bacteria retained on different filtering materials using immunomagnetic separation, highlighting the high efficiency of the magnetic particles to pull out the bacteria directly from solid materials. This promising feature expands the applicability of the method beyond water systems for detecting bacteria retained in air filters of air conditioning units by directly performing the immunomagnetic separation in the filters. Graphical abstract

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Severe neonatal legionellosis associated with use of home humidifiers – A case report

Cited by 2 publications

References 8 publications

Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019

Demographic differences in use of household tap water in a representative sample of US adults, FallStyles 2019

Improved biosensing of Legionella by integrating filtration and immunomagnetic separation of the bacteria retained in filters

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