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

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.

Authors

  • Celia Quinn, MPH, MD
  • Alicia Demirian, MMSc, MD
  • Louise Francois Watkins, MPH, MD
  • Sara Tomczyk, MSc, PHN
  • Claressa Lucas, PhD
  • Ellen Brown
  • Natalia Kozak-Muiznieks, PhD
  • Laurel E. Garrison, MPH
  • Jasen Kunz, MPH
  • Scott Brewer, MPH
  • Samantha Eitnier, MPH
  • Mary DiOrio, MPH, MD
Volume#: 78.5
Page #: 8-13
Publication Month: December 2015

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