Details:

Alternative Title:
BMC Infect Dis
Publisher's site:
http://dx.doi.org/10.1186/1471-2334-13-291
Personal Author:
Silk, Benjamin J ; Foltz, Jennifer L ; Ngamsnga, Kompan ; Brown, Ellen ; Muñoz, Mary Grace ; ... More +
Silk, Benjamin J ; Foltz, Jennifer L ; Ngamsnga, Kompan ; Brown, Ellen ; Muñoz, Mary Grace ; Hampton, Lee M ; Jacobs-Slifka, Kara ; Kozak, Natalia A ; Underwood, J Michael ; Krick, John ; Travis, Tatiana ; Farrow, Olivia ; Fields, Barry S ; Blythe, David ; Hicks, Lauri A Less -
Description:
Background

During a Legionnaires’ disease (LD) outbreak, combined epidemiological and environmental investigations were conducted to identify prevention recommendations for facilities where elderly residents live independently but have an increased risk of legionellosis.

Methods

Survey responses (n = 143) were used to calculate attack rates and describe transmission routes by estimating relative risk (RR) and 95% confidence intervals (95% CI). Potable water collected from five apartments of LD patients and three randomly-selected apartments of residents without LD (n = 103 samples) was cultured for Legionella.

Results

Eight confirmed LD cases occurred among 171 residents (attack rate = 4.7%); two visitors also developed LD. One case was fatal. The average age of patients was 70 years (range: 62–77). LD risk was lower among residents who reported tub bathing instead of showering (RR = 0.13, 95% CI: 0.02–1.09, P = 0.03). Two respiratory cultures were characterized as L. pneumophila serogroup 1, monoclonal antibody type Knoxville (1,2,3), sequence type 222. An indistinguishable strain was detected in 31 (74%) of 42 potable water samples.

Conclusions

Managers of elderly-housing facilities and local public health officials should consider developing a Legionella prevention plan. When Legionella colonization of potable water is detected in these facilities, remediation is indicated to protect residents at higher risk. If LD occurs among residents, exposure reduction, heightened awareness, and clinical surveillance activities should be coordinated among stakeholders. For prompt diagnosis and effective treatment, clinicians should recognize the increased risk and atypical presentation of LD in older adults.


Subjects:
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Aged Algorithms Cohort Studies Disease Outbreaks Drinking Water Female Humans Incidence Legionella Pneumophila Legionnaires' Disease Male Middle Aged Risk Factors
Source:
BMC Infect Dis. 2013; 13:291.
Document Type:
Journal Article
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:baf62c99971f274ca8c7f0efaa004291d4e9f95c15a4a6c888a877bda2b5cec0
Download URL:
https://stacks.cdc.gov/view/cdc/19490/cdc_19490_DS1.pdf
File Type:

Supporting Files

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