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Nosocomial Outbreak of Legionnaires' Disease: Molecular Epidemiology and Disease Control Measures

Published online by Cambridge University Press:  02 January 2015

Jeffrey M. Johnston ,
Robert H. Latham ,
Frederick A. Meier ,
Jon A. Green ,
Rebecca Boshard ,
Barbara R. Mooney  and
Paul H. Edelstein
Jeffrey M. Johnston*
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Robert H. Latham
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Frederick A. Meier
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Jon A. Green
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Rebecca Boshard
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Barbara R. Mooney
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
Paul H. Edelstein
Affiliation:
Center for Infections Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, Salt Lake City, Utah, and the Infectious Disease Section, Medical and Research Services, Wadsworth Veterans Administration Medical Center, Los Angeles, California
*
Center for Infectious Diseases, Diagnostic Microbiology and Immunology, University of Utah School of Medicine, 50 N. Medical Drive, Salt Lake City, UT 84132
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Abstract

Molecular laboratory techniques were used to study the epidemiology of an outbreak of nosocomial Legionnaires' disease. All patient isolates were Legionella pneumophila serogroup 1 and showed identical plasmid profiles and reactions with serogroup-specific monoclonal antibodies. L pneumophila was also cultured from four of five cooling tower water samples; however, the isolate from only one tower was serogroup 1 of the same sub-type as patient isolates. Since the cases were temporally clustered and epidemiologically associated with exposure to cooling tower aerosols, the single cooling tower implicated by molecular analysis was the most likely source of the outbreak. Chlorination of cooling tower ponds has eradicated the epidemic strain. Since potable water also harbored the infecting organism and was the probable source for cooling tower contamination, decontamination of the hospital water system was also undertaken. Superchlorination of hot water holding tanks to 17 ppm on a weekly basis has effectively eradicated L pneumophila from the potable water system and appears to be a reasonable, simple, and relatively inexpensive alternative to previously described methods of control.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 8 , Issue 2 , February 1987 , pp. 53 - 58
Copyright
Copyright © The Society for Healthcare Epidemiology of America 1987

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