Outbreak of Legionnaires' disease associated with cooling towers at a California state prison, 2015.
Epidemiol Infect
; 146(3): 297-302, 2018 02.
Article
in En
| MEDLINE
| ID: mdl-29386076
ABSTRACT
A large outbreak of Legionnaires' disease occurred at a California state prison in August 2015. We conducted environmental and epidemiological investigations to identify the most likely source of exposure and characterise morbidity. Sixty-four inmates had probable Legionnaires' disease; 14 had laboratory-confirmed legionellosis. Thirteen (17%) inmates were hospitalised; there were no deaths. Ill inmates were more likely to be ⩾65 years old (P < 0.01), have the chronic obstructive pulmonary disease (P < 0.01), diabetes mellitus (P = 0.02), hepatitis C infection (P < 0.01), or end-stage liver disease (P < 0.01). The case-patients were in ten housing units throughout the prison grounds. All either resided in or were near the central clinical building (for appointments or yard time) during their incubation periods. Legionella pneumophila serogroup 1 was cultured from three cooling towers on top of the central medical clinic (range, 880-1200 cfu/ml). An inadequate water management program, dense biofilm within the cooling towers, and high ambient temperatures preceding the outbreak created an ideal environment for Legionella sp. proliferation. All state prisons were directed to develop local operating procedures for maintaining their cooling towers and the state health department added a review of the maintenance plans to their environmental inspection protocol.
Key words
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Prisons
/
Water Microbiology
/
Legionnaires' Disease
/
Disease Outbreaks
/
Legionella pneumophila
Type of study:
Etiology_studies
/
Guideline
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adult
/
Aged
/
Aged80
/
Humans
/
Middle aged
Country/Region as subject:
America do norte
Language:
En
Journal:
Epidemiol Infect
Journal subject:
DOENCAS TRANSMISSIVEIS
/
EPIDEMIOLOGIA
Year:
2018
Document type:
Article
Affiliation country:
United States