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Legionella longbeachae detected in an industrial cooling tower linked to a legionellosis outbreak, New Zealand, 2015; possible waterborne transmission?

Abstract A legionellosis outbreak at an industrial site was investigated to identify and control the source. Cases were identified from disease notifications, workplace illness records, and from clinicians. Cases were interviewed for symptoms and risk factors and tested for legionellosis. Implicated environmental sources were sampled and tested for legionella. We identified six cases with Legionnaires' disease and seven with Pontiac fever; all had been exposed to aerosols from the cooling towers on the site. Nine cases had evidence of infection with either Legionella pneumophila serogroup (sg) 1 or Legionella longbeachae sg1; these organisms were also isolated from the cooling towers. There was 100% DNA sequence homology between cooling tower and clinical isolates of L. pneumophila sg1 using sequence-based typing analysis; no clinical L. longbeachae isolates were available to compare with environmental isolates. Routine monitoring of the towers prior to the outbreak failed to detect any legionella. Data from this outbreak indicate that L. pneumophila sg1 transmission occurred from the cooling towers; in addition, L. longbeachae transmission was suggested but remains unproven. L. longbeachae detection in cooling towers has not been previously reported in association with legionellosis outbreaks. Waterborne transmission should not be discounted in investigations for the source of L. longbeachae infection.
PMID
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Prevalence of Legionella strains in cooling towers and legionellosis cases in New Zealand.

Authors

Mayor MeshTerms

Disease Outbreaks

Water Microbiology

Keywords

Legionella longbeachae

Legionnaires' disease

legionella

occupation-related infections

outbreaks

water-borne infections

Journal Title epidemiology and infection
Publication Year Start




PMID- 28625225
OWN - NLM
STAT- MEDLINE
DA  - 20170619
DCOM- 20170818
LR  - 20170818
IS  - 1469-4409 (Electronic)
IS  - 0950-2688 (Linking)
VI  - 145
IP  - 11
DP  - 2017 Aug
TI  - Legionella longbeachae detected in an industrial cooling tower linked to a
      legionellosis outbreak, New Zealand, 2015; possible waterborne transmission?
PG  - 2382-2389
LID - 10.1017/S0950268817001170 [doi]
AB  - A legionellosis outbreak at an industrial site was investigated to identify and
      control the source. Cases were identified from disease notifications, workplace
      illness records, and from clinicians. Cases were interviewed for symptoms and
      risk factors and tested for legionellosis. Implicated environmental sources were 
      sampled and tested for legionella. We identified six cases with Legionnaires'
      disease and seven with Pontiac fever; all had been exposed to aerosols from the
      cooling towers on the site. Nine cases had evidence of infection with either
      Legionella pneumophila serogroup (sg) 1 or Legionella longbeachae sg1; these
      organisms were also isolated from the cooling towers. There was 100% DNA sequence
      homology between cooling tower and clinical isolates of L. pneumophila sg1 using 
      sequence-based typing analysis; no clinical L. longbeachae isolates were
      available to compare with environmental isolates. Routine monitoring of the
      towers prior to the outbreak failed to detect any legionella. Data from this
      outbreak indicate that L. pneumophila sg1 transmission occurred from the cooling 
      towers; in addition, L. longbeachae transmission was suggested but remains
      unproven. L. longbeachae detection in cooling towers has not been previously
      reported in association with legionellosis outbreaks. Waterborne transmission
      should not be discounted in investigations for the source of L. longbeachae
      infection.
FAU - Thornley, C N
AU  - Thornley CN
AUID- ORCID: http://orcid.org/0000-0001-9280-6260
AD  - MidCentral Public Health Services, MidCentral District Health Board,Palmerston
      North,New Zealand.
FAU - Harte, D J
AU  - Harte DJ
AD  - Institute of Environmental Science and Research Ltd,Porirua,New Zealand.
FAU - Weir, R P
AU  - Weir RP
AD  - MidCentral Public Health Services, MidCentral District Health Board,Palmerston
      North,New Zealand.
FAU - Allen, L J
AU  - Allen LJ
AD  - MidCentral Public Health Services, MidCentral District Health Board,Palmerston
      North,New Zealand.
FAU - Knightbridge, K J
AU  - Knightbridge KJ
AD  - MidCentral Public Health Services, MidCentral District Health Board,Palmerston
      North,New Zealand.
FAU - Wood, P R T
AU  - Wood PRT
AD  - MidCentral Public Health Services, MidCentral District Health Board,Palmerston
      North,New Zealand.
LA  - eng
PT  - Journal Article
DEP - 20170619
PL  - England
TA  - Epidemiol Infect
JT  - Epidemiology and infection
JID - 8703737
SB  - IM
MH  - *Disease Outbreaks
MH  - Legionella longbeachae/classification/*isolation & purification
MH  - Legionella pneumophila/classification/*isolation & purification
MH  - Legionellosis/*epidemiology/microbiology/transmission
MH  - Legionnaires' Disease/epidemiology/microbiology/transmission
MH  - New Zealand/epidemiology
MH  - Occupational Diseases/*epidemiology/microbiology
MH  - Risk Factors
MH  - *Water Microbiology
OTO - NOTNLM
OT  - Legionella longbeachae
OT  - Legionnaires' disease
OT  - legionella
OT  - occupation-related infections
OT  - outbreaks
OT  - water-borne infections
EDAT- 2017/06/20 06:00
MHDA- 2017/08/19 06:00
CRDT- 2017/06/20 06:00
AID - S0950268817001170 [pii]
AID - 10.1017/S0950268817001170 [doi]
PST - ppublish
SO  - Epidemiol Infect. 2017 Aug;145(11):2382-2389. doi: 10.1017/S0950268817001170.
      Epub 2017 Jun 19.