Legionnaires' Disease Outbreaks 2002-2004

Iowa City Hospital, 2 Cases, December 2004
Nearly three months after two Legionnaires' cases were confirmed, a hospital in Iowa is still providing patients with bottled water for drinking and filtered water for showering until Legionella can be eradicated from its water system. Hospital officials said that the first patient contracted the disease in December from a showerhead, and has recovered. The second patient, whose case of Legionnaires' was confirmed in January, died, but hospital officials could not confirm that the death was caused by Legionnaires'. Source: Iowa City Press-Citizen  Top

NJ Apartment Building, 2 Cases, October 2004
Two elderly residents of a high-rise apartment building in northern New Jersey were diagnosed with Legionnaires’ disease in recent months, an elderly man in June and a 78-year-old woman with lung cancer in late October, 2004. Both residents have recovered. In November, health officials shut off the water to the building after finding Legionella in a water heater. The 1,000 or so residents used bottled water until the systems were disinfected. Source: The New York Times  Top

Redditch, UK, 3 Cases, 2 Deaths, September 2004
As of mid September health officials had not found the source of contamination that has caused three cases of Legionnaires' disease in Redditch. Two women, aged 62 and 67 years, have died. The third case, a man in his 50s, was hospitalized but is now recovering at home. Of 69 samples collected, five tested positive, but not with the strains found in the people who became ill. Results of further tests are pending. Source: news media. Top

Sweden, 14 Cases, 1 Death, August 2004
Between 10 August and 6 September, Legionnaires' disease was confirmed in 14 people who either live in or had visited the city of Lidköping, in southern Sweden. One patient, an elderly man, has died. The patients range from 36 to 83 years of age. Only three of them were immunocompromised. Twelve of the infections were diagnosed by urinary antigen, and two by culture. The epidemiological investigation ruled out several potential sources of infection, including whirlpools, private humidifiers, and hot water systems in the patients' homes. All of the patients spent time within a small area of the city. Samples from cooling towers in two locations have shown high numbers (>300 cfu/ml) of Legionella pneumophila serogroup 1. These cooling towers have now been shut down for cleaning. A source of contamination has not been implicated, but typing of all Legionella isolates will be undertaken to check for a connection between the cooling towers and the patients. Source: Eurosurveillance Weekly.  Top

Barcelona, Spain, 20 Cases, August 2004
Health authorities in the northeastern Spanish region of Catalonia blamed four cooling towers for an outbreak of Legionnaire's disease in Barcelona that affected 20 men and 7 women in August. Those who contracted the disease ranged from 45 to 83 years of age. As of 19 August, 15 of the 27 people were still in hospital but their conditions were generally satisfactory, according to health authorities. Source: news media.  Top

Cleveland Service Garage, 3 Cases, July 2004
Three workers at a large city service garage in Cleveland contracted Legionnaires' disease; one case occurred about 11 months ago and the other two more recently.  The garage houses dump trucks and street sweepers. Two of eight water samples tested positive for Legionella. The positive samples were collected from the shower in the employees' lounge and the truck wash system. The garage was closed pending further investigation.  Top

NJ Nursing Home, 2 Cases, 1 Death, July 2004
Two cases of Legionnaires' disease were reported in early July in Paterson, New Jersey. Both were residents of the same senior housing center. One of the cases, an 82-year-old man, died 8 July. The other, a 76-year-old woman, was recovering in the hospital as of 14 July. After finding legionellae in the hot water, Paterson Housing Authority officials shut off the system and prepared to disinfect it. Source: New Jersey Star-Ledger   Top

Austrian Campsite, 3 Cases, 1 Death, June 2004
In July three laboratory confirmed (by urinary antigen) cases of Legionnaires' disease were reported to Austrian health authorities. All three cases had stayed at a campsite in Klagenfurt. Patient 1, a 57-year-old Austrian man, became ill on 30 May. He was admitted to hospital with severe pneumonia and transferred to the intensive care unit on 6 June. He died on 4 July. Patient 2, a 71-year-old German man, became ill on 20 June and was admitted to the hospital on 29 June. He has recovered. The third case, a 53-year-old man from the Netherlands, stayed at the campsite from 27 to 29 June and became ill 5 July. He also has recovered. Health authorities believe that the campsite was the likely source of infection. High levels of Legionella pneumophila serogroup 1 were found in samples collected from the water systems on 22 June, just prior to thermal disinfection. A second disinfection, utilizing chlorine, was carried out on 28 June. Legionella bacteria were found in samples collected after the first disinfection procedure, but all samples collected after the second procedure tested negative. Evaluation of the shower facilities revealed that further remedial measures were required. Source: Eurosurveillance Weekly.  Top

Zaragoza, Spain, 27 Cases, 7 Deaths, June 2004
This outbreak involved at least 27 confirmed and 3 probable cases of the Legionnaires' disease, including 7 deaths. The patients who died were aged 87, 84, 83, 75, 64, 45, and 24 years. The reason for the high death rate is uncertain, except that some of the patients were elderly and in poor health. The outbreak has been blamed on two cooling towers at a general hospital because tests confirmed that both towers were contaminated with the same subtype of Legionella pneumophila serogroup 1 that was found in four of the patients. The cooling tower was disinfected and the water treatment program was revised. The outbreak was declared over by the middle of July. Source:

Australia, 4 cases, June 2004
Three women, ages 64, 66, and 78, and a 69-year-old man, were admitted to the hospital with symptoms of Legionnaires’ disease in the northern Victorian town of Cobram earlier this month. A Department of Human Services spokesman said the most recent diagnosis was probably linked to the earlier three. Health officials are investigating cooling towers in the Cobram region. Source: AAP  Top

Austria, 3 Cases Possibly Linked to Whirlpool Display, March 2004
Legionnaires’ disease was confirmed by urinary antigen in three men, between 42 and 65 years of age, who attended a trade show in Austria from 5 to 7 March 2004. All three were hospitalized. The 65-year-old patient developed multiorgan failure and required mechanical ventilation and haemodialysis for 11 days, but was reported in stable condition earlier this month. The three men had visited a whirlpool display at the exhibition at approximately the same time. No additional cases have been detected since 31 March. The Austrian Agency for Health and Food Safety is investigating. Source: Eurosurveillance Weekly    Top

Italian Hospital, Five Cases, Three Deaths, Jan-March 2004
Five cases of Legionnaires’ disease occurred in a hospital in Matera, Italy, during the first quarter of this year. All five patients were elderly or HIV-infected; three have died. The report stated that the hospital plumbing system has been disinfected, but nothing was mentioned about a risk assessment or ongoing water treatment.  Top

Oklahoma City, Pontiac fever, March 2004
Oklahoma State health officials have confirmed that Legionella is the cause of a cluster of respiratory illnesses, likely Pontiac fever, contracted by several persons visiting Oklahoma City last week for a basketball tournament. Of the 240 teams participating in the tournament, only two, one from Houston and one from Indiana, have reported respiratory illnesses among players or family members. At least 13 have tested positive for Legionella. Health officials are collecting environmental samples at the hotel where the Houston and Indiana teams were guests. Source: news media     Top

Maryland Hotel Guests, Feb. 2004
Four people who stayed at an Ocean City, Maryland hotel in the last five months have been diagnosed with Legionnaires disease, according to county health officials. Although initial tests of the hotel water system were negative for Legionella, the health department has found no other link among the four people besides their hotel stays. All got sick within about a week of staying at the hotel. More water testing is under way.  Source: AP    Top

Cyprus Hotel, Jan. 2004
Two British men between 50 and 59 years of age contracted Legionnaires' disease after staying in a hotel in northern Cyprus from 21 December 2003 to 3 January 2004.  One has died.  A case of Legionnaires disease in August 2003 was associated with this same hotel. The European Surveillance Scheme for Travel Associated Legionnaires' Disease (EWGLINET) is handling the environmental investigation and control measures at the hotel.   Top

France's worst outbreak: 85 cases, 13 deaths, Jan. 2004
France's worst outbreak of Legionnaires' disease has infected 85 people and killed 13, most of whom resided in or visited an area to the east of the town of Lens, in the northern part of the country. On 4 January the French government shut down a petrochemical factory after tests revealed that the strain of Legionella found in the plant's cooling tower matched the strain found in at least 14 of the victims. [However, the data reported appears insufficient to implicate a source in this outbreak.] Top

Hereford, UK, 28 cases, 2 deaths, Nov. 2003
Cooling towers at a cider plant in the west of England, in Hereford, are being blamed for 28 cases of Legionnaires’ disease that occurred in October and November. Two persons have died, a man in his 70s and a woman in her 50s. Health experts confirmed that the Legionella strain found in patients matched the strain found in samples collected from a cooling tower at the site. Source: news media  Top

Valencia, Spain, 25 Cases, 1 death, June 2003
In two or more separate outbreaks occurring in May and June in Valencia, 25 cases of legionellosis have been identified, one of which resulted in death. The first was a community outbreak in Alcoy and nearby areas. The second outbreak was associated with the oncology unit and adjacent rehabilitation area of a hospital; seven cases were identified, four patients and three visitors. One of the patients died. Investigators quickly traced the infections to the hospital’s hot water system, blaming two showers as the particular source of contamination. The health department reported that the hospital collected environmental samples, hyperchlorinated the domestic water system, disinfected the rehabilitation pool, and began distributing higher water temperatures to faucets and showers. Source: ABC.es  Top

New Zealand Police Building, 9 Cases, June 2003
Nine police staff that worked in the same building in Auckland contracted Legionnaires’ disease. The building was to be closed for two months, requiring that about 200 staff be moved to other buildings. Source: Independent Newspapers Limited  Top

Spain Spa, 4 Cases, May 2003
Spanish health authorities believe that four recent cases of LD were associated with a spa that provides water-based treatments. All four cases were hospitalized and are recovering. An environmental investigation was conducted but a source of contamination was not confirmed. Source: Diario de Avisos  Top

UK Hotel, 19 CASES, February 2003
19 cases of Legionnaires disease, including two deaths, have been blamed a resort hotel near Chard (UK). Health officials suspect the hotel's whirlpool spa is the source of contamination but have not reported a confirmed link. The showers and spa bath at the hotel leisure center were closed on 27 February 2003 but allowed to reopen on 31 March after officials were satisfied that the remedial work had been carried out. Source: BBC News  Top

Israeli Hotel, 3 CASES, January 2003
Legionnaires' Disease was suspected in three people hospitalized with severe pneumonia after staying at the same hotel in Eilat, Israel.  The Health Ministry ordered the hotel closed for two days while a team conducted tests.  Two separate investigations found the first two people diagnosed stayed at the hotel in late December and both were in rooms with whirlpool spas. Source: Haaretz English Editions  Top