PMID- 38060434
OWN - NLM
STAT- MEDLINE
DCOM- 20231216
LR  - 20231216
IS  - 1545-861X (Electronic)
IS  - 0149-2195 (Print)
IS  - 0149-2195 (Linking)
VI  - 72
IP  - 49
DP  - 2023 Dec 8
TI  - Large Community Outbreak of Legionnaires Disease Potentially Associated with a 
      Cooling Tower - Napa County, California, 2022.
PG  - 1315-1320
LID - 10.15585/mmwr.mm7249a1 [doi]
AB  - Legionnaires disease is a serious infection acquired by inhalation of water 
      droplets from human-made building water systems that contain Legionella bacteria. 
      On July 11 and 12, 2022, Napa County Public Health (NCPH) in California received 
      reports of three positive urinary antigen tests for Legionella pneumophila 
      serogroup 1 in the town of Napa. By July 21, six Legionnaires disease cases had 
      been confirmed among Napa County residents, compared with a baseline of one or 
      two cases per year. NCPH requested assistance from the California Department of 
      Public Health (CDPH) and CDC to aid in the investigations. Close temporal and 
      geospatial clustering permitted a focused environmental sampling strategy of 
      high-risk facilities which, coupled with whole genome sequencing results from 
      samples and investigation of water system maintenance, facilitated potential 
      linking of the outbreak with an environmental source. NCPH, with technical 
      support from CDC and CDPH, instructed and monitored remediation practices for all 
      environmental locations that tested positive for Legionella. The investigation 
      response to this community outbreak illustrates the importance of 
      interdisciplinary collaboration by public health agencies, laboratory support, 
      timely communication with the public, and cooperation of managers of potentially 
      implicated water systems. Timely identification of possible sources, sampling, 
      and remediation of any facility testing positive for Legionella is crucial to 
      interrupting further transmission.
FAU - Grossmann, Narjara V
AU  - Grossmann NV
FAU - Milne, Crystal
AU  - Milne C
FAU - Martinez, Melinda R
AU  - Martinez MR
FAU - Relucio, Karen
AU  - Relucio K
FAU - Sadeghi, Banafsheh
AU  - Sadeghi B
FAU - Wiley, Erica N
AU  - Wiley EN
FAU - Holland, Samuel N
AU  - Holland SN
FAU - Rutschmann, Sarah
AU  - Rutschmann S
FAU - Vugia, Duc J
AU  - Vugia DJ
FAU - Kimura, Akiko
AU  - Kimura A
FAU - Crain, Chad
AU  - Crain C
FAU - Akter, Farhima
AU  - Akter F
FAU - Mukhopadhyay, Rituparna
AU  - Mukhopadhyay R
FAU - Crandall, John
AU  - Crandall J
FAU - Shorrock, Meghann
AU  - Shorrock M
FAU - Smith, Jessica C
AU  - Smith JC
FAU - Prasad, Namrata
AU  - Prasad N
FAU - Kahn, Rebecca
AU  - Kahn R
FAU - Barskey, Albert E
AU  - Barskey AE
FAU - Lee, Sooji
AU  - Lee S
FAU - Willby, Melisa J
AU  - Willby MJ
FAU - Kozak-Muiznieks, Natalia A
AU  - Kozak-Muiznieks NA
FAU - Lucas, Claressa E
AU  - Lucas CE
FAU - Henderson, Kelley C
AU  - Henderson KC
FAU - Hamlin, Jennafer A P
AU  - Hamlin JAP
FAU - Yang, Eungi
AU  - Yang E
FAU - Clemmons, Nakia S
AU  - Clemmons NS
FAU - Ritter, Troy
AU  - Ritter T
FAU - Henn, Jennifer
AU  - Henn J
LA  - eng
PT  - Journal Article
DEP - 20231208
PL  - United States
TA  - MMWR Morb Mortal Wkly Rep
JT  - MMWR. Morbidity and mortality weekly report
JID - 7802429
RN  - 059QF0KO0R (Water)
SB  - IM
MH  - Humans
MH  - *Legionnaires' Disease/diagnosis/epidemiology
MH  - *Legionella pneumophila
MH  - *Legionella
MH  - Disease Outbreaks
MH  - Water Microbiology
MH  - California/epidemiology
MH  - Water
PMC - PMC10715825
COIS- All authors have completed and submitted the International Committee of Medical 
      Journal Editors form for disclosure of potential conflicts of interest. Karen 
      Relucio reports support from Napa County Health & Human Services Agency for 
      travel to and attendance at the Health Officers' Association of California Fall 
      Semiannual Meeting in October 2022; serving on the Board of Directors for the 
      Napa Solano Medical Society and the Health Officers Association of California, 
      serving as the current past president and executive committee member of the 
      California Conference of Local Health Officers, and serving as co-chair of the 
      Napa Opioid Safety Coalition; stock option payments made through Perlita's 
      Daughters LLC from Johnson & Johnson, Medtronic, Pfizer, and GE Healthcare; and 
      managing partnership in Perlita's Daughters LLC equities, cash and real estate 
      holdings in Illinois unrelated to this outbreak and none related to hotels or 
      health care entities. No other potential conflicts of interest were disclosed.
EDAT- 2023/12/07 18:42
MHDA- 2023/12/17 13:19
PMCR- 2023/12/08
CRDT- 2023/12/07 13:13
PHST- 2023/12/17 13:19 [medline]
PHST- 2023/12/07 18:42 [pubmed]
PHST- 2023/12/07 13:13 [entrez]
PHST- 2023/12/08 00:00 [pmc-release]
AID - mm7249a1 [pii]
AID - 10.15585/mmwr.mm7249a1 [doi]
PST - epublish
SO  - MMWR Morb Mortal Wkly Rep. 2023 Dec 8;72(49):1315-1320. doi: 
      10.15585/mmwr.mm7249a1.