Most knowledge regarding Legionnaires’ disease comes from outbreak investigations; however, only 4% of cases are associated with known outbreaks and are thoroughly investigated. From 2000 to 2014, there was a 4-fold rise in the number of cases in the U.S. Outbreaks of Legionnaires’ disease are associated with inhalation or aspiration of aerosolized water from a variety of sources. Major risk factors include older age, a history of smoking, chronic lung disease, and a compromised immune system. Closing research and policy gaps around Legionnaires’ disease is imperative to preventing further increases in disease. Because this disease is tied so closely with built water systems, successful efforts will require collaboration between partners in public health, microbiology, environmental health, and engineering, among others.
- Parr A, Whitney EA, Berkelman RL. Legionellosis on the Rise: A Review of Guidelines for Prevention in the United States. Journal of Public Health Management and Practice 2015;21(5):E17-E26.
- Lu J, Struewing I, Vereen E, Kirby AE, Levy K, Moe C, et al. Molecular Detection of Legionella spp. and their associations with Mycobacterium spp., Pseudomonas aeruginosa and amoeba hosts in a drinking water distribution system. J Appl Microbiol 2016;120(2):509-21.
- Barker KA, Whitney EA, Blake S, Berkelman RL. A Review of Guidelines for the Primary Prevention of Legionellosis in Long-Term Care Facilities. J Am Med Dir Assoc 2015;16(10):832-6.
- Berkelman RL. Letter: Consideration of prophylactic antibiotic therapy during an outbreak of Legionnaires' disease. Clin Infect Dis 2014;58(1):144-5.
- Flanders WD, Kirkland KH, Shelton BG. Effects of holding time and measurement error on culturing Legionella in environmental water samples. Water Res 2014;62:293-301.
- Whitney EA, Berkelman RL. Legionella hospital laboratory testing practices in georgia. Infect Control Hosp Epidemiol 2014;35(11):1441-2.
- Brzozowski AK, Silk BJ, Berkelman RL, Loveys DA, Caliendo AM. Use, location, and timeliness of clinical microbiology testing in Georgia for select infectious diseases. J Public Health Manag Pract 2012;18(4):E4-E10.