Potable water as a source of Legionnaires' disease.

A three-year epidemic of legionnaires' disease in a hospital was dramatically curtailed following hyperchlorination of the potable water supply. The hypothesis that potable water was the source for the outbreak was further supported by isolation of Legionella pneumophila (the agent of legionnaires' disease) from the hospital water supply, observation that a sudden upsurge had occurred in the number of cases following a peculiar manipulation of the hospital water system, and documentation of a 30-fold increase in concentration of organisms in the water when this manipulation was artificially recreated. Thus, potable water may be an important source of epidemic legionnaires' disease and continuous hyperchlorination a method of control.

[1]  J. Feeley,et al.  A major focus of Legionnaires' disease in Bloomington, Indiana. , 1979, Annals of internal medicine.

[2]  J. Dowling,et al.  Hot water systems as sources of Legionella pneumophila in hospital and nonhospital plumbing fixtures , 1982, Applied and environmental microbiology.

[3]  R. Fallon,et al.  Legionnaires' disease: further evidence to implicate water storage and distribution systems as sources. , 1981, British medical journal.

[4]  V. Yu,et al.  Ubiquitousness of Legionella pneumophila in the water supply of a hospital with endemic Legionnaires' disease. , 1982, The New England journal of medicine.

[5]  R. Weaver,et al.  Detection of Legionnaires disease bacteria by direct immunofluorescent staining , 1978, Journal of clinical microbiology.

[6]  D. Deubner,et al.  Nonpneumonic, short-incubation-period Legionellosis (Pontiac fever) in men who cleaned a steam turbine condenser. , 1979, Science.

[7]  R. J. Gibson,et al.  Pittsburgh pneumonia agent: direct isolation from human lung tissue. , 1980, The Journal of infectious diseases.

[8]  J. Plouffe,et al.  Relationship between colonization of hospital building with Legionella pneumophila and hot water temperatures , 1983, Applied and environmental microbiology.

[9]  J. A. Taylor,et al.  LEGIONELLA PNEUMOPHILA IN WATER PLUMBING SYSTEMS , 1982, The Lancet.

[10]  J. Phair,et al.  Isolation of Legionella pneumophila from hospital shower heads. , 1981, Annals of internal medicine.

[11]  C. Bartlett,et al.  Isolation of Legionella pneumophila from water systems: methods and preliminary results. , 1981, British medical journal.

[12]  S. Finegold,et al.  Legionnaires' Disease: Report of Sixty‐five Nosocomially Acquired Cases and Review of the Literature , 1980, Medicine.

[13]  C. E. Haley,et al.  Nosocomial Legionnaires' disease: a continuing common-source epidemic at Wadsworth Medical Center. , 1979, Annals of internal medicine.

[14]  M. Muers,et al.  LEGIONNAIRES' DISEASE IN A TRANSPLANT UNIT: ISOLATION OF THE CAUSATIVE AGENT FROM SHOWER BATHS , 1980, The Lancet.

[15]  G F Mallison,et al.  Legionnaires' disease: description of an epidemic of pneumonia. , 1977, The New England journal of medicine.

[16]  S. Finegold,et al.  Legionnaires' disease: clinical features of 24 cases. , 1978, Annals of internal medicine.

[17]  V. Yu,et al.  LEGIONELLACEAE IN THE HOSPITAL WATER-SUPPLY Epidemiological Link with Disease and Evaluation of a Method for Control of Nosocomial Legionnaires' Disease and Pittsburgh Pneumonia , 1983, The Lancet.

[18]  W. Baine,et al.  Sporadic community-acquired Legionnaires' disease in the United States. A case-control study. , 1979, Annals of internal medicine.

[19]  A. Nelson,et al.  INVESTIGATION AND CONTROL OF AN OUTBREAK OF LEGIONNAIRES' DISEASE IN A DISTRICT GENERAL HOSPITAL , 1981, The Lancet.

[20]  W. Elsea,et al.  Legionnaires' disease outbreak at an Atlanta, Georgia, Country Club: evidence for spread from an evaporative condenser. , 1980, American journal of epidemiology.

[21]  C. Helms,et al.  Legionnaires' disease associated with a hospital water system: a cluster of 24 nosocomial cases. , 1983, Annals of internal medicine.

[22]  P. Skaliy,et al.  Survival of the Legionnaires' disease bacterium in water. , 1979, Annals of internal medicine.

[23]  W. W. Rhodes,et al.  Pontiac fever. An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects. , 1978, American journal of epidemiology.