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ARTICLE |

Legionella in Water: What Should Be Done? FREE

Stephen C. Redd, MD; Mitchell L. Cohen, MD
JAMA. 1987;257(9):1221-1222. doi:10.1001/jama.1987.03390090093033
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Over 700 cases of legionellosis are reported to the Centers for Disease Control (CDC) each year, but these cases probably represent only a fraction of those actually occurring. Although outbreaks of legionellosis have received the greatest public attention and the most intensive study, evidence from hospital- and population-based studies suggests that most cases are sporadic or unassociated with recognized outbreaks.1-3 Many features of these sporadic cases remain poorly defined, including the way infections are acquired. In this issue of The Journal, Stout et al4 report isolation of the same Legionella from two sporadic cases of legionellosis and from their household water supplies. Since legionellae have been isolated from water sources epidemiologically associated with outbreaks of human disease,5-11 it is not surprising that some sporadic cases will have similar associations. It is important, however, that this observation not be overinterpreted. The roles of environmental cultures and decontamination procedures

REFERENCES

Foy HM, Broome CV, Hayes PS, et al:  Legionnaires' disease in a prepaid medical-care group in Seattle, 1963-1975 . Lancet 1979;;1:767-771.
Muder RR, Yu VL, McClure JK, et al:  Nosocomial legionnaires' disease uncovered in a prospective pneumonia study . JAMA 1983;;249:3184-3188.
MacFarlane JT, Finch RG, Ward MJ, et al:  Hospital study of adult community acquired pneumonia . Lancet 1982;;1:255-258.
Stout JE, Yu VL, Muraca P:  Legionnaires' disease acquired within the homes of two patients . JAMA 1987;;257:1215-1217.
Arnow PM, Chou T, Weil D, et al:  Nosocomial legionnaires' disease caused by aerosolized tap water from respiratory devices . J Infect Dis 1982;;146: 460-467.
Shands KN, Ho JL, Meyer RD, et al:  Potable water as a source of legionnaires' disease . JAMA 1985;;253:1412-1416.
Dondero TJ, Rendtorff RC, Mallison GF, et al:  An outbreak of legionnaires' disease associated with a contaminated air-conditioning cooling tower . N Engl J Med 1980;;302:365-370.
Helms CM, Massanair RM, Zeitler R, et al:  Legionnaires' disease associated with a hospital water system . Ann Intern Med 1983;;99:172-178.
Parry MF, Stampleman L, Hutchinson JH, et al:  Waterborne Legionella bozemanii and nosocomial pneumonia in immunosuppressed patients . Ann Intern Med 1985;;103:205-210.
Garbe PL, Davis B, Weisfield JS, et al:  Nosocomial legionnaires' disease: Epidemiologic demonstration of cooling towers as a source . JAMA 1985;;254: 521-524.
Cordes LG, Fraser DW, Skaliy P, et al:  Legionnaires' disease outbreak at an Atlanta, Georgia country club: Evidence for spread from an evaporative condenser . Am J Epidemiol 1980;;111:425-431.
Arnow P, Weil D, Para MF:  Prevalence and significance of Legionella pneumophila contamination of residential hot-tap water systems . J Infect Dis 1985;;152:145-151.
Fliermans CB, Cherry WB, Orrison LH, et al:  Isolation of Legionella pneumophila from nonepidemic related aquatic habitats . Appl Environ Microbiol 1979;;37:1239-1242.
Wilson MG, Nelson RC, Phillips LH, et al:  New source of Pseudomonas aeruginosa in a nursery . JAMA 1961;;175:1146-1149.
Fierer J, Taylor PM, Gezon HM:  Pseudomonas aeruginosa epidemic traced to delivery room resuscitators . N Engl J Med 1967;;276:991-996.

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Foy HM, Broome CV, Hayes PS, et al:  Legionnaires' disease in a prepaid medical-care group in Seattle, 1963-1975 . Lancet 1979;;1:767-771.
Muder RR, Yu VL, McClure JK, et al:  Nosocomial legionnaires' disease uncovered in a prospective pneumonia study . JAMA 1983;;249:3184-3188.
MacFarlane JT, Finch RG, Ward MJ, et al:  Hospital study of adult community acquired pneumonia . Lancet 1982;;1:255-258.
Stout JE, Yu VL, Muraca P:  Legionnaires' disease acquired within the homes of two patients . JAMA 1987;;257:1215-1217.
Arnow PM, Chou T, Weil D, et al:  Nosocomial legionnaires' disease caused by aerosolized tap water from respiratory devices . J Infect Dis 1982;;146: 460-467.
Shands KN, Ho JL, Meyer RD, et al:  Potable water as a source of legionnaires' disease . JAMA 1985;;253:1412-1416.
Dondero TJ, Rendtorff RC, Mallison GF, et al:  An outbreak of legionnaires' disease associated with a contaminated air-conditioning cooling tower . N Engl J Med 1980;;302:365-370.
Helms CM, Massanair RM, Zeitler R, et al:  Legionnaires' disease associated with a hospital water system . Ann Intern Med 1983;;99:172-178.
Parry MF, Stampleman L, Hutchinson JH, et al:  Waterborne Legionella bozemanii and nosocomial pneumonia in immunosuppressed patients . Ann Intern Med 1985;;103:205-210.
Garbe PL, Davis B, Weisfield JS, et al:  Nosocomial legionnaires' disease: Epidemiologic demonstration of cooling towers as a source . JAMA 1985;;254: 521-524.
Cordes LG, Fraser DW, Skaliy P, et al:  Legionnaires' disease outbreak at an Atlanta, Georgia country club: Evidence for spread from an evaporative condenser . Am J Epidemiol 1980;;111:425-431.
Arnow P, Weil D, Para MF:  Prevalence and significance of Legionella pneumophila contamination of residential hot-tap water systems . J Infect Dis 1985;;152:145-151.
Fliermans CB, Cherry WB, Orrison LH, et al:  Isolation of Legionella pneumophila from nonepidemic related aquatic habitats . Appl Environ Microbiol 1979;;37:1239-1242.
Wilson MG, Nelson RC, Phillips LH, et al:  New source of Pseudomonas aeruginosa in a nursery . JAMA 1961;;175:1146-1149.
Fierer J, Taylor PM, Gezon HM:  Pseudomonas aeruginosa epidemic traced to delivery room resuscitators . N Engl J Med 1967;;276:991-996.
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