American Journal of Epidemiology Vol. 119, No. 3: 382-391
Copyright © 1984 by The Johns Hopkins University School of Hygiene and Public Health
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LEGIONNAIRES' DISEASE: THE EPIDEMIOLOGY OF TWO OUTBREAKS IN BURLINGTON, VERMONT, 1980
1Vermont Department of Health Burlington, VT
2Field Services Division, Epidemiology Program Office, Centers for Disease Control Atlanta, GA
3Center for Infectious Diseases, Centers for Disease Control Atlanta, GA
4Environmental Health Consultant, Vermont Department of Health Burlington, VT
Send reprint requests to: Dr. Richard L. Vogt, Vermont Department of Health, Epidemiology Di-vision, 60 Main Street, P.O. Box 70, Burlington, VT 05401.
Klaucke, D. N., R. L. Vogt (Vermont Dept. of Health, Burlington, VT 05401), D. LaRue, L. E. Witherell, L. A. Orclari, K. C. Spitalny, R. Pelletier, W. B. Cherry and L. F. Novick. Legionnaires’ disease: the epidemiology of two outbreaks in Burlington, Vermont, 1980. Am J Epidemiol 1984; 119: 382–91.
Eighty-five cases of Legionnaires' disease were diagnosed in two major outbreaks at a large regional medical center in Burlington, Vermont, in the summer of 1980. Cases in both outbreaks were positive for Legionelia pneumophlia, serogroup 1 by culture, serology, or direct fluorescent antibody tests. All cases had spent time in the city of Burlington in the 10 days before the onset of symptoms. Cases in both outbreaks were both hospital- and community-acquired. A case-control study identified no common in-hospital exposure, including shower use, that was associated with illness. Cases without previous exposure to the hospital were more likely to occur in persons with residences in neighborhoods Just downwind of cooling tower A, but not throughout the municipal water system. Epidemiologic and environmental studies supported the association of this cooling tower, located 150 m from the hospital, with both outbreaks. Maintenance employees who worked with tower A had higher Legionelia titers than those who worked with a comparison tower located 1.6 km away. Aerosolization of L. pneumophlia by tower A and airborne spread to the hospital and community are postulated. The distance of airborne transmission of L. pneumophlia in these consecutive outbreaks is greater than previously reported.
aerosols; Legionnaires' disease; nosocomial infections; pneumonia
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