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American Journal of Epidemiology Vol. 130, No. 3: 557-568
Copyright © 1989 by The Johns Hopkins University School of Hygiene and Public Health

research-article

COMMUNITY-ACQUIRED LEGIONNAIRES' DISEASE ASSOCIATED WITH A COOLING TOWER: EVIDENCE FOR LONGER-DISTANCE TRANSPORT OF LEGIONELLA PNEUMOPHILA

DAVID G. ADDISS1,2,, JEFFREY P. DAVIS1,3, MARTIN LAVENTURE1, PHILIP J. WAND4, MARGARET A. HUTCHMSON4 and ROGER M. McKINNEY5

1Acute and Communicable Disease Epidemiology Section. Wisconsin Division of Health Madison, W1.
2Division of Field Services, Epidemiology Program Office, Centers for Disease Control Atlanta, GA.
3Departments of Pediatrics and Preventive Medicine, University of Wisconsin Madison, W1.
4Wisconsin State Labratory of Hygiene Madison, W1.
5Immunology Laboratory, Meningitis and Special Pathogens Branch, Center for Infectious Diseases, Centers for Disease Control Atlanta, GA.

Reprint requests to Dr. David G. Addiss, Wisconsin Division of Health, Acute and Communicable Disease Epidemiology Section, P.O. Box 309, Madison, WI 53701-0309.

in the period August 10–29, 1986,29 confinned cases of Legionnaires' disease occurred in Sheboygan, Wisconsin; two cases were fatal. No common source of indoor exposure was identified. Water specimens were obtained from all known cooling tower units in Sheboygan; Legionella pneumophila serogroup 1 was isolated at 1 × 106 colony-forming units per liter from a specimen obtained August 27 at plant A. This isolate was identical to the only clinical isolate by monoclonal antibody and isoenzyme subgrouping. Of 29 persons with Legionnaires' disease, 21 lived or worked withln one mile (1.6 km) of plant A; seven of the remaining eight vistted within one to two miles (1.6 to 3.2 km) of plant A from three to seven days before onset of illness. Attsck rates were highest for persons living within 0.5 mile (0.8 km) of plant A. These findings associate a cooling tower with community-acquired Legionnaires' disease and suggest that dlssemination of Legionella may occur over longer than previously recognized distances.

aerosols; air conditioning; Legionella; Legionnaires' disease; pneumonia


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