title: Large outbreak of Legionnaires' disease and Pontiac fever at a military base.
abstract: We investigated a mixed outbreak of Legionnaires' disease (LD) and Pontiac fever (PF) at a military base to identify the outbreak's environmental source as well as known legionellosis risk factors. Base workers with possible legionellosis were interviewed and, if consenting, underwent testing for legionellosis. A retrospective cohort study collected information on occupants of the buildings closest to the outbreak source. We identified 29 confirmed and probable LD and 38 PF cases. All cases were exposed to airborne pathogens from a cooling tower. Occupants of the building closest to the cooling tower were 6·9 [95% confidence interval (CI) 2·2-22·0] and 5·5 (95% CI 2·1-14·5) times more likely to develop LD and PF, respectively, than occupants of the next closest building. Thorough preventive measures and aggressive responses to outbreaks, including searching for PF cases in mixed legionellosis outbreaks, are essential for legionellosis control.
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: J
authors.initials: J
authors.lastname: Ambrose
authors.affiliation: Epidemic Intelligence Service,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: L M
authors.initials: LM
authors.lastname: Hampton
authors.affiliation: Epidemic Intelligence Service,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: K E
authors.initials: KE
authors.lastname: Fleming-Dutra
authors.affiliation: Michigan Department of Community Health, Lansing, MI,USA.
authors.forename: C
authors.initials: C
authors.lastname: Marten
authors.affiliation: Michigan Air National Guard, Harrison Township, MI,USA.
authors.forename: C
authors.initials: C
authors.lastname: McClusky
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: C
authors.initials: C
authors.lastname: Perry
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: N A
authors.initials: NA
authors.lastname: Clemmons
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: Z
authors.initials: Z
authors.lastname: McCormic
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: S
authors.initials: S
authors.lastname: Peik
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: J
authors.initials: J
authors.lastname: Mancuso
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: E
authors.initials: E
authors.lastname: Brown
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: N
authors.initials: N
authors.lastname: Kozak
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: T
authors.initials: T
authors.lastname: Travis
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: C
authors.initials: C
authors.lastname: Lucas
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: B
authors.initials: B
authors.lastname: Fields
authors.affiliation: Respiratory Diseases Branch,Centers for Disease Control and Prevention,Atlanta, GA,USA.
authors.forename: L
authors.initials: L
authors.lastname: Hicks
authors.affiliation: U.S. Army Public Health Command,Aberdeen Proving Ground, MD,USA.
authors.forename: S B
authors.initials: SB
authors.lastname: Cersovsky
mesh_terms: D000208:Acute Disease; D000328:Adult; D017677:Age Distribution; D015331:Cohort Studies; D016001:Confidence Intervals; D004196:Disease Outbreaks / Q000706:statistics & numerical data*; D004781:Environmental Exposure / Q000009:adverse effects; D005260:Female; D005334:Fever / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D016952:Legionella pneumophila / Q000302:isolation & purification*; D007876:Legionellosis / Q000175:diagnosis / Q000453:epidemiology; D007877:Legionnaires' Disease / Q000175:diagnosis / Q000453:epidemiology*; D008297:Male; D008875:Middle Aged; D058749:Military Facilities; D008889:Military Personnel / Q000706:statistics & numerical data; D012141:Respiratory Tract Infections / Q000453:epidemiology* / Q000382:microbiology; D012189:Retrospective Studies; D012307:Risk Factors; D012720:Severity of Illness Index; D017678:Sex Distribution; D014481:United States / Q000453:epidemiology; D055815:Young Adult