TY - JOUR AU - Fitzhenry, Robert AU - Weiss, Don AU - Cimini, Dan AU - Balter, Sharon AU - Boyd, Christopher AU - Alleyne, Lisa AU - Stewart, Renee AU - McIntosh, Natasha AU - Econome, Andrea AU - Lin, Ying AU - Rubinstein, Inessa AU - Passaretti, Teresa AU - Kidney, Anna AU - Lapierre, Pascal AU - Kass, Daniel AU - Varma, Jay T1 - Legionnaires’ Disease Outbreaks and Cooling Towers, New York City, New York, USA T2 - Emerging Infectious Disease journal PY - 2017 VL - 23 IS - 11 SP - 1776 SN - 1080-6059 AB - The incidence of Legionnaires’ disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires’ disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires’ disease incidence in New York City. KW - Legionnaires’ disease KW - legionellosis KW - environmental exposure KW - disease outbreaks KW - epidemiology KW - legislation KW - space-time clustering KW - pneumonia KW - bacteria KW - bacterial infection KW - cooling towers KW - New York City KW - United States KW - Legionnaires disease DO - 10.3201/eid2311.161584 UR - https://wwwnc.cdc.gov/eid/article/23/11/16-1584_article ER - End of Reference