Global S&T Development Trend Analysis Platform of Resources and Environment
DOI | 10.1289/EHP5663 |
Multiple Sources of the Outbreak of Legionnaires' Disease in Genesee County, Michigan, in 2014 and 2015 | |
Smith, Anya F.1; Huss, Anke2; Dorevitch, Samuel3; Heijnen, Leo1; Arntzen, Vera H.1; Davies, Megan4; Holle, Mirna Robert-Du Ry van Beest5; Fujita, Yuki1; Verschoor, Antonie M.1; Raterman, Bernard1; Oesterholt, Frank1; Heederik, Dick2; Medema, Gertjan1 | |
2019-12-01 | |
发表期刊 | ENVIRONMENTAL HEALTH PERSPECTIVES
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ISSN | 0091-6765 |
EISSN | 1552-9924 |
出版年 | 2019 |
卷号 | 127期号:12 |
文章类型 | Article |
语种 | 英语 |
国家 | Netherlands; USA |
英文摘要 | BACKGROUND: A community-wide outbreak of Legionnaires' disease (LD) occurred in Genesee County, Michigan, in 2014 and 2015. Previous reports about the outbreak are conflicting and have associated the outbreak with a change of water source in the city of Flint and, alternatively, to a Flint hospital. OBJECTIVE: The objective of this investigation was to independently identify relevant sources of Legionella pneumophila that likely resulted in the outbreak. METHODS: An independent, retrospective investigation of the outbreak was conducted, making use of public health, health care, and environmental data and whole-genome multilocus sequence typing (wgMLST) of clinical and environmental isolates. RESULTS: Strong evidence was found for a hospital-associated outbreak in both 2014 and 2015: a) 49% of cases had prior exposure to Flint hospital A, significantly higher than expected from Medicare admissions; b) hospital plumhing contained high levels of L. pneumophila; c) Legionella control measures in hospital plumbing aligned with subsidence of hospital A-associated cases; and d) wgMLST showed Legionella isolates from cases exposed to hospital A and from hospital plumbing to be highly similar. Multivariate analysis showed an increased risk of LD in 2014 for people residing in a home that received Flint water or was located in proximity to several Flint cooling towers. DISCUSSION: This is the first LD outbreak in the United States with evidence for three sources (in 2014): a) exposure to hospital A, b) receiving Flint water at home, and c) residential proximity to cooling towers; however, for 2015, evidence points to hospital A only. Each source could he associated with only a proportion of cases. A focus on a single source may have delayed recognition and remediation of other significant sources of L. pneumophila. |
领域 | 资源环境 |
收录类别 | SCI-E |
WOS记录号 | WOS:000505244800012 |
WOS关键词 | FLINT WATER CRISIS ; DRINKING-WATER ; UNITED-STATES ; LEGIONELLA-PNEUMOPHILA ; DISTRIBUTION-SYSTEM ; DEFICIENCIES ; PREVENTION ; CLUSTERS |
WOS类目 | Environmental Sciences ; Public, Environmental & Occupational Health ; Toxicology |
WOS研究方向 | Environmental Sciences & Ecology ; Public, Environmental & Occupational Health ; Toxicology |
引用统计 | |
文献类型 | 期刊论文 |
条目标识符 | http://119.78.100.173/C666/handle/2XK7JSWQ/224635 |
专题 | 环境与发展全球科技态势 |
作者单位 | 1.KWR Water Res Inst, Groningenhaven 7, NL-3433 PE Nieuwegein, Netherlands; 2.Univ Utrecht, Inst Risk Assessment Sci, Utrecht, Netherlands; 3.Univ Illinois, Sch Publ Hlth, Chicago, IL USA; 4.Davies Publ Hlth Consulting LLC, Raleigh, NC USA; 5.Mirna Robert Epidemiol, Gorinchem, Netherlands |
推荐引用方式 GB/T 7714 | Smith, Anya F.,Huss, Anke,Dorevitch, Samuel,et al. Multiple Sources of the Outbreak of Legionnaires' Disease in Genesee County, Michigan, in 2014 and 2015[J]. ENVIRONMENTAL HEALTH PERSPECTIVES,2019,127(12). |
APA | Smith, Anya F..,Huss, Anke.,Dorevitch, Samuel.,Heijnen, Leo.,Arntzen, Vera H..,...&Medema, Gertjan.(2019).Multiple Sources of the Outbreak of Legionnaires' Disease in Genesee County, Michigan, in 2014 and 2015.ENVIRONMENTAL HEALTH PERSPECTIVES,127(12). |
MLA | Smith, Anya F.,et al."Multiple Sources of the Outbreak of Legionnaires' Disease in Genesee County, Michigan, in 2014 and 2015".ENVIRONMENTAL HEALTH PERSPECTIVES 127.12(2019). |
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