This was the worst outbreak of Legionnaires in French history. The guidance now also recommends that routine testing for legionella bacteria in wet cooling systems be carried out at least quarterly, and more frequently when a system is being commissioned, or if the bacteria have been identified on a previous occasion. , In September 2019, 141 visitors to the Western North Carolina Mountain State Fair were diagnosed with Legionnaires' disease, with four reported deaths, after a hot tub exhibit is suspected to have developed and spread the bacteria. , An outbreak is defined as two or more cases where the onset of illness is closely linked in time (weeks rather than months) and in space, where there is suspicion of, or evidence of, a common source of infection, with or without microbiological support (i.e.  For the general population, among those exposed, between 0.1 and 5.0% develop the disease, while among those in hospital, between 0.4 and 14% develop the disease. 56 confirmed cases, with a further 36 suspected cases, bringing the total number of people affected to 92. , A 2011 study by Lin, Stout and Yu found Copper-Silver ionization to be the only Legionella control technology which has been validated through a 4-step scientific approach. , Legionella bacteria themselves can be inactivated by UV light. The recommended treatment is 5–10 days of levofloxacin or 3–5 days of azithromycin, but in people who are immunocompromised, have severe disease, or other pre-existing health conditions, longer antibiotic use may be necessary. If a similar count is found again, a review of the control measures and risk assessment should be carried out to identify any remedial actions.  Hospitalization is often required. The first outbreak in Hotel Rio Park occurred in 1973, four tourists died, but at the time it was not recognized as Legionnaires' disease until a subsequent outbreak in the same hotel in 1977. Chest X-ray of a severe case of legionellosis upon admission to the emergency department. Delay in giving the appropriate antibiotic leads to higher mortality.  In July and August 2015, another, unrelated outbreak in the Bronx killed 12 people and made about 120 people sick; the cases arose from a cooling tower on top of a hotel. Legionella spp. In 2003, ionization became the first such hospital disinfection process to have fulfilled a proposed four-step modality evaluation; by then it had been adopted by over 100 hospitals. , The guidance issued by the UK government's Health and Safety Executive (HSE) now recommends that microbiological monitoring for wet cooling systems, using a dipslide, should be performed weekly. The Legionella bacteria can be cultured from sputum or other respiratory samples. State and local health departments take the lead in investigating outbreaks. The most likely sources of infection include water used for showering, hot tubs, decorative fountains, and cooling towers (structures that contain water and a fan as part of centralized air cooling systems for a building or industrial processes). 70 to 80 °C (158 to 176 °F): Disinfection range, At 66 °C (151 °F): Legionellae die within 2 minutes, At 60 °C (140 °F): They die within 32 minutes, At 55 °C (131 °F): They die within 5 to 6 hours, Above 50 °C (122 °F): They can survive but do not multiply, 35 to 46 °C (95 to 115 °F): Ideal growth range, Below 20 °C (68 °F): They can survive but are dormant, This page was last edited on 19 October 2020, at 21:03.
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