Emory researchers explore public health response to New York's 2015 Legionnaires' disease outbreak

Woodruff Health Sciences Center | June 12, 2017

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Melva Robertson
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melva.robertson@emory.edu

A recent study conducted by Emory University's Rollins School of Public Health on the highly publicized 2015 outbreak of Legionnaires' disease in New York City has been published in the July/August issue of the Journal of Public Health Management and Practice

Featured online as a hot topic article by the journal, the case study, supported by the Alfred P. Sloan Foundation, chronicles steps the New York City Department of Health and Mental Hygiene (DOHMH) took to address the abnormally high number of Legionnaires' disease cases reported in the South Bronx starting in summer of 2015. 

"The opportunity for us to interview NYC DOHMH staff intimately involved in the identification, management and control of this unprecedented outbreak was unique," said lead author Allison Chamberlain, Ph.D., assistant professor of Epidemiology. "Our observations of DOHMH's decision processes offered a critical window into public health preparedness and planning. As a result, we have been able to highlight lessons other jurisdictions can use to improve their own response and prevention activities."

Legionnaires' disease is a type of pneumonia caused by inhalation of aerosolized water containing Legionella bacteria. Reported cases of Legionnaires' disease have risen four-fold in the U.S. since 2001. The disease kills between 5-10 percent of its victims, but is largely preventable when building water systems – including premise plumbing and cooling towers – are properly maintained.

Publication of the case study coincides with recent national events related to Legionnaires' disease prevention. The Centers for Disease Control recently released its monthly Vital Signs report, which focused on prevention of healthcare-associated Legionnaires' disease. This follows a memorandum  released on June 2 by the Centers for Medicare and Medicaid Services (CMS) requiring all Medicare-certified health care facilities to "establish water management programs and policies" to reduce growth of Legionella bacteria and other waterborne pathogens.

Senior author Ruth Berkelman, M.D., Rollins Chair of Public Health Preparedness and Research and director of the Emory Center for Public Health Preparedness and Research (CPHPR), concurred that, "routine and accurate monitoring for Legionella, together with adequate control measures and maintenance of engineered water systems, may prevent a large proportion of Legionnaires' disease cases."

Emory first drew attention to the rise in Legionnaires' cases in 2008 when Drs. Karen Neil and Berkelman published a paper describing the increasing incidence of the disease in the U.S. from 1990 – 2005.  Since that time, Emory CPHPR has focused attention on this topic, receiving a grant from the Alfred P. Sloan Foundation to host the first national public health conference on Legionnaires' disease in more than 25 years at Emory in May 2016.