Abstract
During the summer of 2015, New York, New York, USA, had one of the largest and deadliest outbreaks of Legionnaires’ disease in the history of the United States. A total of 138 cases and 16 deaths were linked to a single cooling tower in the South Bronx. Analysis of environmental samples and clinical isolates showed that sporadic cases of legionellosis before, during, and after the outbreak could be traced to a slowly evolving, single-ancestor strain. Detection of an ostensibly virulent Legionella strain endemic to the Bronx community suggests potential risk for future cases of legionellosis in the area. The genetic homogeneity of the Legionella population in this area might complicate investigations and interpretations of future outbreaks of Legionnaires’ disease.
Highlights
During the summer of 2015, New York, New York, USA, had one of the largest and deadliest outbreaks of Legionnaires’ disease in the history of the United States
Pulsed-field gel electrophoresis (PFGE), realtime PCR, sequence-based typing (SBT), and wholegenome sequencing (WGS) were used to characterize human and environmental L. pneumophila isolates from the investigation
L. pneumophila isolates recovered from a sample taken later during the outbreak from a homeless shelter located in the vicinity of the South Bronx hotel and other facilities within the outbreak zone were found to have PFGE and SBT patterns identical to that of the outbreak strain, raising the possibility that the South Bronx hotel might not have been the only source of an aerosolized
Summary
During the summer of 2015, New York, New York, USA, had one of the largest and deadliest outbreaks of Legionnaires’ disease in the history of the United States. A total of 138 cases and 16 deaths were linked to a single cooling tower in the South Bronx. Detection of an ostensibly virulent Legionella strain endemic to the Bronx community suggests potential risk for future cases of legionellosis in the area. The outbreak, which remains the largest community-associated outbreak of LD in United States, was later linked to the cooling system of the hosting hotel, and a bacterium classified as L. pneumophila serogroup 1 was subsequently isolated from 4 persons [7,8]. In the summer of 2015, a large community-associated LD outbreak affected persons who resided or traveled through a large area in the South Bronx region of New York, New York, USA. L. pneumophila isolates recovered from a sample taken later during the outbreak from a homeless shelter located in the vicinity of the South Bronx hotel and other facilities within the outbreak zone were found to have PFGE and SBT patterns identical to that of the outbreak strain, raising the possibility that the South Bronx hotel might not have been the only source of an aerosolized
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