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Legionellosis Cluster Associated With Working at a Racetrack Facility in West Virginia, 2018

Abstract

In October 2018, the Centers for Disease Control and Prevention was notified of a cluster of Legionnaires' disease cases in workers at a racetrack facility. The objective of the resulting investigation was to determine the extent of the outbreak and identify potential sources of exposure to halt transmission. Case-finding and interviews were conducted among symptomatic racetrack workers who were known to be at the facility within 14 days prior to symptom onset. An environmental assessment of the facility and surrounding area was conducted for sources of potential Legionella exposure. In total, 17 legionellosis cases were identified. The environmental assessment revealed a poorly maintained hot tub in the jockey locker room as the most likely source. Further investigation identified deficiencies in the facility's ventilation systems, which suggested a transmission mechanism for workers who never entered the locker room floor. Considering indirect exposure routes via air handling systems can be useful for source identification and case-finding in legionellosis outbreaks.

Authors

  • Jared R. Rispens, MD, REHS, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Marisa Hast, PhD, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Chris Edens, PhD, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Troy Ritter, PhD, REHS, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Jeffrey W. Mercante, PhD, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Miriam Siegel, DrPH, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Stephen B. Martin, MPH, PhD, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Erica Thomasson, PhD, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
  • Albert E. Barskey, MPH, National Center for Environmental Health, National Center for Immunization and Respiratory Diseases, CDC
Volume#: 83.6
Page #: 14-19
Publication Month: January/February 2021

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