Publications

Epidemiology, Surveillance, and Outbreaks

• Centers for Disease Control and Prevention. Legionnaires’ Disease Surveillance Summary Report, 2014–2015 [PDF – 3 MB]. Published October 2018.
• Hlavsa MC, Cikesh BL, Roberts VA, et al. Outbreaks associated with treated recreational water – United States, 2000–2014. MMWR Morb Mortal Wkly Rep. 2018;67(19):547–51.
• Francois Watkins LK, Toews KE, Harris AM, et al. Lessons from an outbreak of Legionnaires’ disease on a hematology-oncology unit. Infect Control Hosp Epidemiol. 2017;38(3):306–313.
• Benedict KM, Reses H, Vigar M, et al. Surveillance for waterborne disease outbreaks associated with drinking water — United States, 2013–2014. MMWR Morb Mortal Wkly Rep. 2017;66(44):1216–1221.
• McClung Paul, Roth DM, Vigar M, et al. Waterborne disease outbreaks associated with environmental and undetermined exposures to water — United States, 2013–2014. MMWR Morb Mortal Wkly Rep. 2017;66(44):1222–1225.
• Soda EA, Barskey AE, Shah PP, et al. Vital Signs: Health care-associated Legionnaires’ disease surveillance data from 20 states and a large metropolitan area—United States, 2015. MMWR Morb Mortal Wkly Rep. 2017;66(22):584–9.
• Hampton LM, Garrison L, Kattan J, et al. Legionnaires’ disease outbreak at a resort in Cozumel, Mexico. [22 pages]. Open Forum Infect Dis. 2016;3(3): ofw170.

• Garrison LE, Kunz JM, Cooley LA, et al. Vital Signs: Deficiencies in environmental control identified in outbreaks of Legionnaires’ disease—North America, 2000–2014. MMWR Morb Mortal Wkly Rep. 2016;65(22):576–84.
• Quinn C, Demirjian A, Lucas C, et al. Legionnaires’ disease outbreak at a long-term care facility caused by a cooling tower using an automated disinfection system—Ohio, 2013 [6 pages]. J Environ Health. 2015;78(5):8–13.
• Adams D, Fullerton K, Jajosky R, et al. Summary of notifiable infectious diseases and conditions — United States, 2013. MMWR Morb Mortal Wkly Rep. 2015;62(53):1–122.
• Dooling KL, Toews KA, Hicks LA, et al. Active Bacterial Core surveillance for legionellosis—United States, 2011–2013. MMWR Morb Mortal Wkly Rep. 2015;64(42):1190–3.
• Beer KD, Gargano JW, Roberts VA, et al. Outbreaks associated with environmental and undetermined water exposures—United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2015;64(31):849–51.
• Beer KD, Gargano JW, Roberts VA, et al. Surveillance for waterborne disease outbreaks associated with drinking water—United States, 2011–2012. MMWR Morb Mortal Wkly Rep. 2015;64(31):842–8.
• Demirjian A, Lucas CE, Garrison LE, et al. The importance of clinical surveillance in detecting Legionnaires’ disease outbreaks: A large outbreak in a hospital with a Legionella disinfection system—Pennsylvania, 2011–2012. Clin Infect Dis. 2015;60(11):1596–1602.
• Hlavsa MC, Roberts VA, Kahler AM, et al. Recreational water-associated disease outbreaks—United States, 2009-2010. MMWR Morb Mortal Wkly Rep. 2014;63:6–10.
• Silk BJ, Moore MR, Bergtholdt M, et al. Eight years of Legionnaires’ disease transmission in travellers to a condominium complex in Las Vegas, Nevada. Epidemiol Infect. 2012;140:1993–2002.
• Collier SA, Stockman LJ, Hicks LA, Garrison LE, Zhou FJ, Beach MJ. Direct healthcare costs of selected diseases primarily or partially transmitted by water. Epidemiol Infect. 2012;140(11):2003–13.
• Hicks LA, Garrison LE, Nelson GE, Hampton LM. [Increasing incidence of] Legionellosis in the United States, 2000-2009. MMWR Morb Mortal Wkly Rep. 2011;60:1083–6.
• Kioski C, Montefour K, Saubolle M, et al. Pseudo-outbreak of Legionnaires’ disease among patients undergoing bronchoscopy—Arizona, 2008. MMWR Morb Mortal Wkly Rep. 2009;58(31):849–54.
• Neil K, Berkelman R. Increasing incidence of legionellosis in the United States, 1990-2005: changing epidemiologic trends. Clin Infect Dis 2008;47:591–9.
• Smith P, Moore MR, Alexander N, Hicks LA, O’Loughlin R. Surveillance for travel-associated Legionnaires’ disease—United States, 2005-2006. MMWR Morb Mortal Wkly Rep. 2007;56(48):1261–3.
• Joseph C, van Wijngaarden J, Mshar P, et al. Cruise-ship—associated Legionnaires’ disease, November 2003–May 2004. MMWR Morb Mortal Wkly Rep. 2005;54(45):1153–5.
• Goeller D, Blythe D, Davenport M, et al. Legionnaires’ disease associated with potable water in a hotel — Ocean City, Maryland, October 2003–February 2004. MMWR Morb Mortal Wkly Rep. 2005;54(7):165–8.
• Cowgill KD, Lucas CE, Benson RF, et al. Recurrence of Legionnaires’ disease at a hotel in the United States Virgin Islands over a 20-year period. Clin Infect Dis. 2005;40(8):1205–7.
• Fields BS, Benson RF, Besser RE. Legionella and Legionnaires’ disease: 25 years of investigation. Clin Microbiol Rev. 2002;15:506–26.
• Benin AL, Benson RF, Arnold KE, et al. An outbreak of travel-associated Legionnaires’ disease and Pontiac fever: The need for enhanced surveillance of travel-associated legionellosis. J Infect Dis. 2002;185:237–43.
• Benin AL, Benson RF, Besser RE. Trends in Legionnaires’ disease, 1980-1998: Declining mortality and new patterns of diagnosis. Clin Infect Dis. 2002;35:1039–46.
• Kool JL, Fiore AE, Kioski CM, et al. More than 10 years of unrecognized nosocomial transmission of Legionnaires’ disease among transplant patients. Infect Control Hosp Epidemiol. 1998;19:898–904.
• Lepine LA, Jernigan DB, Butler JC, et al. A recurrent outbreak of nosocomial Legionnaires’ disease detected by urinary antigen testing: Evidence for long-term colonization of a hospital plumbing system. Infect Control and Hosp Epidemiol. 1998;19:905–10.
• Marston BJ, Plouffe JF, File TM Jr, et al. Incidence of community-acquired pneumonia requiring hospitalization. Results of a population-based active surveillance study in Ohio. The Community-Based Pneumonia Incidence Study Group.  Arch Intern Med. 1997;157(15):1709–18.
• Jernigan DB, Hofmann J, Cetron MS, et al. Outbreak of Legionnaires’ disease among cruise ship passengers exposed to a contaminated whirlpool spa. Lancet. 1996;347(9000):494–9.
• Fraser DW, Tsai TR, Orenstein W, et al. Legionnaires’ disease: Description of an epidemic of pneumonia. N Engl J Med. 1977;297(22):1189–97.
• McDade JE, Shepard CC, Fraser DW, Tsai TR, Redus MA, Dowdle WR. Legionnaires’ disease: Isolation of a bacterium and demonstration of its role in other respiratory disease. N Engl J Med. 1977;297(22):1197–203.

Laboratory and Environment

• Hunter C, Cooley L, Kunz J. Advancing public health department Legionnaires’ disease prevention efforts through the Epidemiology and Laboratory Capacity for Infectious Diseases Cooperative Agreement. J Environ Health. 2018;81(1):30–3.
• Llewellyn AC, Lucas CE, Roberts SE, et al. Distribution of Legionella and bacterial community composition among regionally diverse US cooling towers. PloS One. 2017;12(12):e0189937.
• Hunter CM, Kunz J. Reducing Legionnaires’ disease in public spas [3 pages]. ASHRAE J. 2017;Dec:56–8.
• Kunz J, Cooley L. Preventing Legionnaires’ disease: Environmental health expertise is key [3 pages]. J Environ Health. 2016;79(1):24–6.
• Mercante JW, Morrison SS, Desai HP, Raphael BH, Winchell JM. Genomic analysis reveals novel diversity among the 1976 Philadelphia Legionnaires’ disease outbreak isolates and additional ST36 strains. PLoS One. 2016;11(9):e0164074.
• Raphael BH, Baker DJ, Nazarian E, et al. Genomic resolution of outbreak-associated Legionella pneumophila serogroup 1 isolates from New York state. Appl Environ Microbiol. 2016;82(12):3582–90.
• Mercante JW, Winchell JM. Current and emerging Legionella diagnostics for laboratory and outbreak investigations. Clin Microbiol Rev. 2015;28(1):95–133.
• Kozak-Muiznieks NA, Lucas CE, Brown E, et al. Prevalence of sequence types among clinical and environmental isolates of Legionella pneumophila serogroup 1 in the United States from 1982 to 2012. J Clin Micro. 2014;52(1):201–11.
• Kozak NA, Lucas CE, Winchell JM. Identification of Legionella in the environment[23 pages]. Methods Mol Biol. 2013;954:3–25.
• Burnsed LJ, Hicks LA, Smithee LM, et al. A large, travel-associated outbreak of legionellosis among hotel guests: Utility of the urine antigen assay in confirming Pontiac fever. Clin Infect Dis. 2007;44:222–8.
• Moore MR, Pryor M, Fields B, et al. Introduction of monochloramine into a municipal water system: Impact on colonization of buildings by Legionella spp. Appl Environ Microbiol. 2006;72: 378–83.
• Rowbotham TJ. Legionellosis associated with ships: 1977 to1997. Comm Dis Public Health. 1998;1(3):146–51.
• Kohler RB, Winn Jr. WC, Wheat LJ. Onset and duration of urinary antigen excretion in Legionnaires’ disease. J Clin Microbiol. 1984;20:605–7.
• Barbaree JM, Gorman GW, Martin WT, et al. Protocol for sampling environmental sites for legionellae. Appl Environ Microbiol. 1987;53(7):1454–8.