Publications

Epidemiology, Surveillance, and Outbreaks

• Ahmed SS, Hunter CM, Mercante JW, Garrison LE, Turabelidze G, Kunz J, Cooley LA. Legionnaires’ disease in a hotel in Missouri, 2015: The importance of environmental health expertise in understanding water systemsexternal icon. J Environ Hlth. 2019;81(7):8–13.
• Centers for Disease Control and Prevention. Legionnaires’ Disease Surveillance Summary Report, 2014–2015 pdf icon[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 unitexternal icon. 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. pdf icon[22 pages]external icon. 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 pdf icon[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, 2011–2012external icon. 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, Nevadaexternal icon. 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 waterexternal icon. 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 trendsexternal icon. 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 periodexternal icon. Clin Infect Dis. 2005;40(8):1205–7.
• Fields BS, Benson RF, Besser RE. Legionella and Legionnaires’ disease: 25 years of investigationexternal icon. 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 legionellosisexternal icon. 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 diagnosisexternal icon. 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 patientsexternal icon. 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 systemexternal icon. 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 Groupexternal icon.  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 spaexternal icon. Lancet. 1996;347(9000):494–9.
• Fraser DW, Tsai TR, Orenstein W, et al. Legionnaires’ disease: Description of an epidemic of pneumoniaexternal icon. 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 diseaseexternal icon. 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 Agreementpdf iconexternal icon. 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 towersexternal icon. PloS One. 2017;12(12):e0189937.
• Hunter CM, Kunz J. Reducing Legionnaires’ disease in public spas pdf icon[3 pages]. ASHRAE J. 2017;Dec:56–8.
• Kunz J, Cooley L. Preventing Legionnaires’ disease: Environmental health expertise is key pdf icon[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 strainsexternal icon. 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 stateexternal icon. Appl Environ Microbiol. 2016;82(12):3582–90.
• Mercante JW, Winchell JM. Current and emerging Legionella diagnostics for laboratory and outbreak investigationsexternal icon. 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 2012external icon. J Clin Micro. 2014;52(1):201–11.
• Kozak NA, Lucas CE, Winchell JM. Identification of Legionella in the environment[23 pages]external icon. 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 feverexternal icon. 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 sppexternal icon. Appl Environ Microbiol. 2006;72: 378–83.
• Rowbotham TJ. Legionellosis associated with ships: 1977 to1997external icon. 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’ diseaseexternal icon. J Clin Microbiol. 1984;20:605–7.
• Barbaree JM, Gorman GW, Martin WT, et al. Protocol for sampling environmental sites for legionellaeexternal icon. Appl Environ Microbiol. 1987;53(7):1454–8.