{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,21]],"date-time":"2026-09-21T02:09:31Z","timestamp":1789956571354,"version":"4.0.1"},"reference-count":39,"publisher":"Cambridge University Press (CUP)","issue":"3","license":[{"start":{"date-parts":[[2016,12,6]],"date-time":"2016-12-06T00:00:00Z","timestamp":1480982400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Infect. Control Hosp. Epidemiol."],"published-print":{"date-parts":[[2017,3]]},"abstract":"<jats:sec id=\"S0899823X16002816_abs1\" sec-type=\"objectives\"><jats:title>OBJECTIVES<\/jats:title><jats:p>To define the scope of an outbreak of Legionnaires\u2019 disease (LD), to identify the source, and to stop transmission.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002816_abs2\" sec-type=\"general\"><jats:title>DESIGN AND SETTING<\/jats:title><jats:p>Epidemiologic investigation of an LD outbreak among patients and a visitor exposed to a newly constructed hematology-oncology unit.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002816_abs3\" sec-type=\"methods\"><jats:title>METHODS<\/jats:title><jats:p>An LD case was defined as radiographically confirmed pneumonia in a person with positive urinary antigen testing and\/or respiratory culture for<jats:italic>Legionella<\/jats:italic>and exposure to the hematology-oncology unit after February 20, 2014. Cases were classified as definitely or probably healthcare-associated based on whether they were exposed to the unit for all or part of the incubation period (2\u201310 days). We conducted an environmental assessment and collected water samples for culture. Clinical and environmental isolates were compared by monoclonal antibody (MAb) and sequence-based typing.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002816_abs4\" sec-type=\"results\"><jats:title>RESULTS<\/jats:title><jats:p>Over a 12-week period, 10 cases were identified, including 6 definite and 4 probable cases. Environmental sampling revealed<jats:italic>Legionella pneumophila<\/jats:italic>serogroup 1 (Lp1) in the potable water at 9 of 10 unit sites (90%), including all patient rooms tested. The 3 clinical isolates were identical to environmental isolates from the unit (MAb2-positive, sequence type ST36). No cases occurred with exposure after the implementation of water restrictions followed by point-of-use filters.<\/jats:p><\/jats:sec><jats:sec id=\"S0899823X16002816_abs5\" sec-type=\"conclusions\"><jats:title>CONCLUSIONS<\/jats:title><jats:p>Contamination of the unit\u2019s potable water system with Lp1 strain ST36 was the likely source of this outbreak. Healthcare providers should routinely test patients who develop pneumonia at least 2 days after hospital admission for LD. A single case of LD that is definitely healthcare associated should prompt a full investigation.<\/jats:p><jats:p><jats:italic>Infect Control Hosp Epidemiol<\/jats:italic>2017;38:306\u2013313<\/jats:p><\/jats:sec>","DOI":"10.1017\/ice.2016.281","type":"journal-article","created":{"date-parts":[[2016,12,6]],"date-time":"2016-12-06T09:16:02Z","timestamp":1481015762000},"page":"306-313","source":"Crossref","is-referenced-by-count":24,"title":["Lessons From an Outbreak of Legionnaires\u2019 Disease on a Hematology-Oncology Unit"],"prefix":"10.1017","volume":"38","author":[{"given":"Louise K.","family":"Francois Watkins","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karrie-Ann E.","family":"Toews","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron M.","family":"Harris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sherri","family":"Davidson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephanie","family":"Ayers-Millsap","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claressa E.","family":"Lucas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian C.","family":"Hubbard","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natalia A.","family":"Kozak-Muiznieks","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edward","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Preeta K.","family":"Kutty","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,12,6]]},"reference":[{"key":"S0899823X16002816_ref30","doi-asserted-by":"publisher","DOI":"10.1086\/511159"},{"key":"S0899823X16002816_ref26","doi-asserted-by":"publisher","DOI":"10.1111\/j.1532-5415.2000.tb03868.x"},{"key":"S0899823X16002816_ref3","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6442a2"},{"key":"S0899823X16002816_ref21","unstructured":"Legionella and the prevention of legionellosis. 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