list of legionnaires' disease outbreaks list of legionnaires' disease outbreaks this is a list of legionnaires' disease outbreaks; legionnaire's is a potentially fatal infectious disease caused by gram negative, aerobic bacteria belonging to the genus legionella. the first reported outbreak was in philadelphia, pennsylvania in 1976 during a legionnaires convention at the bellevue-stratford hotel. an outbreak is defined as two or more cases where the onset of illness is closely linked in time (weeks rather than months) and in space, where there is suspicion of, or evidence of, a common source of infection, with or without microbiological support (i.e. common spatial location of cases from travel history). worldwide listings by year 1960s yearcityvenuesourcecasesdeathsfatality ratenotes 1965washington, d.c., united statesst. elizabeths hospitalunknown941617%the outbreak occurred in 1965, but was not identified as legionnaires' disease until saved blood serum was exposed to bacterial samples from the 1976 philadelphia legionnaires' disease outbreak. 1970s yearcityvenuesourcecasesdeathsfatality ratenotes 1973,1977benidorm, spainhotel rio parkshower pipesat least 44unknownthe first outbreak in hotel rio park occurred in 1973, four tourists died, but at the time it was not recognized as legionnaires' disease until a subsequent outbreak in the same hotel in 1977. 1976philadelphia, pennsylvania, united states1976 philadelphia legionnaires' disease outbreakair conditioning2213415.4%this was the first recognized outbreak of legionellosis, although earlier cases of legionellosis were later discovered to have occurred as far back as 1947. the philadelphia outbreak, however, had the highest death rate. 1978memphis, tennessee, united statesbaptist memorial hospital-memphis (1912–2000)air-conditioning cooling tower441978 memphis legionnaire's disease outbreak 1979melbourne, australialight industrial buildingmedium-sized evaporative condenser 1979ballarat, australiapsychiatric hospitalshower water system 1980s yearcityvenuesourcecasesdeathsfatality ratenotes 1985wollongong, australiasocial club buildingsmall cooling tower 1985stafford, englandstafford district hospitalair conditioning1752816%in april 1985, 175 patients were admitted to the district or kingsmead stafford hospitals with chest infection or pneumonia. a total of 28 people died. medical diagnosis showed that legionnaires' disease was responsible and the immediate epidemiological investigation traced the source of the infection to the air-conditioning cooling tower on the roof of stafford district hospital. 1986adelaide, australiacommunitysmall cooling tower at hospital 1987wollongong, australiashopping centresmall cooling tower at a shop 1988adelaide, australiacommunitypotting mixes 1989sydney, australiabowling clubsmall cooling tower 1989burnie, australiacommunitysmall cooling tower at hospital 1990s yearcityvenuesourcecasesdeathsfatality ratenotes 1992sydney, australiashopping centresmall cooling tower 1994sunshine coast, australiaholiday apartment unitprivate spa pool 1995sydney, australiashopping centresmall cooling tower at hospital 1999bovenkarspel, netherlands1999 bovenkarspel legionellosis outbreakhot tub3183210%in march 1999, an outbreak in the netherlands occurred during the westfriese flora flower exhibition in bovenkarspel. 318 people became ill and at least 32 people died. there is a possibility that more people died from it (which might make it the deadliest recorded outbreak), but these people were interred before the legionella infection was recognized. the source of the bacteria was a hot tub in the exhibition area. 2000s yearcityvenuesourcecasesdeathsfatality ratenotes 2000melbourne, australiasea life melbourne aquariumcooling tower12543.2%in april 2000, an outbreak of legionella pnemophila serogroup 1 occurred in melbourne, australia. the outbreak resulted in 125 confirmed cases of legionnaire's disease, with 95 (76%) hospitalised. it is reported that 4 died from the outbreak. the investigation traced the source of the infection to the cooling tower at the newly opened aquarium. since this outbreak, legionella infection statistics are required to be reported by the state government as a notifiable disease. regulations were introduced by the state to control legionella in 2001. 2000vizela, portugalpublic squaredecorative fountain1100%in august 2000, an outbreak of legionnaires' disease occurred in vizela, northern portugal. a total of 11 persons with legionnaires' disease were admitted to the hospital. there were no fatalities. all patients had been in the main square of vizela in the night of august 11–12, 2000, where the annual festivities of the municipality were being held. investigators traced the source of the outbreak to a decorative fountain located in the square. 2001murcia, spainhospitalcooling towers 800+60.8%the world's largest outbreak of legionnaires' disease happened in july 2001 with patients appearing at the hospital on july 7, in murcia, spain. more than 800 suspected cases were recorded by the time the last case was treated on july 22; 636–696 of these cases were estimated and 449 confirmed (so, at least 16,000 people were exposed to the bacterium) and 6 died . a case-fatality rate of approximately 1%. 2002barrow-in-furness, england2002 barrow-in-furness legionellosis outbreakair conditioning17274.1%in 2002, barrow-in-furness in england had an outbreak of legionnaires' disease. six women and one man died as a result of the illness; another 172 people also contracted the disease. the cause was found to be a contaminated cooling tower at the town's forum 28 arts centre. barrow borough council later became the first public body in the uk to be charged with corporate manslaughter but were cleared. they were, however, along with architect gillian beckingham, fined for breaches of health and safety regulations in a trial that ended in 2006. 2003-2004pas-de-calais, francepetrochemical plantcooling tower861820.93%this was the worst outbreak of legionnaires in french history. 2004zaragoza, spainhospitalcooling tower27726%five out of seven of the fatalities were above the age of 50. 2005toronto, canadaseven oaks home for the agedcooling tower1272116.5%in late september, 2005, 127 residents of a nursing home became ill with legionella pneumophila. within a week, twenty-one of the residents had died. culture results at first were negative. the source of the outbreak was traced to the air-conditioning cooling towers on the nursing home's roof. 2005fredrikstad, norwayfactoryair scrubber103109.7%at least 103 people became ill and ten died from legionnaires' disease caused by bacteria growing in an air scrubber of a nearby factory. 2007 jastrzębie zdrój, poland 2nd district specialist hospital, ophthalmic ward water system 4 3 75% in january 2007 in the 2nd district specialist hospital in jastrzębie-zdrój two patients on the ophthalmic ward unexpectedly died. it was noted that they suddenly had a high fever, coughs and hallucinations. first they were transferred to the infectious diseases ward for some hours with a suspicion of pneumonia, later they were transferred to intensive care. tests showed that both patients had legionellosis. the disease proved to be the cause of death of one of the patients, the other also had circulatory failure. the bacteria responsible for legionellosis was found in four patients from this hospital. in total the outbreak resulted in three deaths 2008new brunswick, new jersey, united statessaint peter's university hospitaldrinking water6233.3%chlorination in the water system had dropped below effective levels. 2010s yearcityvenuesourcecasesdeathsfatality ratenotes 2010walessouth wales valleyslikely cooling towers2229%thought to be cooling towers in local industry. 2011dayton, ohio, united statesdaytonhospital air conditioning11545%was the largest outbreak in ohio since 1994 at the time. 2012québec city, canadalower québec citypossibly cooling towers180137.22%180 confirmed cases as of september 14, 2012, probably due to contaminated water in industrial cooling towers. 2012calp, spainar diamante beach hotelplumbing system18317%large hotel with solar water heating system for spa and domestic hot water. a month before the deaths, local government authorities may have known about the problem, but were accused of not alerting the public to avoid disruption of the tourism industry. 2012edinburgh, scotlandsouth west of edinburghpossibly cooling towers9243%56 confirmed cases, with a further 36 suspected cases, bringing the total number of people affected to 92. four people are known to have died from the outbreak. 2012chicago, illinois, united statesjw marriott hoteldecorative lobby fountain10330%8 confirmed cases with people who stayed at the jw marriott chicago during july–august 2012. 2012auckland, new zealandunknownwater source and/or air conditioning1119%the number of people affected in a major outbreak of legionnaires' disease in auckland, which has claimed one life, has risen to 11. 2012stoke-on-trent, englandwarehouse, fentonhot tub1915.2%infection began in warehouse hot tub. seventeen of the confirmed cases visited the warehouse a couple of weeks before becoming ill. 2012pittsburgh, pennsylvania, united statesveteran's administration hospitalunknown22627%2012 pittsburgh legionellosis outbreak 2014portugal2014 legionella outbreak in portugalcooling tower375123.2%a widespread outbreak in vila franca de xira district, portugal. 2015bronx, new york, united statesco-op cityco-op city cooling towers1200.0%12 people sickened in january 2015. no fatalities reported. 2015bronx, new york, united statessouth bronxlincoln hospital and concourse plaza cooling towers1131210.6%the 2015 new york legionnaires' disease outbreak was investigated the new york city health department out of 17 buildings with cooling towers, five tested positive to the disease, including cooling towers in the concourse plaza hotel and lincoln hospital. the opera house hotel in the south bronx is also considered a source of the outbreak. 2015bronx, new york, united statesmorris parkunknown1516.6%the outbreak is currently being investigated by the new york city health department "environmentalists sampled 35 cooling towers in the morris park area, and 15 came back with positive results." 2015 northland, new zealand pahiatua fonterra plant unknown 3 0 unknown this outbreak occurred at one of fonterra's milk plants in northland, new zealand, in november 2015. currently three cases have been reported, though currently no deaths. 2015quincy, illinois, united statesveterans homeunknown581327.7%the outbreak investigation is ongoing 2014–2016flint, genesee county, michigan, united statescountywidemclaren regional medical center871213.8%investigation by frontline also examined cases diagnosed as pneumonia that could have been misdiagnosed and diagnosed as legionnaires' disease. mclaren and the michigan department of environmental quality is being sued for $100 million in regards to the outbreak.