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{{Short description|none}}
This is a '''list of [[Legionnaires' disease]] outbreaks'''; Legionnaire's is a potentially fatal [[infectious disease]] caused by [[gram-negative bacteria|gram negative]], aerobic [[bacteria]] belonging to the [[genus]] ''[[Legionella]]''.<ref name=Sherris>{{cite book | author = Ryan KJ, Ray CG
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).<ref>{{Cite web|title=Legionella Outbreak Toolbox|url=https://legionnaires.ecdc.europa.eu/?pid=205|access-date=2020-07-01|website=legionnaires.ecdc.europa.eu}}</ref>
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|1988|| [[Adelaide]], Australia || community || potting mixes || || || || <ref name = "Broadbent"/>
|-▼
|1988|| [[Westminster]], England || [[BBC]] headquarters || cooling tower at [[Broadcasting House]] || || || ||
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|1989|| [[Sydney]], Australia || bowling club || small cooling tower || || || || <ref name = "Broadbent"/>
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|1995|| [[Sydney]], Australia || shopping centre || small cooling tower at hospital || || || || <ref name = "Broadbent"/>
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| 1999 || [[Bovenkarspel]], Netherlands || [[1999 Bovenkarspel legionellosis outbreak]] || [[Hot tub]]|| {{sort|318|318}} ||{{sort|032|32}} || 10% || In March 1999, an outbreak occurred in the [[Netherlands]]
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! Year !! City !! Venue !! Source !! Cases !! Deaths !! Fatality rate || Notes
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|2000 || [[Melbourne]], Australia || [[Sea Life Melbourne Aquarium]] || [[Cooling tower]] ||{{sort|125|125}} ||{{sort|004|4}} || 3.2% || 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.<ref>{{cite journal | vauthors = Greig JE, Carnie JA, Tallis GF, Ryan NJ, Tan AG, Gordon IR, Zwolak B, Leydon JA, Guest CS, Hart WG | title = An outbreak of Legionnaires' disease at the Melbourne Aquarium, April 2000: investigation and case-control studies | journal = [[Medical Journal of Australia]]| volume = 180 | issue = 11 | pages = 566–72 | date = June 2004 | doi = 10.5694/j.1326-5377.2004.tb06093.x | pmid = 15174987 | s2cid = 15441893 | url = https://www.mja.com.au/public/issues/180_11_070604/gre10735_fm.html }}</ref> Since this outbreak, ''legionella'' infection statistics are required to be reported by the state government as a notifiable disease.<ref>{{cite web |url=http://docs2.health.vic.gov.au/docs/doc/F268771876D8B028CA257ACA0012BB28/$FILE/cts_ehindicators.pdf |title=Legionella pneumophila cases |publisher=Docs2.health.vic.gov.au |access-date=2015-08-30 |archive-date=2016-02-04 |archive-url=https://web.archive.org/web/20160204110407/http://docs2.health.vic.gov.au/docs/doc/F268771876D8B028CA257ACA0012BB28/$FILE/cts_ehindicators.pdf |url-status=dead }}</ref> Regulations were introduced by the state to control legionella in 2001.<ref>{{cite web |title=Health (Legionella) Regulations 2001 S.R. No. 13/2001 |url=http://www.legislation.vic.gov.au/Domino/Web_Notes/LDMS/PubStatbook.nsf/93eb987ebadd283dca256e92000e4069/5d04907fa02c7983ca256e5b0021a910/$FILE/01-013sr.pdf|access-date=2017-07-01|website=Legislation.vic.gov.au}}</ref>
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|2000 || [[Vizela]], [[Portugal]] || Public square || Decorative fountain ||{{sort|11|11}} ||{{sort|000|0}} || 0% || In August 2000, an outbreak of Legionnaires' disease occurred in [[Vizela]], [[Northern Portugal]].<ref name="Porto Canal 2014">{{cite AV media |date=13 November 2014 |title=Vizela já enfrentou a legionella em Agosto de 2000 com 11 infectados |trans-title=Vizela already faced legionella in August 2000, with 11 cases |language=pt |url=http://portocanal.sapo.pt/noticia/43244 |access-date=5 March 2019 |publisher=Porto Canal }}</ref> A total of 11 persons with Legionnaires' disease were admitted to the hospital.<ref name="Correia 2001">{{cite journal |last1=Correia |first1=AM |last2=Gonçalves |first2=G |last3=Reis |first3=J |last4=Cruz |first4=JM |last5=Castro e Freitas |first5=JA |date=July 2001 |title=An outbreak of legionnaires disease in a municipality in northern Portugal. |journal=Euro Surveill |volume= 6|issue= 7|pages=121–4 |doi= 10.2807/esm.06.07.00228-en|pmid=12631957 |doi-access=free }}</ref> 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.<ref name="Porto Canal 2014" /> Investigators traced the source of the outbreak to a decorative fountain located in the square.<ref name="Correia 2001" />
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| 2005 || [[Toronto]], Canada || Seven Oaks Home for the Aged || [[Cooling tower]] || {{sort|127|127}}|| {{sort|021|21}} || 16.5% || 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.<ref>{{cite news |title=Toronto legionnaires' outbreak linked to 3 more deaths |date=October 21, 2005 |publisher=[[CBC News]]|url=http://www.cbc.ca/news/canada/toronto-legionnaires-outbreak-linked-to-3-more-deaths-1.525458 }}</ref>
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| 2005 || [[Fredrikstad]], Norway || Factory || [[Air scrubber]] ||{{sort|103|103}} ||{{sort|010|10}} || 9.7% || At least 103 people became ill and ten died from Legionnaires' disease caused by bacteria growing in an air scrubber of a nearby factory.<ref>{{cite journal | vauthors = Simonsen Ø, Wedege E, Kanestrøm A, Bolstad K, Aaberge IS, Ragnhildstveit E, Ringstad J | title = Characterization of the extent of a large outbreak of Legionnaires' disease by serological assays | journal = BMC Infectious Diseases | volume = 15 | pages = 163 | date = March 2015 | pmid = 25887275 | pmc = 4383209 | doi = 10.1186/s12879-015-0903-2 | doi-access = free }}</ref>
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|2007
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|75%
|In January 2007 in the 2nd district specialist hospital in [[Jastrzębie-Zdrój]] two patients on the [[Ophthalmology|ophthalmic]] ward unexpectedly died. It was noted that they suddenly had a high fever, [[cough]]s and [[hallucination]]s. First they were transferred to the [[Infectious disease (medical specialty)|infectious diseases]] ward for some hours with a suspicion of [[pneumonia]], later they were transferred to intensive care.
Tests showed that both patients had [[Legionnaires' disease|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 [[Legionnaires' disease|legionellosis]] was found in four patients from this hospital.<ref>{{cite web
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|2008 || [[New Brunswick, New Jersey|New Brunswick]], New Jersey, [[United States]] ||[[Saint Peter's University Hospital]] || [[Drinking water]] ||{{sort|006|6}} ||{{sort|002|2}} || 33.3% || [[Water chlorination|Chlorination]] in the water system had dropped below effective levels.<ref>{{cite news |title=Second patient with Legionnaires' disease dies at New Brunswick hospital |url=http://www.nj.com/news/index.ssf/2008/09/second_patient_with_legionnair.html |newspaper=[[The Star-Ledger]] |date= September 24, 2008 |access-date=2011-10-08 }}</ref>
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|2014||[[Portugal]]||[[2014 Legionella outbreak in Portugal]]|| Cooling tower<ref>{{cite web |url=https://www.dgs.pt/a-direccao-geral-da-saude/comunicados-e-despachos-do-director-geral/surto-de-infecao-por-legionella-pdf8.aspx |title=Joint Communication — Preliminary report of Legionnaries' disease 07 to 21 November 2014 |author=<!--Not stated--> |date=21 November 2014 |website=[[:pt:Direção-Geral da Saúde|Direção-Geral da Saúde]] |access-date=5 March 2019 }}</ref>||{{sort|375|375}}||{{sort|012|12}}|| 3.2% || A widespread outbreak in [[Vila Franca de Xira]] district, Portugal.<ref name="rrsapo">{{cite web |url=https://rr.sapo.pt/informacao_detalhe.aspx?fid=25&did=169622 |title=Extinto o surto de legionella |date=November 21, 2014 |website=rr.sapo.pt |language= pt |access-date=November 23, 2014}}</ref>
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|2015||[[The Bronx|Bronx, New York]], [[United States]]||[[Co-op City, Bronx|Co-op City]], [[South Bronx]], and [[Morris Park, Bronx|Morris Park]]|| Cooling Towers in the Bronx, such as Co-op City, Lincoln Hospital, and Concourse Plaza
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▲|2015||[[The Bronx|Bronx, New York]], [[United States]]||[[South Bronx]]|| Lincoln Hospital and Concourse Plaza Cooling Towers ||{{sort|113|113}}||{{sort|012|12}}|| 10.6% || The [[2015 New York Legionnaires' disease outbreak]] was investigated the [[Government of New York City|New York City]] Health Department<ref>{{cite web|url=http://www.dnainfo.com/new-york/20150730/civic-center/legionnaires-disease-bacteria-found-ac-of-bronx-hospital-mayor-says/|title=Legionnaires' Disease Bacteria Found in A/C on Bronx Hospital, Mayor says|work=DNAinfo New York|url-status=dead|archive-url=https://web.archive.org/web/20150801133024/http://www.dnainfo.com/new-york/20150730/civic-center/legionnaires-disease-bacteria-found-ac-of-bronx-hospital-mayor-says|archive-date=2015-08-01}}</ref><ref>{{cite web|url=http://edition.cnn.com/2015/08/01/health/new-york-legionnaires-disease/|title=There have been 65 cases since mid-July|author=David Shortell|date=2 August 2015|work=[[CNN News]]}}</ref> Out of 17 buildings with cooling towers, five tested positive to the disease, including cooling towers in the [[Concourse Plaza Hotel]] and [[Lincoln Hospital (Bronx)|Lincoln Hospital]].<ref>{{cite web|url=http://www.capitalnewyork.com/article/city-hall/2015/08/8573205/city-confirms-71-cases-legionnaires-disease|title=City confirms 71 cases of Legionnaire's Disease|work=capitalnewyork.com}}</ref> The Opera House Hotel in the South Bronx is also considered a source of the outbreak.<ref>{{cite news|url=https://www.nytimes.com/2015/08/11/nyregion/death-toll-from-legionnaires-disease-outbreak-in-bronx-rises-to-12.html|title=Hotel that enlivened the Bronx is now a 'hot spot' for Legionnaire's|work=[[The New York Times]]|date=10 August 2015 |last1=Hu |first1=Winnie |last2=Remnick |first2=Noah }}</ref>
|-▼
|-
|2015
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|SpringHill Suites hotel
| Swimming pool and hot tub
|6<ref>{{Cite news|url=http://cbsaustin.com/news/local/sixth-case-of-legionnaires-disease-confirmed-at-round-rock-hotel|title=Sixth case of Legionnaires' disease confirmed at Round Rock hotel|last=Austin|first=CBS|work=KEYE|access-date=2017-10-10 }}</ref><ref>{{Cite news|url=http://www.statesman.com/news/local/sixth-case-legionnaires-disease-confirmed-from-round-rock-hotel/2At7rMDESHTxTTgbtSJWlM/|title=Sixth case of Legionnaires' disease confirmed from Round Rock hotel|last=Osborn|first=Claire
|0
|0
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|2018
|[[Washington Heights, Manhattan|Washington Heights]], [[New York (state)|New York]], [[United States]]
|The Sugar Hill Project (Building)<ref name=":4">{{Cite web|url=https://www1.nyc.gov/site/doh/about/press/pr2018/pr065-18.page|title=pr065-18|website=www1.nyc.gov|access-date=2018-09-06|archive-date=2018-09-06|archive-url=https://web.archive.org/web/20180906124539/https://www1.nyc.gov/site/doh/about/press/pr2018/pr065-18.page|url-status=dead}}</ref><ref name=":5">{{Cite news|url=https://newyork.cbslocal.com/2018/08/15/source-of-legionnaires-outbreak/|title=NYC Health Officials ID Source Of Legionnaires' Outbreak In Upper Manhattan|date=2018-08-15|access-date=2018-09-06|language=en}}</ref>
|Cooling towers<ref name=":0">{{Cite news|url=https://nytimes.com/2018/07/17/nyregion/new-york-today-a-legionnaires-disease-outbreak.html|title=New York Today: A Legionnaires' Disease Outbreak|work=The New York Times |date=17 July 2018 |access-date=2018-07-18 |last1=Levine |first1=Alexandra S. }}</ref><ref name=":1">{{Cite news|url=http://abc7ny.com/health/nyc-legionnaires-cluster-up-to-18-cases-1-death-reported/3777596/|title=NYC Legionnaires cluster up to 18 cases, 1 death reported|date=2018-07-17|work=ABC7 New York|access-date=2018-07-18|language=en-US}}</ref><ref name=":4" /><ref name=":5" />
|27<ref name=":2">{{Cite web|url=https://www1.nyc.gov/assets/doh/downloads/pdf/cd/legionnaires-wash-cluster-faq.pdf|title=Notice to Residents of Lower Washington Heights|date=24 June 2018|website=NYC Department of Heath|publisher=NYC Department of Health|access-date=24 July 2018}}</ref><ref name=":1" />
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|0
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|[https://www.nytimes.com/2019/07/29/us/legionnaires-disease-sheraton-atlanta.html
|-
|2019
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''[https://www.buzzfeednews.com/article/olivianiland/hot-tub-north-carolina-legionnaires-disease-outbreak Four People Have Died From A Legionnaires' Outbreak Linked To A Hot Tub Display At A State Fair]''
''[https://www.usatoday.com/story/news/nation/2019/10/15/legionnaires-disease-outbreak-kills-third-north-carolina-fairgoer/3993542002/
''[https://www.npr.org/2019/10/04/767210215/n-c-officials-trace-124-legionnaires-disease-cases-to-hot-tub-at-a-fair N.C. Officials Trace 124 Legionnaires' Disease Cases To Hot Tub At A Fair]''
''[https://epi.dph.ncdhhs.gov/cd/legionellosis/outbreak.html Investigation of an Outbreak of Legionellosis in Western North Carolina]''
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|22
|6
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|Cluster of pneumonia cases associated with a health clinic. 22 cases and 6 deaths (all with comorbidities). The source of the bacteria is still unknown.<ref>{{Cite news|last=|first=|date=2022-09-05|title=Legionella identified as cause of cluster of pneumonia cases in Tucuman, Argentina|work=PAHO|url=https://www.paho.org/en/news/3-9-2022-update-legionella-identified-cause-cluster-pneumonia-cases-tucuman-argentina|access-date=}}</ref>
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|2023
|[[Rzeszów]], [[Subcarpathian Voivodeship]],
[[Poland]]
|Multiple locations
|Under investigation
|164
|41
|25%
|Ongoing outbreak. The source of the bacteria is suspected to be contaminated water sources.<ref>{{Cite news|last=|first=|date=2023-08-23|title=Bakteria Legionella pneumophila w Rzeszowie. Nie żyją trzy zakażone osoby|work=PAP|url=https://www.pap.pl/aktualnosci/bakteria-legionella-pneumophila-w-rzeszowie-nie-zyja-trzy-zakazone-osoby|access-date=2023-08-23}}</ref>
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|2024
|[[Lincoln, New Hampshire|Lincoln]], [[New Hampshire]], [[United States]]
|RiverWalk Resort
|Cooling Tower
|5
|0
|0%
|<ref>{{Cite web |last=Callery |first=Tim |date=2024-08-16 |title=Officials wait for more test results after Legionnaires' disease cases in Lincoln |url=https://www.wmur.com/article/legionnaires-disease-testing-lincoln-81624/61900707 |access-date=2024-08-19 |website=WMUR |language=en}}</ref>
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===Regulations and ordinances===
The guidance issued by the UK government's Health and Safety Executive (HSE) now recommends that microbiological monitoring for wet cooling systems, using a [[dipslide]], should be performed weekly. The guidance now also recommends that routine testing for legionella bacteria in wet cooling systems be carried out at least quarterly, and more frequently when a system is being commissioned, or if the bacteria have been identified on a previous occasion.<ref>[http://www.hse.gov.uk/lau/lacs/46-2.htm#para8] {{webarchive|url=https://web.archive.org/web/20121020031125/http://www.hse.gov.uk/lau/lacs/46-2.htm|date=2012-10-20}}</ref>
Further non-statutory UK guidance from the Water Regulations Advisory Scheme now exists for pre-heating of water in applications such as [[solar water heating]] systems.<ref name="Makin2014">{{cite web |date=November 2014 |title=Preheated Domestic Hot Water: Storage of Preheated Domestic Hot Water and Possible Growth of Legionella Bacteria |url=https://www.wras.co.uk/downloads/public_area/publications/general/preheated_water_Nov_2014.pdf |publisher=The Water Regulations Advisory Scheme |vauthors=Makin T |access-date=2017-07-01 |archive-date=2017-01-08 |archive-url=https://web.archive.org/web/20170108122407/https://www.wras.co.uk/downloads/public_area/publications/general/preheated_water_Nov_2014.pdf/ |url-status=dead }}</ref>
The City of [[Garland, Texas]], [[United States]] requires yearly testing for legionella bacteria at cooling towers at apartment buildings.<ref>{{cite web |url=http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/DN-legionella_01eas.ART0.East.Edition1.29739cd.html |title=The Dallas Morning News, Garland tough on bacteria |publisher=Dallasnews.com |date=2007-02-01 |access-date=2010-09-11 |archive-date=2010-04-24 |archive-url=https://web.archive.org/web/20100424212858/http://www.dallasnews.com/sharedcontent/dws/news/localnews/stories/DN-legionella_01eas.ART0.East.Edition1.29739cd.html |url-status=dead }}</ref>
[[Malta]] requires twice yearly testing for ''Legionella'' bacteria at cooling towers and water fountains. [[Malta]] prohibits the installation of new cooling towers and evaporative condensers at health care facilities and schools.<ref>{{cite web |url=http://www.doi.gov.mt/EN/legalnotices/2006/01/LN5.pdf |title=299601 Legionella |access-date=2010-09-11 |archive-date=2011-06-06 |archive-url=https://web.archive.org/web/20110606130555/http://www.doi.gov.mt/EN/legalnotices/2006/01/LN5.pdf |url-status=dead }}</ref>
The Texas Department of State Health Services has provided guidelines for hospitals to detect and prevent the spread of [[nosocomial infection]] due to legionella.<ref>Report of the Texas Legionnaires' Disease Task Force, Texas Department of State Health Services{{full citation needed|date=July 2017}}</ref>
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