Emerg Infect Dis. 2017 Nov;23(11):1769-76. doi: 10.3201/eid2311.161584.
The incidence of Legionnaires' disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires' disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. Three outbreaks occurred in 2015, including the largest on record (138 cases). Three outbreaks were linked to cooling towers by molecular comparison of human and environmental Legionella isolates, and the sources for the other 3 outbreaks were undetermined. The evolution of investigation methods and lessons learned from these outbreaks prompted enactment of a new comprehensive law governing the operation and maintenance of New York City cooling towers. Ongoing surveillance and program evaluation will determine if enforcement of the new cooling tower law reduces Legionnaires' disease incidence in New York City.
自 2000 年以来,美国军团病的发病率一直在上升。爆发和聚集与装饰性、娱乐性、家用和工业用水系统有关,最大的爆发是由冷却塔引起的。自 2006 年以来,纽约市发生了 6 起社区相关军团病爆发,导致 213 例病例和 18 人死亡。其中 3 起爆发发生在 2015 年,包括有记录以来最大的一次(138 例)。通过对人和环境军团菌分离物的分子比较,发现 3 起爆发与冷却塔有关,而另外 3 起爆发的来源尚未确定。调查方法的演变以及从这些爆发中吸取的教训促使颁布了一项新的全面法律,该法律管辖纽约市冷却塔的运行和维护。正在进行的监测和计划评估将确定执行新的冷却塔法律是否会降低纽约市军团病的发病率。