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Published Date: 2019-07-17 11:42:37
Subject: PRO/EDR> Legionellosis - USA (14): (GA) hotel
Archive Number: 20190717.6573167
LEGIONELLOSIS - USA (14): (GEORGIA) HOTEL
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Date: Wed 17 Jul 2019 1111 GMT (1911 HKT)
Source: CNN [abridged, edited]
https://edition.cnn.com/2019/07/16/us/legionnaires-disease-atlanta-hotel-trnd/index.html


Officials said 5 guests who stayed at a prominent downtown Atlanta hotel have become sick with legionnaires' disease, prompting an investigation of the hotel on [Mon 15 Jul 2019]. "Based on epidemiological evidence we have an outbreak among people who stayed at the [Sheraton Atlanta] during the same time period," said Nancy Nydam, director of communications at Georgia Department of Public Health, on [Tue 16 Jul 2019].

Legionnaires' is a serious form of pneumonia that is non-contagious. Guests who complained of lung problems and were later diagnosed with legionnaires' [disease] had attended a convention at the Atlanta hotel a couple of weeks ago.

The bacterium causing legionnaires' has not yet been confirmed at the hotel, which has hired outside experts to conduct testing. The hotel has voluntarily shuttered its doors until the source of infection is found and remediation is complete, Nydam said. More than 400 guests have been relocated to nearby hotels, CNN affiliate WSB-TV reported.

About one in 10 people who get sick from legionnaires' disease will die, a recent government report found. The disease infects an estimated 10 000 to 18 000 people in the United States each year. People can get sick when they breathe in mist or accidentally swallow water into the lungs containing the bacteria that causes the lung infection. It can be treated with antibiotics, according to the US Centers for Disease Control and Prevention.

The hotel's general manager, Ken Peduzzi, said, "The health and safety of our guests is our greatest priority." The hotel is working with the state health department as well as Fulton County Board of Health and environmental specialists to test for the bacteria, Georgia's health department said. The Sheraton Atlanta has closed "out of an abundance of caution ... while we await the results," Peduzzi said.

"This is the typical way these situations are handled since the assessment and testing can be complicated," according to Nydam. The state health department plus "Fulton County Board of Health epidemiologists and environmental health staff will work with them on the next steps in the investigation (technical assessment, sampling plan and submission)," she added.

In addition to relocating current guests to nearby hotels, Sheraton is also reaching out to guests with upcoming reservations "to assist in directing them to other nearby hotels," according to Peduzzi.

State epidemiologist Cherie Drenzek told WSB[-TV] that past outbreaks have been associated with "shower heads, hot tubs, perhaps even ... decorative fountains." Drenzek added that the Sheraton is also working on the filtration system in the hotel's swimming pool.

[byline: Susan Scutti]

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communicated by:
ProMED-mail
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[Five guests at the Sheraton Atlanta Hotel in downtown Atlanta developed legionnaires' disease after having attended a convention at the hotel "a couple of weeks ago", the incubation period being 2 to 10 or even more days in some outbreaks settings (https://www.who.int/news-room/fact-sheets/detail/legionellosis).

Genotyping the clinical isolates from the 5 cases of legionnaires' disease who stayed at the Sheraton Atlanta will help confirm if this is a common source outbreak, if the genotypes match. Matching the genotypes of clinical and environmental isolates of legionella will identify the environmental source for the individual cases. However, if the diagnosis of legionnaires' disease was based only on a positive urinary antigen assay, there will be no clinical isolates for genotyping.

According to the US CDC, about 20-25% of all legionnaires' disease reported to CDC is travel-associated (https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5648a2.htm and http://wwwnc.cdc.gov/travel/yellowbook/2016/conveyance-transportation-issues/cruise-ship-travel). Travelers typically disperse to their homes widely separated from one another and perhaps at a very great distance from the source of infection before developing symptoms, so that a cluster of cases of legionnaires' disease in travelers associated with the same source may not be readily appreciated. A travel history is essential and should be actively sought from patients with community-acquired pneumonia, and legionella testing should be performed for those diagnosed with community-acquired pneumonia who have traveled in the 2 weeks before onset of symptoms.

The Sheraton Atlanta is a hotel with a conference/meeting center, fitness center, pool and heated whirlpool, located in downtown Atlanta, Georgia (https://www.marriott.com/hotels/hotel-information/fitness-center/atlxs-sheraton-atlanta-hotel/). A map showing its location can be found at https://www.marriott.com/hotels/maps/travel/atlxs-sheraton-atlanta-hotel/.

We await further developments in the investigation of this outbreak. - Mod.ML

HealthMap/ProMED-mail map of Georgia, United States: http://healthmap.org/promed/p/65150]

See Also

Legionellosis - USA (03): (ND) hotel indoor water park susp. 20190224.6334167
Legionellosis - USA: (MN) hotel 20190218.6323477
2018
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Legionellosis - USA (14): (NC) casino 20181122.6159663
2017
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Legionellosis - USA (21): (CA) fatal, amusement park, cooling tower susp., RFI 20171111.5438167
Legionellosis - Europe (11): UK (England) hotel, 2015 20170927.5344840
Legionellosis - Europe (10): ex United Arab Emirates (Dubai) 20170926.5340709
Legionellosis - Europe (08): UK (England) fatal, hotel, recurrence 20170915.5318438
Legionellosis - Europe (05): 2011-2015 20170708.5159730
Legionellosis - Europe (04): ex United Arab Emirates (DU) 20170706.5156162
Legionellosis - Europe (03): ex United Arab Emirates (Dubai) 20170602.5079438
Legionellosis - China: Hong Kong ex Macao, hotel, RFI 20170427.4998033
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