Current Environmental Health Reports

, Volume 5, Issue 2, pp 263–271 | Cite as

Outbreaks of Legionnaires’ Disease and Pontiac Fever 2006–2017

  • K. A. HamiltonEmail author
  • A. J. PrussinII
  • W. Ahmed
  • C. N. Haas
Water and Health (T Wade, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Water and Health


Purpose of Review

The global importance of Legionnaires’ disease (LD) and Pontiac fever (PF) has grown in recent years. While sporadic cases of LD and PF do not always provide contextual information for evaluating causes and drivers of Legionella risks, analysis of outbreaks provides an opportunity to assess these factors.

Recent Findings

A review was performed and provides a summary of LD and PF outbreaks between 2006 and 2017. Of the 136 outbreaks, 115 were LD outbreaks, 4 were PF outbreaks, and 17 were mixed outbreaks of LD and PF. Cooling towers were implicated or suspected in the a large portion of LD or PF outbreaks (30% total outbreaks, 50% confirmed outbreak-associated cases, and 60% outbreak-associated deaths) over this period of time, while building water systems and pools/spas were also important contributors.


Potable water/building water system outbreaks seldom identify specific building water system or fixture deficiencies. The outbreak data summarized here provides information for prioritizing and targeting risk analysis and mitigation strategies.


Legionnaires’ disease Legionellosis Pontiac fever Outbreak Cooling tower Water Buildings 



This research was developed under Assistance Agreement No. R836880 awarded by the U.S. Environmental Protection Agency. It has not been formally reviewed by EPA. The views expressed in this document are solely those of the authors and do not necessarily reflect those of the Agency. EPA does not endorse any products or commercial services mentioned in this publication. Additional support was provided by the Virginia Tech Institute for Critical Technology and Applied Science.

Compliance with Ethical Standards

Conflict of Interest

The authors declare that they have no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Supplementary material

40572_2018_201_MOESM1_ESM.docx (237 kb)
ESM 1 (DOCX 92.0 kb)


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Copyright information

© Springer International Publishing AG, part of Springer Nature 2018

Authors and Affiliations

  • K. A. Hamilton
    • 1
    Email author
  • A. J. PrussinII
    • 2
  • W. Ahmed
    • 3
  • C. N. Haas
    • 1
  1. 1.Drexel UniversityPhiladelphiaUSA
  2. 2.Virginia Polytechnic Institute and State UniversityBlacksburgUSA
  3. 3.CSIRO Land and WaterEcosciences PrecinctBrisbaneAustralia

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