Association of Natural Waterways and Legionella pneumophila Infection in Eastern Wisconsin: A Case-Control Study

• Published in: Journal of patient-centered research and reviews Vol. 9; no. 2; pp. 128 - 131
• Main Authors: William, Hannah M, Heslin, Kayla, Kram, Jessica J F, Toberna, Caroline P, Baumgardner, Dennis J
• Format: Journal Article
• Language: English
• Published: United States Aurora Health Care, Inc 01.01.2022; Advocate Aurora Health
• Subjects: bacteria; Brief Report; environment; fresh water; legionella; legionnaire’s disease; pneumonia; waterways; waterways; environment; bacteria; pneumonia; Legionnaire’s disease; Legionella; fresh water
• ISSN: 2330-0698; 2330-068X; 2330-0698
• DOI: 10.17294/2330-0698.1872

Preliminary research has suggested possible associations between natural waterways and infection, and we previously explored these associations in eastern Wisconsin using positive serogroup 1 urine antigen tests (LUAT) as diagnostic. This case-control study was a secondary analysis of home address data from patients who underwent LUAT at a single eastern Wisconsin health system from 2013 to 2017. Only zip codes within the health system's catchment area that registered ≥3 positive cases and ≥50 completed tests, as well as geographically adjacent zip codes with ≥2 positive cases and ≥50 tests, were included. A 1:3 ratio of cases to randomly selected controls was used. Home addresses were geocoded and mapped using ArcGIS software (Esri); nearest waterway and distance to home was identified. Distance to nearest waterway according to ArcGIS was verified/corrected using Google Maps incognito. Distances were analyzed using chi-squared and 2-sample -tests. Overall, mean distance to nearest waterway did not differ between cases (2958 ± 2049 ft) and controls (2856 ± 2018 ft; P=0.701). However, in a subset of nonurban zip codes, cases were closer to nearest waterway than controls (1165 ± 905 ft vs 2113 ± 1710 ft; P=0.019). No association was found between cases and type of waterway. Further research is needed to investigate associations and differences between natural and built environmental water sources in relation to legionellosis.