Investigation of atmospheric conditions fostering the spreading of legionnaires' disease in outbreaks related to cooling towers.

Legionnaires' disease (LD) is a severe lung infection caused by the bacteria Legionella pneumophila which is usually associated with water managing installations like cooling towers. Several outbreaks of LD have been linked to individual sources of bioaerosol in the past. However, the transmission pathways as well as the influence of meteorological factors in the spreading of such bioaerosols remain unclear. Using the meteorological data near 12 LD outbreaks in Europe for the period 2000-2016, the correlation between key meteorological factors and the occurrence of LD was assessed. Temperature, humidity, atmospheric pressure, wind speed, precipitation, cloud cover and, for the first time, fog occurrence were included as potential risk factors. It was found that the occurrence of fog was related to four of the LD outbreaks, suggesting that the presence of fog droplets and/or the thermal inversions associated with fog may play a role in the disease spreading. This finding can contribute to outbreak investigations and to the prevention of future outbreaks.