{"id":10222,"date":"2025-03-01T14:03:11","date_gmt":"2025-03-01T19:03:11","guid":{"rendered":"https:\/\/dhss.delaware.gov\/dph\/dhan256\/"},"modified":"2025-03-02T00:50:29","modified_gmt":"2025-03-02T05:50:29","slug":"dhan256","status":"publish","type":"page","link":"https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan256\/","title":{"rendered":"php\/alerts\/dhan256 ~  Division of Public Health &#8212; Health Alert  &#8211; Delaware Health and Social Services &#8211; State of Delaware"},"content":{"rendered":"<div data-swiftype-index=\"true\">\n\n\n\n  <br>\n\n\n\n  <div class=\"container\" id=\"main_header\"> \n\n    <!-- BEGIN readspeaker div -->\n\n    <div class=\"rs_skip rsbtn rs_preserve\" id=\"readspeaker_button1\">\n\n      <a accesskey=\"L\" class=\"rsbtn_play\" href=\"https:\/\/app-na.readspeaker.com\/cgi-bin\/rsent?customerid=7262&#038;lang=en_us&#038;readid=main_content&#038;url=https:\/\/dhss.delaware.gov\/dph\/php\/alerts\/dhan256.html\" title=\"Listen to this page using ReadSpeaker\">\n\n        <span class=\"rsbtn_left rsimg rspart\"><span class=\"rsbtn_text\"><span>Listen<\/span><\/span><\/span>\n\n        <span class=\"rsbtn_right rsimg rsplay rspart\"><\/span>\n\n      <\/a>\n\n    <\/div>\n\n    <!-- END readspeaker div -->\n\n\n\n    \n\n    <header class=\"pull-left\">\n\n      <h1>Delaware Health Alert Network #<!--[type=EDIT name=\"DHAN Number\"]-->256 <!--[END]--> <\/h1>\n\n      <h2> <!--[type=EDIT name=\"DHAN Date\"]-->September 22, 2011 9:14am <!--[END]--> <\/h2>\n\n    <\/header>\n\n  <\/div><br>\n\n \n\n  <div class=\"container\">\n\n    <div class=\"row\">\n\n      <div class=\"col-md-3\" id=\"leftCol\">\n\n        <div class=\"panel-group\" id=\"accordion\">\n\n          <div class=\"panel sectionmenu_panel\">\n\n            <div class=\"panel-heading\">\n\n              <p class=\"panel-title\"><a class=\"agency_nav\" data-parent=\"#accordion\" data-toggle=\"collapse\" href=\"#collapseOne\"><strong><i class=\"fa fa-align-justify fa-fw\"><\/i> Public Health Menu<\/strong><\/a><\/p>\n\n            <\/div>\n\n\n\n            <div class=\"panel-collapse collapse in\" id=\"collapseOne\">\n\n              <div class=\"panel-body\" id=\"clf_nav\">\n\n                  <ul class=\"nav nav-stacked nav-pills-clf\" id=\"agency_sidebar\">\n    <li><a href=\"\/dph\/\"><h2>Home <i class=\"fa fa-home fa-fw\"><\/i><\/h2><\/a><\/li>\n    <li class=\"toplevel\"><a data-parent=\"#agency_sidebar\" data-toggle=\"collapse\" href=\"#HomeMenu\"><h2>About <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"HomeMenu\">\n        <li><a href=\"\/dph\/about.html\">About DPH<\/a><\/li>\n        <li><a href=\"\/dph\/sections.html\">Sections &#038; Programs<\/a><\/li>\n        <li><a href=\"\/dph\/ofclocations.html\">Office Locations<\/a><\/li>\n        <li><a href=\"\/dph\/contact.html\">Contact Info<\/a><\/li>\n      \n        <li><a href=\"\/calendars.html\" target=\"_blank\">Calendar<\/a><\/li>\n      <\/ul>\n    <\/li>\n    <li class=\"toplevel\"><a data-parent=\"#sidebar\" data-toggle=\"collapse\" href=\"#ServicesMenu\"><h2>Services <i class=\"fa fa-caret-right fa-fw\"><\/i><\/h2><\/a>\n      <ul class=\"panel-collapse collapse\" id=\"ServicesMenu\">\n        <li><a href=\"\/dph\/servicesaz.html\">A-Z Services<\/a><\/li>\n        <li><a href=\"\/dph\/hsp\/environmental.html\">Air &#038; Water Quality<\/a><\/li>\n        <li><a href=\"\/dph\/ss\/vitalstats.html\">Birth, Death, &#038; Marriage Records<\/a><\/li>\n        <li><a href=\"\/dph\/clinics.html\">Clinics<\/a><\/li>\n        <li><a href=\"\/dph\/healthdatastats.html\">Health Data &#038; Statistics<\/a><\/li>\n        <li><a href=\"\/dph\/php\/emsps.html\">Emergency Preparedness<\/a><\/li>\n        <li><a href=\"\/dph\/healthandwellness.html\">Health &#038; 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So far during 2011, 11 cases have been\n\n\n  confirmed. Six of these cases (2 from New Castle County, 1 from Kent County, 3 from Sussex County) have reported onsets of illness\n\n\n  between August 19 and September 14, 2011. No common sources of exposure have been identified&#8212;one possible common denominator is heavy\n\n\n  rainfall and flooding. All cases have been hospitalized with varying spectrum of illness. No associated deaths have been reported.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Reporting\n\n\n<\/h3>\n\n\n<p>\n\n\n  Legionellosis is a reportable disease in Delaware, therefore laboratories and healthcare providers are required to report any diagnosed\n\n\n  case to DPH, Bureau of Epidemiology (1-888-295-5156 or 1-302-744-4541). All cases of LD are investigated to include date of onset, method\n\n\n  of diagnosis, underlying medical conditions, smoking history, occupation, travel history, recent medical or dental visits (to rule-out\n\n\n  hospital-acquired infection), and any known water exposures.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Background\n\n\n<\/h3>\n\n\n<p>\n\n\n  LD is a common cause of severe pneumonia requiring hospitalization. As estimated 8,000 \u2013 18,000 cases occur in the United States\n\n\n  each year. While outbreaks of Legionellosis have been linked to sources such as hot tub displays and air conditioning cooling towers, the\n\n\n  majority (80-90%) of cases is sporadic and no specific water source is identified.\n\n\n<\/p>\n\n\n<p>\n\n\n  During 2003, the Mid-Atlantic region experienced a sharp rise in LD coinciding with a period of record-breaking rainfall. [1]\u00a0 DPH\n\n\n  confirmed 32 sporadic cases during this time period. No evidence of a common source or outbreak was identified in Delaware. Wet weather\n\n\n  and humidity were associated with the increase. [2]\n\n\n<\/p>\n\n\n<h3>\n\n\n  Disease\n\n\n<\/h3>\n\n\n<p>\n\n\n  Legionellosis is associated with two clinically and epidemiologically distinct illnesses: Legionnaires\u2019 disease, which is\n\n\n  characterized by fever, myalgia, cough, and clinical or radiographic pneumonia; and Pontiac fever, a milder illness without pneumonia.\n\n\n<\/p>\n\n\n<p>\n\n\n  Legionellosis is a respiratory disease caused by the bacterium <em>Legionella<\/em>. <em>Legionella<\/em> are widely distributed in the\n\n\n  environment, particularly in warm, stagnant bodies of water. Human infection appears to occur through inhalation of bacteria when\n\n\n  contaminated water or soil is aerosolized; person-to-person transmission has never been documented. Legionellosis occurs year-round, but\n\n\n  is more commonly reported in summer months. The incubation period is 2-10 days and the clinical spectrum of disease is quite varied, from\n\n\n  asymptomatic infection to mild, self-limited illness, to severe pneumonia and death. Anyone can develop Legionellosis, but those at most\n\n\n  risk are the middle-aged and elderly, smokers, those with chronic lung disease or those who are immune-compromised.\n\n\n<\/p>\n\n\n<h3>\n\n\n  Diagnosis\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>Urinary antigen assay <em>and<\/em>culture of respiratory secretions on selective media are the preferred diagnostic tests for\n\n\n  Legionnaires\u2019s disease\n\n\n  <\/li>\n\n\n  <li>Sensitivity and specificity of diagnostic tests\n\n\n  <\/li>\n\n\n<\/ul>\n\n\n<table class=\"table table-condensed table-hover\">\n\n\n  <tbody>\n\n\n    <tr>\n\n\n      <th scope=\"col\">\n\n\n        Test\n\n\n      <\/th>\n\n\n      <th scope=\"col\">\n\n\n        Sensitivity (%)\n\n\n      <\/th>\n\n\n      <th scope=\"col\">\n\n\n        Specificity (%)\n\n\n      <\/th>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td>\n\n\n        Culture\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        80\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        100\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td>\n\n\n        Urine antigen\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        70\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        100\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td>\n\n\n        Paired serology*\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        70-80\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        >90\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td>\n\n\n        Direct fluorescent antibody stain\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        25-75%\n\n\n      <\/td>\n\n\n      <td class=\"text-center\">\n\n\n        95\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n    <tr>\n\n\n      <td colspan=\"3\">\n\n\n        <p>\n\n\n          * Note: A single antibody titer of any level is not diagnostic of legionellosis.\n\n\n        <\/p>\n\n\n      <\/td>\n\n\n    <\/tr>\n\n\n  <\/tbody>\n\n\n<\/table><br>\n\n\n<h3>\n\n\n  Additional Information\n\n\n<\/h3>\n\n\n<ul>\n\n\n  <li>DPH, Bureau of Epidemiology: 1-888-295-5156 or 1-302-744-4541\n\n\n  <\/li>\n\n\n  <li>Centers for Disease Control and Prevention: <a href=\"http:\/\/www.cdc.gov\/legionella\/index.htm\">http:\/\/www.cdc.gov\/legionella\/index.htm<\/a>\n\n\n    <ul>\n\n\n      <li>Top 10 Things Every Clinician Needs to Know About Legionellosis <a href=\"http:\/\/www.cdc.gov\/legionella\/top10.htm\">http:\/\/www.cdc.gov\/legionella\/top10.htm<\/a>\n\n\n      <\/li>\n\n\n    <\/ul>\n\n\n  <\/li>\n\n\n<\/ul><br>\n\n\n<br>\n\n\n<p>\n\n\n  [1] Epidemiology and Infection (2007); Increased Rainfall is Associated with Increased Risk for Legionellosis, 135:811-817.\n\n\n<\/p>\n\n\n<p>\n\n\n  [2] Journal of Infectious Disease (2005); It\u2019s Not the Heat, It\u2019s the Humidity: Wet Weather Increases Legionellosis Risk in\n\n\n  the Greater Philadelphia Metropolitan Area, 192:2066-2073.\n\n\n<\/p>\n\n\n<p>\n\n\n  *************************\n\n\n<\/p>\n\n\n<p>\n\n\n  You are receiving this message because you are a registered member of the Delaware Health Alert Network. If you are not a member and\n\n\n  would like to subscribe, please register at <a href=\"https:\/\/healthalertde.org\">https:\/\/healthalertde.org<\/a>\n\n\n<\/p><!--[END]-->\n\n  \n\n        <div class=\"panel panel-danger\">\n\n          <div class=\"panel-heading\">    \n\n      <h2>Categories of Health Alert messages:<\/h2>\n\n       <\/div>\n\n       <div class=\"panel-body\">\n\n      <ul>\n\n        <li><strong>Health Alert:<\/strong> Conveys the highest level of importance; warrants immediate action or attention.<\/li>\n\n        <li><strong>Health Advisory:<\/strong> Provides important information for a specific incident or situation; may not require immediate action.<\/li>\n\n        <li><strong>Health Update:<\/strong> Provides updated information regarding an incident or situation; unlikely to require immediate action.<\/li>\n\n            <\/ul>\n\n         <div><strong>NOTE: This page is for informational purposes only and dated material (e.g. temporary websites) may not be available.<\/strong><\/div>\n\n          <\/div> \n\n        <\/div><br>  \n\n\n\n      <\/div>\n\n    <\/div>\n\n  <\/div><!-- \/container -->\n\n  <\/div>","protected":false},"excerpt":{"rendered":"<p>Listen Delaware Health Alert Network #256 September 22, 2011 9:14am Public Health Menu Home About About DPH Sections &#038; Programs Office Locations Contact Info Calendar Services A-Z Services Air &#038; Water Quality Birth, Death, &#038; Marriage Records Clinics Health Data &#038; Statistics Emergency Preparedness Health &#038; Wellness Healthy Homes Healthy Workplaces Laboratory Restaurant Inspections Screening [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":0,"parent":9294,"menu_order":0,"comment_status":"closed","ping_status":"closed","template":"","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"class_list":["post-10222","page","type-page","status-publish","hentry"],"acf":[],"_links":{"self":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10222","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages"}],"about":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/types\/page"}],"author":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/comments?post=10222"}],"version-history":[{"count":1,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10222\/revisions"}],"predecessor-version":[{"id":11398,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/10222\/revisions\/11398"}],"up":[{"embeddable":true,"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/pages\/9294"}],"wp:attachment":[{"href":"https:\/\/dhss.delaware.gov\/dph\/wp-json\/wp\/v2\/media?parent=10222"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}