Rolling epidemic of Legionnaires’ disease outbreaks in small geographic areas

Figures & data

Fig. 1 Location of Legionnaires’ disease outbreaks in Bronx, New York City, from 1 March 2015 to 21 September 2015.

Outbreak locations are represented by circle (Melrouse houses), square (Morris Park) and triangle (South Bronx) shapes. Grey areas represent the streets within the Bronx district. Outbreak data in the Bronx, NYC was retrieved from the New York City Department of Health and Mental Hygiene and from the Centres for Disease Control and Prevention (CDC) website. Base map data was taken from NYC Department of city planning¹⁷. Coordinates of outbreak locations retrieved by searching names of locations on Google maps. Maps were created using ArcMap 10.2

Fig. 2 Timeline of Legionnaires’ disease outbreaks in Bronx, New York City, from 1 March 2015 to 21 September 2015.

Red circles indicate the date of report of individual cases in Melrose houses. Lines indicate dates of outbreak durations at South Bronx (blue) and Morris Park (green). Outbreak data in the Bronx, NYC was retrieved from the New York City Department of Health and Mental Hygiene and from the Centres for Disease Control and Prevention (CDC) website. Plot was created using R (version 3.1.3)

Fig. 3 Number of Legionnaires’ disease cases over time in South Bronx, Morris Park and Melrose Houses in New York from 1 March 2015 to 21 September 2015.

The first panel a shows the number of Legionnaire’s disease (LD) cases in the South Bronx, the top right panel b shows Morris Park and the bottom right c shows number of cases in Melrose Houses. Outbreak data in the Bronx, NYC was retrieved from the New York City Department of Health and Mental Hygiene and from the Centres for Disease Control and Prevention (CDC) website. Graph was created in Microsoft Excel

Fig. 4 Source and size of outbreaks in New York 2000-2012. coloured bars indicate the number of outbreaks in New York state over time.

Bars are coloured according to water source: Cooling tower (red), device (blue), mist/steam (green), potable water (purple), spa (yellow) and unknown (grey). Plot was created using R (version 3.1.3)

Fig. 5 Location of Legionnaries’ disease outbreaks in Sydney, Australia from 27 February 2016 to 29 April 2016.

Outbreak locations are represented by circle (CBD district), square (Dee Why), triangle (Inner West) and cross (Kogarah) shapes. Grey areas represent the administrative districts within the Sydney region. Data source of outbreak data: NSW Health²⁶. Base map data was taken from the Australian Standard Geographical Classification (ASGC) Digital Boundaries, Australia¹⁴. Coordinates of outbreak locations retrieved by searching names of locations on Google maps. Maps were created using ArcMap 10.2

Fig. 6 Timeline of Legionnaires’ disease outbreaks in Sydney, Australia, from 27 February 2016 to 29 April 2016.

Solid lines indicate dates of outbreak durations in central business district (CBD) locations (red), Kogorah (purple), Dee Why (green) and Inner West (teal) locations. Data source of outbreak data: NSW Health 26. Plot was created using R (version 3.1.3)

Fig. 7 Number of Legionnaires’ disease cases in the central business district of Sydney.

Blue bars represent cases in the first outbreak and red bars represent cases during the second outbreak. Data source of outbreak data: NSW Health²⁶. Graph was created in Microsoft Excel

Fig. 8 Number of notifications of Legionnaires’ disease in NSW, January 2007–September 2016.

Data source: Australia’s notifiable diseases status: Annual report of the National Notifiable Diseases Surveillance System³³. Graph was created in Microsoft Excel

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