INFECTIOUS DISEASES
Expanding Access to Legionella Testing with the Legionella Reference Center
By Valérie Reeb , PhD , assistant research scientist , State Hygienic Laboratory at the University of Iowa , and Elizabeth Toure , MPH , senior specialist , Infectious Diseases
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Specimens , samples and isolates were tested during the Legionella Reference Center ’ s first year .
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Public health laboratories have enrolled to date .
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Legionnaires ’ disease public heatlh investigations have been supported .
Legionella anisa isolated by the LRC at the State Hygienic Laboratory fluoresce blue-white under UV light . Photo : Valérie Reeb .
When Oklahoma State Department of Health Communicable Disease Epidemiologist Carolyn McCrea , MS , started working on Oklahoma ’ s first Legionnaires ’ disease ( LD ) investigation in several years , the aptly nicknamed “ water queen ” got right to work identifying possible sources of exposure to the potentially deadly bacteria . After a tight cluster of LD cases was reported with a history of staying at the same hotel , McCrea and her colleagues consulted with US Centers for Disease Control and Prevention ( CDC ) epidemiologists to develop a plan to conduct an environmental assessment at the hotel in April 2024 .
Environmental samples would need to be collected and tested to confirm their suspicions ; however , the Oklahoma State Public Health Laboratory does not conduct Legionella testing , and sending samples to a commercial laboratory would be cost-prohibitive and potentially limit the scope of the sampling . Luckily , McCrea was able to submit a request for environmental testing assistance with the
Legionella Reference Center ( LRC ). McCrea and the team collected water and swab samples from the hotel and coordinated with the Oklahoma State Public Health Laboratory to package and ship the samples to the LRC . The LRC quickly turned around the results , ultimately confirming the epidemiologists ’ suspicions and allowing further public health actions to be taken to remediate the issue .
The Legionella Reference Center
APHL and CDC launched the Legionella Reference Center in fall 2023 at the State Hygienic Laboratory at the University of Iowa to improve access to high quality Legionella testing for governmental public health and environmental laboratories . The LRC provides culture and molecular testing for Legionella from clinical specimens , environmental samples and Legionella isolates submitted by laboratories . Next-generation sequencing capability will soon be available to aid with further strain characterization , providing valuable supporting evidence that , when combined with traditional epidemiologic investigation , aids in linkage of clinical cases to environmental sources .
LRC tests both clinical and environmental samples and isolates . Requests for environmental sample testing in support
State Hygenic Laboratory Environmental Laboratory Specialist Carrie Lueck filters water samples received by the LRC to prepare the samples for culture . Photo : Valérie Reeb .
24 LAB MATTERS Spring 2025
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