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PHO Rounds: Legionella Outbreak Investigations: A Practical Approach, Part III

Legionella is a bacteria that resides in the environment, usually contracted by inhalation of contaminated aerosolized water from human-made water systems. Exposure can result in Pontiac fever, a self-limited flu-like illness or Legionnaires’ disease, a severe form of pneumonia. This three-part series provides a practical overview of public health investigations of legionellosis, including assessment of the epidemiology, potential environmental sources, appropriate clinical and environmental testing, and environmental control and remediation.

Part 1 (May 9) described key components and strategies in a legionellosis investigation including the epidemiology of cases, clinical testing and environmental risk factors and assessment.

Part 2 (May 16) reviewed environmental sampling, interpretation of results and remediation measures to mitigate Legionella growth in water systems.

Part 3 (June 8) will describe a cooling tower-associated outbreak investigated by Simcoe Muskoka District Health Unit, lessons learned and approaches used to communicate with the public.

Intended audience: Public Health Unit (PHU) staff in case and outbreak management, environmental health, Associate Medical Officers of Health (AMOHs), Medical Officers of Health (MOHs)

By the end of this session, participants will be able to:

  • Describe how to do an environmental risk assessment of a cooling tower including the evaluation of bacteria control maintenance programs.
  • Discuss the value and interpretation of various environmental testing protocols when investigating Legionella outbreaks.
  • Describe potential interventions and communication strategies during a community Legionella outbreak.

Présentateur(s): Dr. Colin Q-T Lee and Karen Kivilahti

Dr. Colin Q-T Lee MD, MSc, CCFP(EM), FRCPC, is an Associate Medical Officer of Health at the Simcoe Muskoka District Health Unit. He provides medical consultation to the Infectious Disease, Immunization and Sexual Health programs.

Karen Kivilahti, HBPE, BASc, CIPH(C), is a Program Manager at the Simcoe Muskoka District Health Unit. She oversees the Safe Water Program, specializing in drinking water safety and Small Drinking Water Systems.

Avis de non-responsabilité

The opinions expressed by speakers and moderators do not necessarily reflect the official policies or views of Public Health Ontario, nor does the mention of trade names, commercial practices, or organizations imply endorsement by Public Health Ontario.


Public Health Ontario Grand Rounds are a self-approved group learning activity (Section 1) as defined by the Maintenance of Certification Program of the Royal College of Physicians and Surgeons of Canada (RCPSC). In order to receive written documentation for Continuing Medical Education (CME) credits, please check “Yes” beside the question “Do you require CME credits?” on the registration form.

College of Family Physicians of Canada (CFPC) Affiliate Members may count RCPSC credits toward their Mainpro+ credit requirements. All other CFPC members may claim up to 50 Certified credits per cycle for participation in RCPSC MOC Section 1 accredited activities.

PHO Grand Rounds are also approved by the Council of Professional Experience for professional development hours (PDHs) for members of the Canadian Institute of Public Health Inspectors (CIPHI).

For more information or for a record of registration for other Continuing Education purposes, please contact events@oahpp.ca


Public Health Ontario is committed to complying with the Accessibility for Ontarians with Disabilities Act (AODA). If you require accommodations to participate in this event, please contact 647-260-7100 or events@oahpp.ca.

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Mis à jour le 22 juin 2023