Pontiac fever outbreak associated with a cooling tower.

In late April 1984, an outbreak of Pontiac fever was investigated in an office building in lower Manhattan (New York City). The outbreak was characterized by a high attack rate (78 per cent overall); the predominant symptoms were myalgias, chills, fatigue, fever, and headache. There was a clustering of cases in an office that was air cooled by a dedicated cooling tower separate from the remainder of the building. A high concentration of live L. Pneumophila cells in the cooling tower was quantified. Airborne spread via settle plates placed along the air intake system and within the office was demonstrated. Legionella pneumophila serogroup 1 antigen was found in the urine of two cases, and identical monoclonal antibody reactivity patterns of isolates from all sources was observed. Difficulty was experienced in eliminating the organism from the tower.