One outbreak in a Michigan state prison earlier this year affected 17 people, killing one. Investigating that case and several others in civilian communities, health officials concluded that cooling towers were the source of the contamination. Cooling towers had been previously identified as possible transmission routes but this is the first time they were identified with actual outbreaks of Legionnaire's disease. The CDC is now developing guidelines for the prevention of Legionnaire's disease, including improved maintenance of cooling towers. Many prisons, especially those in rural areas, are supplied by water cooling towers.
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