1649. That’s Not Cricket! Outbreak of Legionella pneumophila (L. pneumophila) in a Community Cricket Club in the UK, 2018: Challenges in Legionella Control in This Setting

BACKGROUND: Cricket clubs in the UK are frequently collocated with community venues which host a range of activities, often for vulnerable members of society, such as children and elderly people. In July 2018, two cases of local laboratory-confirmed Legionnaires’ disease were notified to Public Health England (PHE). The cases were found to be players in the same cricket team (via the enhanced Legionnaires’ disease surveillance system) and had multiple shared potential exposures during their incubation periods. METHODS: A three-pronged outbreak investigation was conducted, with epidemiological, microbiological, and environmental components. Case-finding and potential shared exposures were identified through completion and analysis of Legionella enhanced surveillance questionnaires. Following risk assessment, environmental samples were obtained from aerosolizing outlets at identified sites. Additionally, sputum and urine samples were obtained from cases. All samples were sent to the PHE reference laboratory for confirmation of species and sequence typing. RESULTS: All cases were confirmed as L. pneumophila serogroup 1. Only one case provided a sputum sample suitable for sequence typing, which yielded a partial result. This result was consistent with a strain of L. pneumophila found in abundance at numerous water outlets at a local cricket club epidemiologically linked to all cases. On the emergence of these findings, control measures were put in place to prevent further exposure to the pathogen including shot-dosing of the water systems and closure of aerosolizing outlets. However, eradication of the organism proved challenging. CONCLUSION: This is the first known outbreak of L. pneumophila epidemiologically and microbiologically linked to a cricket club in the UK. Control of the outbreak was challenging for two reasons. Firstly, the nature of the setting as a community venue meant that there was a large number of people potentially exposed, many with characteristics putting them at increased risk of Legionnaires’ disease. Secondly, the cricket club was run by a committee of volunteers with limited expertise and financial resource. There was a resultant lack of clarity about who was ultimately responsible for Legionella risk management and the implementation of control measures. DISCLOSURES: All authors: No reported disclosures.