MONTGOMERY-There has been significant confusion about the timeliness of Legionella reporting by UAB of the outbreak. In Alabama, reporting of communicable disease often follows multiple tracks, including both clinical and laboratory reports.
Lab test results were forwarded in a timely manner from UAB to ADPH between 
April 11 and May 19. Each identified positive Legionella result was investigated locally. Since Legionella is very prevalent in the environment, the identification of an outbreak from isolated laboratory reports is very difficult as in this instance.
The identification of a cluster of cases associated with an outbreak is more easily done through clinical reporting. It is for this reason that ADPH requires suspected outbreak reporting within 24 hours of identification. However, we recognize that an outbreak cannot be reported by the facility until it is identified. In a hospitalized population with multiple severe underlying health problems, the diagnosis of Legionella is often difficult to make.
UAB focused on protecting patients and reducing the risk of future cases. Based upon the information available at this time, it appears that there have been no further cases after the UAB interventions of May 7-9. We continue to work with UAB, CDC, and the Jefferson County Health Department.
Every outbreak presents an opportunity to improve the surveillance system. We will continue to work with laboratories, hospitals, physicians, and other reporting entities to enhance reporting and our ability to identify outbreaks.
MEDIA RELEASE/State of Alabama Public Health
