Transmission of Legionnaires' Disease Through Toilet Flushing

Jeanne Couturier; Christophe Ginevra; Didier Nesa; Marine Adam; Cyril Gouot; Ghislaine Descours; Christine Campèse; Giorgia Battipaglia; Eolia Brissot; Laetitia Beraud; Anne-Gaëlle Ranc; Sophie Jarraud; Frédéric Barbut


Emerging Infectious Diseases. 2020;26(7):1526-1528. 

In This Article


We describe 2 cases in which LD was probably caused by L. pneumophila transmitted through contaminated toilet water that became aerosolized during flushing. We reached this conclusion because we found little to no detectable difference between whole genomes in isolates obtained from 2 patients hospitalized 5 months apart in the same room and those from the toilet in that room. The other commonly suspected sources, in this case the shower and the sink, tested negative for L. pneumophila.

This investigation suggests that transmission of L. pneumophila through toilet flushing should be considered when investigating a LD case. However, as previously suggested, there remains a need for a laboratory-based study to explore whether flushing toilets can generate and spread contaminated aerosols.[8,9]