Press Room

ASTHO Statement on Public Notification of Legionella Outbreaks

ARLINGTON, VA (Nov. 8, 2018)—The Association of State and Territorial Health Officials (ASTHO) issued the following statement today regarding the role of public health officials in notifying the public about complex infectious disease outbreaks, particularly as states continue to deal with Legionella outbreaks.

“As leaders of state and territorial public health agencies charged with promoting and protecting the health of our jurisdictions, we are keenly aware that decisions on whether and when to notify the public of infectious disease outbreaks are complex. There is no national standard concerning the timing of public notification to prevent the spread of Legionella. Health officials must instead rely on the facts of the specific outbreak situation, assess the risks and benefits of notification, and consider other factors to determine the appropriate course of action to reduce harm, protect health, and save lives.

The most urgent priorities in managing Legionella outbreaks are identifying those who have been potentially exposed and mitigating the environmental sources of infection. Both priorities require health authorities to provide immediate guidance to the facility where the outbreak is occurring. Public notification is, therefore, often not an urgent priority, particularly when there is no ongoing risk to the public and health agencies are actively working with facilities on how to (1) identify and notify anyone potentially exposed and at risk for illness and (2) implement potential remedial measures. The decision to issue public notification also involves carefully considering the potential ramifications of acting on preliminary or incomplete information, which could lead to unnecessary and burdensome protective actions being taken and result in erosion of trust in the public health authority.

Decisions regarding public notification of Legionella outbreaks should be thoughtfully made by qualified, experienced public health professionals and should be informed by a solid understanding of the epidemiology of the disease and the particular characteristics of each individual outbreak setting. We strongly assert that public health officials should not be subjected to civil penalties or criminal charges for decisions made in good faith using available information and informed by sound public health science and practice.”


ASTHO is the national nonprofit organization representing the public health agencies of the United States, the U.S. territories and freely associated states, and the District of Columbia, as well as the more than 100,000 public health professionals these agencies employ. ASTHO members, the chief health officials of these jurisdictions, are dedicated to formulating and influencing sound public health policy and to ensuring excellence in public health practice.