Two infants delivered via water birth in Arizona were diagnosed with Legionnaires' disease in early 2016. The two cases are detailed in the CDC's most recent Morbidity and Mortality Weekly Report.
Here are six things to know.
1. Legionnaires' — a virulent form of pneumonia caused by Legionella bacteria — is contracted through the inhalation of small droplets of contaminated water.
2. The first infant was born on Jan. 6, 2016, in Maricopa County. A midwife delivered the newborn at home in a tub filled with tap water.
3. The next day, the baby experienced respiratory distress and was rushed to the hospital, where clinicians detected fluid in the child's lungs. Lab tests later confirmed Legionnaires'.
4. The second infant was born on April 5, 2016. A different midwife delivered the newborn at home in a rented Jacuzzi hot tub, instead of a disposable birthing tub.
5. Three days after birth, the child developed a 101-degree fever. After the fever reoccurred on the second day, the baby was taken to the emergency room where its fever increased to 102.6 degrees. An X-ray of the child's chest revealed opacities in the lungs, and Legionnaires' was later confirmed.
6. "Investigation of these two cases identified numerous gaps in infection prevention for water births, including use of a jetted Jacuzzi rather than a disposable birthing tub, and allowing the water to remain for a week at 98 degrees … which is within the optimum range for Legionella growth," wrote the CDC researchers in the report. "Although the tub for delivery in the first case was filled immediately before the birth, tap water is not sterile, and Legionella can grow and spread in man-made water systems, such as plumbing systems. Because both tubs were emptied immediately after the births, no environmental sampling was performed."
To read the full report, click here.
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