Research – Vehicle Windshield Wiper Fluid as Potential Source of Sporadic Legionnaires’ Disease in Commercial Truck Drivers

CDC

Abstract

Sporadic Legionnaires’ disease is frequently detected in commercial truck drivers. We report 2 sporadic cases of this disease in Barcelona, Spain, that occurred during December 2019 and September 2020. Laboratory findings were consistent with windshield wiper fluid without added screen wash as a possible source of infection for both cases.

Legionnaires’ disease is a severe form of acute pneumonia caused by inhalation of aerosols containing Legionella bacteria. Most Legionella infections are related to contaminated artificial water systems. Systems with warm water (35°C), stagnation, and lack of disinfection and maintenance can lead to proliferation of Legionella spp. . Cooling towers, warm water systems, and whirlpool spas are well-established sources of infection . However, in most sporadic cases, the source of infection remains unknown.

Commercial truck drivers are at increased risk for Legionnaires’ disease. Exposures related to the vehicle are usually considered secondary to outside sources in industrial areas, such as cooling towers, and are seldomley investigated, despite some studies suggesting them as potential sources. Using windshield wiper fluid without added screen wash has been identified as a risk factor for Legionnaires’ disease in commercial drivers in a previous case‒control study. In addition, Legionella spp. can grow in windshield wiper fluid that does not contain screen wash. However, no studies have epidemiologically confirmed the fluid as the source of infection. We report 2 cases of Legionnaires’ disease cases diagnosed by urine antigen testing (UAT) linked to detection of the bacteria in the windshield wiper fluid.

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