Responding to a Crisis in Infection Prevention: Legionella

Loreen Herwaldt
Dr. Herwaldt is a professor of Internal Medicine at the University of Iowa Carver College of Medicine and a Professor of Epidemiology in the University of Iowa College of Public Health. She served as the hospital epidemiologist at the University of Iowa Hospitals and Clinics for > 20 years. She currently does infectious diseases consults and continues to do research on healthcare-associated infections. She has investigated clusters of infections and she has studied the epidemiology of several organisms that cause healthcare-associated infections, including staphylococci and Legionella. Her recent work has addressed risk factors for and prevention of surgical site infections (SSI) and healthcare workers’ risk of self-contamination while removing personal protective equipment. She currently is the principal investigator (PI) for the University of Iowa’s CDC Prevention Epicenter grant and she is the project PI for 2 of the 7 projects and the PI on another grant from CDC. She is also partnering with Vickie Miene, who directs the Institute for Public Health Practice, Research and Policy, to do tabletop exercises on Candida auris and carbapenem-resistant Acinetobacter baumannii. During 1999-2000, she took developmental leave to study narratives of illness and interview authors to learn about their experiences of getting healthcare for illnesses, injuries, and disabilities. In 2008, the University of Iowa Press published her book Patient Listening: A Doctor’s Guide, which grew out of the interviews she conducted with the authors.  In 2012, she received the Society for Healthcare Epidemiology of America’s mentor scholar award and in 2016, she received the University of Iowa Graduate College’s Outstanding Faculty Postdoctoral Mentor Award.


  1. Describe steps in determining if an infection caused by Legionella pneumophilia was healthcare or community acquired.
  2. Identify three different Legionella amelioration systems that have been used in hospitals and other healthcare settings.
  3. List three possible reservoirs for Legionella in a healthcare setting.