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Hello Lauri, Dr. Janet Stout referred me to you. We are currently experiencing a legionella outbreak in our county and are investigating multiple sources as potential causes for our increase. Since June 2014, we have had 47 cases of Legionella, almost four times the number of cases we had during 2013, and the highest number of cases per county in the state for 2014. We have investigated a hospital as a potential source for the disease, but have expanded our investigation to include the city water supply. Of our 47 cases, 25 cases have occurred within the city water supply distribution system. No common links or associations have been determined between the cases. The majority of our cases are home bound immune-comprised individuals who have not traveled and are not readily mobile. They are also unable to answer our questions when we investigate due to the severity of their conditions once hospitalized. We are in the process of developing a survey to implement for all new incoming cases as well as going back to all our previous cases. Dr. Stout xxxEND_PAGE:dhhs02_b0554_2097_2100_3 002100 mentioned your experience and knowledge with legionella and suggested we seek your input on the survey we have developed. We would really appreciate any feedback, or the opportunity to talk any time you are free. We are working ona tight deadline and we need to have our survey done by Friday. | have attached the survey and | am looking forward to hearing from you soon. Thank You, Shurooq Shuroog Hasan, M.P.H Epidemiologist Genesee County Health Department 630 S. Saginaw Street Flint, MI 48502 (810) 257-3815 [email protected] xxxEND_PAGE:dhhs02_b0554_2097_2100_4