The cooling towers from which the people were infected in the latter outbreak had been cleaned during the summer outbreak, raising concerns about how well the bacteria could be controlled.On 28 August 2015, an outbreak of Legionnaires disease was detected at San Quentin State Prison in Northern California; 81 people were sickened and the cause was sludge that had built up in cooling towers.Between June 2015, and January 2016, 87 cases of Legionnaires disease were reported by the Michigan Department of Health and Human Services for the city of Flint, Michigan, and surrounding areas. The outbreak may have been linked to the Flint water crisis, in which the citys water source was changed to a cheaper and inadequately treated source. Ten of those cases were fatal.In November 2017, an outbreak was detected at Hospital de São Francisco Xavier, Lisbon, Portugal, with up to 53 people being diagnosed with the disease and five of them dying from it.In Quincy, Illinois, at the Illinois Veterans Home, a 2015 outbreak of the disease killed 12 people and sickened more than 50 others. It was believed to be caused by infected water supply. Three more cases were identified by November 2017.In the autumn of 2017, 22 cases were reported in a Legionnaires disease outbreak at Disneyland in Anaheim, California. It was believed to have been caused by a cooling tower that releases mist for the comfort of visitors.
It was originally thought that because the mite is a normal inhabitant of the dogs skin, the presence of the mites does not conclusively mean the dog has demodicosis. Recent research, however, found that the demodex mite is rarely found on clinically normal dogs, meaning that the presence of any number of mites in a sample is very likely to be significant. In breeds such as the West Highland White Terrier, relatively minor skin irritation which would otherwise be considered allergy should be carefully scraped because of the predilection of these dogs to demodectic mange. Skin scrapings may be used to follow the progress of treatment in demodectic mange. Alternatively, plasma levels of zinc and copper have been seen to be decreased in dogs with demodicosis. This may be due to inflammation involved in the immune response of demodicosis which can lead to oxidative stress, resulting in dogs with demodicosis to exhibit higher levels of antioxidant productivity. The catalases involved in the antioxidant pathway require the trace minerals zinc and copper. Dogs with demodicosis show a decrease in plasma copper and zinc levels due to the increased demand for antioxidant activity. Therefore, this may be considered as a potential marker for demodicosis. Treatment
Dogs
Localized demodectic mange is considered a common puppyhood ailment, with roughly 90% of cases resolving on their own with no treatment. Minor, localized cases should be left to resolve on their own to prevent masking of the more severe generalized form.