From Crisis to Control: Managing a High-Acuity Legionella Outbreak

Session Description: In early 2025, Central Harlem experienced a Legionella outbreak that coincided with a surge in emergency department (ED) visits and high inpatient occupancy. As the primary acute-care hospital in the outbreak zone, our facility faced a dual challenge, managing a high volume of acutely ill patients while rapidly executing an emergency water management and infection prevention strategy.
Central to our success was robust surveillance to detect cases early, confirm them rapidly, and immediately inform hospital leadership and local health departments. This enabled swift, data-driven decision-making and timely activation of control measures.
This session will provide a detailed, case-based walkthrough of our outbreak response, emphasizing operational agility under surge conditions. We will explore the integration of environmental controls, patient care adjustments, and multidisciplinary coordination with public health agencies, engineering, and laboratory services.
Attendees will learn how our team balanced clinical demands with regulatory compliance, implemented rapid water restrictions and remediation, maintained continuity of care for a vulnerable urban population, and sustained heightened post-outbreak surveillance to prevent recurrence. The lessons shared will equip infection preventionists with adaptable, real-world strategies for outbreak detection, notification, and control in resource-stretched environments.

Kinta Alexander

Director of Infection Prevention, New York City Health and Hospitals/Harlem

Dr. Kinta Alexander, DrPH, MS, MPH, CIC, FNYAM, is Director of Infection Prevention and Control at NYC Health + Hospitals | Harlem and CEO of MICRO Consulting Corporation. With over 18 years in infection prevention, she has led innovative initiatives, including the development of a system-wide protocol to combat multidrug-resistant Candida auris (recently reclassified as Candidozyma auris) while at Mount Sinai Brooklyn, later recognized by the New York State Department of Health as a best practice. An accomplished presenter and author, Dr. Alexander has shared her expertise at ICPIC in Geneva and APIC’s national conference, with publications covering CRE, C. difficile, measles, CAUTI, neonatal Pseudomonas, and hand hygiene compliance. She serves as a manuscript reviewer for AJIC and ICHE, co-chairs the Infection Prevention Council for NYC Health + Hospitals, and leads the mentorship program as a Board Director for the APIC Greater New York Chapter. Her honors include the 2019 United Hospital Fund Excellence in Health Care Award and induction as a Fellow of the New York Academy of Medicine in 2024.

Sean Brown

Associate Director, Infection Prevention, NYC + Health & Hospitals | Harlem

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Trent MacAllister

Infection Preventionist, Washington State Department of Health

Trent MacAllister, MPH, MS, CIC, is an Infection Preventionist at the Washington State Department of Health within the Healthcare-Associated Infections and Antimicrobial Resistance Section. In this role, Trent conducts Infection Control and Response (ICAR) consultations with healthcare facilities throughout the state. He has also provided outbreak investigation and response support to acute care, long-term care, ambulatory care, residential treatment, and behavioral health facilities. Trent worked as an infection preventionist in an acute care hospital before transitioning to his current role in public health. Trent is the Association for Professionals in Infection Control and Epidemiology (APIC) 2026 Annual Conference Committee (ACC) Chair. In his free time, Trent enjoys mountain biking, hiking, hanging out with his dogs at the lake, and traveling the world with his wife.