LEGIONELLA - World Health Organization

More documents

Recommendations

Info

Table 0. Selected European regulat ons developed for the control of Legionella n water systems General prevent on Preventon Bas s for after Country DW Wp SB CT AC WP regulat on outbreak Comments Austria x x • Health Yes Aspects of • Bathing drinking-water hygiene covered by decree of Ministry of Health Special decree for prevention in spa pools and water systems of swimming baths Some provinces: regulations by public health authorities Belgium x x x x x x • Environment Yes? Different risk (Flanders) • Public health • Labour safety • Biosafety levels covered Bulgaria x x x x • Public health Yes Croatia x x x • Public health Yes Guidelines — Law on communicable diseases England x x x x x x • Health and ? Primary legis- and safety at lation, approved Wales work code of practice • Health and guidance • Management of safety at work Other legislation: reporting of injuries, diseases; water supply (water fittings); notification of cooling towers 0 LEGIONELLA AND THE PREVENTION OF LEGIONELLOSIS
General prevent on Country DW Wp SB CT AC WP Bas s for regulat on Finland x x x • Health protection • Housing health • Building code • Communicable diseases France x x x • Public health (parti ally) • Drinking-water • Environment Germany x x x x x x • Public health • Drinking-water • EWGLI LEGIONELLA AND THE PREVENTION OF LEGIONELLOSIS Preventon after outbreak Comments Hungary Yes There are plans to develop regulations on general prevention of legionellosis Ireland • Labour safety No Guidelines exist Special attention given to potential risks of dentist systems and high risk in hospitals Italy x x x x x x • Public health Yes Guidelines for the prevention and control of legionellosis Latvia x x x x x x • Labour safety • Public health Yes Yes Yes Yes
Page 1 and 2:
LEGIONELLA AND THE PREVENTION OF LE
Page 3 and 4:
LEGIONELLA AND THE PREVENTION OF LE
Page 5 and 6:
Foreword Legionellosis is a collect
Page 7 and 8:
Contents Foreword . . . . . . . . .
Page 9 and 10:
Chapter 5 Cooling towers and evapor
Page 11 and 12:
Chapter 9 Disease surveillance and
Page 13 and 14:
Tables Table 1.1 Main characteristi
Page 15 and 16:
Figure 8.1 Visible biofilm on inter
Page 17 and 18:
Acknowledgements The World Health O
Page 19 and 20:
• John Newbold, Health and Safety
Page 21 and 22:
Executive summary Legionellosis is
Page 23 and 24:
• Health-care facilities — Chap
Page 25 and 26:
Chapter 1 Legionellosis Britt Horne
Page 27 and 28:
Legionnaires’ disease is often in
Page 29 and 30:
1.1.2 Pontiac fever Symptoms Pontia
Page 31 and 32:
Table . Extrapulmonary nfect ons ca
Page 33 and 34:
Proteins produced by the body’s i
Page 35 and 36:
Aspiration may occur in patients wi
Page 37 and 38:
Table . R sk factors for Legionella
Page 39 and 40:
In the outbreak of Legionnaires’
Page 41 and 42:
Table . Potent al treatments for d
Page 43 and 44:
1.4.2 Species and serogroups associ
Page 45 and 46:
Other causes of infection In Europe
Page 47 and 48:
The interaction of virulent legione
Page 49 and 50:
1.5.2 Surface structures involved i
Page 51 and 52:
1.5.4 Host defence The host defence
Page 53 and 54:
Chapter 2 Ecology and environmental
Page 55 and 56:
L. pneumophila is thermotolerant an
Page 57 and 58:
2.2.3 Environmental factors and vir
Page 59 and 60:
Figure 2.1 Biofilm formation Biofil
Page 61 and 62:
2.4 Sources of Legionella infection
Page 63 and 64:
Chapter 3 Approaches to risk manage
Page 65 and 66:
Table . Cool ng tower outbreaks Fac
Page 67 and 68:
Even when a source reaches a state
Page 69 and 70:
The WSP should be prepared in conju
Page 71 and 72:
Identify control measures Control m
Page 73 and 74:
F gure . Dec mal reduct on t mes fo
Page 75 and 76:
Method Advantages D sadvantages Dos
Page 77 and 78:
Validate effectiveness of water saf
Page 79 and 80:
• clear statements of responsibil
Page 81 and 82:
Chapter 4 Potable water and in-buil
Page 83 and 84:
The remainder of this chapter provi
Page 85 and 86:
4.3.1 Document and describe the sys
Page 87 and 88:
Construction materials — risk fac
Page 89 and 90:
Where temperature controls (discuss
Page 91 and 92:
4.4.2 Monitor control measures This
Page 93 and 94:
Chapter 5 Cooling towers and evapor
Page 95 and 96:
5.1.1 Cross-flow cooling towers As
Page 97 and 98:
water treatments (including chemica
Page 99 and 100:
5.3 System assessment This section
Page 101 and 102:
Spray drift — risk factors Even w
Page 103 and 104:
The section on control measures for
Page 105 and 106:
• periodic or continuous bleed-of
Page 107 and 108:
Box . Po nts to be noted when clean
Page 109 and 110:
In certain circumstances, samples m
Page 111 and 112:
Table . Example documentat on for m
Page 113 and 114:
Chapter 6 Health-care facilities Ma
Page 115 and 116:
For 1999 and 2000, a total of 384 c
Page 117 and 118:
6.3 System assessment This section
Page 119 and 120:
Table . Type of colon zat on of wat
Page 121 and 122:
6.4.1 Identify control measures Thi
Page 123 and 124:
6.5.1 Prepare management procedures
Page 125 and 126:
Until the situation is under contro
Page 127 and 128:
Chapter 7 Hotels and ships Roisin R
Page 129 and 130:
F gure . Detected and reported case
Page 131 and 132:
Table . Rev ew of outbreaks (more t
Page 133 and 134:
7.2 Water safety plan overview WSPs
Page 135 and 136:
The risk of legionellosis is increa
Page 137 and 138:
Kingdom to 66% in Spain (Starlinger
Page 139 and 140:
Agency, Legionella Section, United
Page 141 and 142:
Given the complexity of distributio
Page 143 and 144: Chapter 8 Natural spas, hot tubs an
Page 145 and 146: Spas “Natural spa”, denotes fac
Page 147 and 148: Rare cases of Legionnaires’ disea
Page 149 and 150: Process step P pework Water n hot t
Page 151 and 152: Hosepipes may sometimes be used to
Page 153 and 154: Hot tubs that are not effectively d
Page 155 and 156: Nutrients — control measures Bath
Page 157 and 158: Various additives may also be used
Page 159 and 160: • descriptions of any significant
Page 161 and 162: Table . Examples of m crob olog cal
Page 163 and 164: Chapter 9 Disease surveillance and
Page 165 and 166: Exposure histories allow cases to b
Page 167 and 168: F gure . Invest gat ng a s ngle cas
Page 169 and 170: Box . (cont nued) Since the incepti
Page 171 and 172: Country United Kingdom All reported
Page 173 and 174: F gure . Annual reported cases, - 0
Page 175 and 176: Training opportunities Trainees in
Page 177 and 178: Box . Example of terms of reference
Page 179 and 180: ecause doing anything more could un
Page 181 and 182: 9.4 Case studies This section descr
Page 183 and 184: 9.4.4 Concrete batcher process on a
Page 185 and 186: Chapter 10 Regulatory aspects David
Page 187 and 188: • validation of the effectiveness
Page 189 and 190: • operating conditions, such as t
Page 191 and 192: 10.4.6 Outbreak investigation and n
Page 193: hot water (e.g. health-care facilit
Page 197 and 198: Country General prevent on DW Wp SB
Page 199 and 200: Chapter 11 Laboratory aspects of Le
Page 201 and 202: • detection of the bacterium in t
Page 203 and 204: Method Sens t v ty (%) PCR • Rapi
Page 205 and 206: 11.2.2 Detecting Legionella antigen
Page 207 and 208: DFA has been used successfully with
Page 209 and 210: • Serologic testing can be used f
Page 211 and 212: Although not all strains can be rel
Page 213 and 214: Generally, any water source that ma
Page 215 and 216: During outbreak investigations, swa
Page 217 and 218: • other Legionella species that d
Page 219 and 220: Appendix 1 Example of a water syste
Page 221 and 222: Weekly water system check list Week
Page 223 and 224: Appendix 2 Example of a 2-week foll
Page 225 and 226: Travel Work/travel in the UK: ❑ Y
Page 227 and 228: Checklist of local places Health/sp
Page 229 and 230: Appendix 3 Example of a national su
Page 231 and 232: Strictly Confidential 2 Hospital Ac
Page 233 and 234: Glossary aerobic bacteria Bacteria
Page 235 and 236: health-care acquired Legionellosis
Page 237 and 238: surveillance The process of systema
Page 239 and 240: References Abu KY, Eisenstein BI, E
Page 241 and 242: Barbaree JM et al. (1987). Protocol
Page 243 and 244: Blatt SP et al. (1994). Legionnaire
Page 245 and 246:
Byrne B, Swanson MS (1998). Express
Page 247 and 248:
Crespi S (1993). Legionella y legio
Page 249 and 250:
Edelstein PH (1982b). Comparative s
Page 251 and 252:
Falguera M et al. (2001). Nonsevere
Page 253 and 254:
Gaia V et al. (2003). Sequence-base
Page 255 and 256:
Hayden RT et al. (2001). Direct det
Page 257 and 258:
Ingram JG, Plouffe JF (1994). Dange
Page 259 and 260:
Ko KS et al. (2003). Molecular evol
Page 261 and 262:
Loret JF et al. (2003). Comparison
Page 263 and 264:
McEvoy M et al. (2000). A cluster o
Page 265 and 266:
Olaechea PM et al. (1996). A predic
Page 267 and 268:
Regan CM et al. (2003). Outbreak of
Page 269 and 270:
Schulze-Robbecke R, Rodder M, Exner
Page 271 and 272:
Surman SB, Morton LHG, Keevil CW (1
Page 273 and 274:
Tully M, Williams A, Fitzgeorge RB
Page 275 and 276:
Welti M et al. (2003). Development
show all

LEGIONELLA - World Health Organization

You also want an ePaper? Increase the reach of your titles

Delete template?

Save as template?