LEGIONELLA - World Health Organization

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Joseph C (2004a). European surveillance of travel-associated Legionnaires’ disease. Eurosurveillance, 9(2). Joseph CA (2004b). Epidemiology of Legionnaires’ disease in Europe 2000–2002. Epidemiology and Infection, 132:417–424. Joseph CA, Lee JV (1996). Outbreak of Legionnaires’ disease associated with the Hotel Imbat, Kusadasi, Turkey. London, Public Health Laboratory Service, 1–49. Joseph C et al. (1996). An international investigation of an outbreak of Legionnaires’ disease among UK and French tourists. European Journal of Epidemiology, 12(3):215–219. Joseph CA et al. (1998). Legionnaires’ disease in residents of England and Wales: 1997. Communicable Disease Public Health, 1(4):252–257. Junge-Mathys E, Mathys W (1994). Die Legionellose — ein Beispiel für umweltbedingte Infektionen. [Legionellosis — an example of environmentally caused infections.] Intensiv, 2:29–34. Karim A, Ahmed S, Rossoff LJ (2002). Legionnaires’ disease associated with acute encephalitis and arrhythmia. Critical Care Medicine, 30(5):1028–1029. Katz SM, Hammond JM (1987). The effect of drying, heat, and pH on the survival of Legionella pneumophila. Ann. Clin. Lab. Sci. 17(93):150–156. Kazandjian D, Chiew R, Gilbert GL (1997). Rapid diagnosis of Legionella pneumophila serogroup 1 infection with the Binax enzyme immunoassay urinary antigen test. Journal of Clinical Microbiology, 35:954–956. Keevil CW (2003). Rapid detection of biofilms and adherent pathogens using scanning confocal laser microscopy and episcopic differential interference contrast microscopy. Water Science and Technology, 47:105–116. Keevil CW et al. (1989). Detection of biofilms associated with pitting corrosion of copper pipework in Scottish hospitals. In: Biodeterioration Society Proceedings: Biocorrosion, Volume 5, Preston Biodeterioration Society, 99–117. Khanna M et al. (2005). The pneumoplex assays, a multiplex PCR-enzyme hybridization assay that allows simultaneous detection of five organisms, Mycoplasma pneumoniae, Chlamydia (Chlamydophila) pneumoniae, Legionella pneumophila, Legionella micdadei, and Bordetella pertussis, and its real-time counterpart. Journal of Clinical Microbiology, 43:565–571. Kilvington S, Price J (1990). Survival of Legionella pneumophila within cysts of Acanthamoeba polyphaga following chlorine exposure. Journal of Applied Bacteriology, 68(5):519–525. Kim BR et al. (2002). Literature review–efficacy of various disinfectants against Legionella in water systems. Water Research, 36:4433–4444. King CH et al. (1988). Survival of coliforms and bacterial pathogens within protozoa during chlorination. Applied and Environmental Microbiology, 54(12):3023–3033. Klismanicacute NZ et al. (1990). An epidemic of legionellosis at a hotel at the Makarska seashore. Lijecnicki Vjesnik, 112(5–6):152–155. LEGIONELLA AND THE PREVENTION OF LEGIONELLOSIS
Ko KS et al. (2003). Molecular evolution of the dotA gene in Legionella pneumophila, Journal of Bacteriology, 185:6269–6277. Koide M et al. (1993). Detection of Legionella spp. in cooling tower water by the polymerase chain reaction method. Applied and Environmental Microbiology, 59:1943–1946. Koide M et al. (1999). Isolation of Legionella longbeachae serogroup 1 from potting soils in Japan. Clinical Infectious Diseases, 29:943–934. Kool JL, Carpenter JC, Fields BS (1999). Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires’ disease. Lancet, 353(9149):272–277. Kool JL et al. (1998). More than 10 years of unrecognized nosocomial transmission of legionnaires’ disease among transplant patients. Infection Control and Hospital Epidemiology, 19:898–904. Kool JLD et al. (1999). Hospital characteristics associated with colonization of water systems by Legionella and risk of nosocomial Legionnaires’ disease: a cohort study of 15 hospitals. Infection Control and Hospital Epidemiology, 20(12):798–805. Kramer MH, Ford TE (1994). Legionellosis: ecological factors of an environmentally “new” disease. Zentralblatt für Hygiene und Umweltmedizin, 195:470–482. Kuchta JM et al. (1983). Susceptibility of Legionella pneumophila to chlorine in tap water. Applied and Environmental Microbiology, 46(5):1134–1139. Kuchta JM et al. (1985). Enhanced chlorine resistance of tap water-adapted Legionella pneumophila as compared with agar medium passaged strains. Applied and Environmental Microbiology, 50(1):21–26. Kusnetsov JM et al. (1996). Growth, respiration and survival of Legionella pneumophila at high temperatures. Journal of Applied Bacteriology, 81:341–347. Kusnetsov JM et al. (1997). Efficacy of three prevention strategies against Legionella in cooling water systems. Journal of Applied Microbiology, 82:763–768. La Scola B et al. (2004). Legionella drancourtii sp. nov., a strictly intracellular amoebal pathogen. International Journal of Systematic and Evolutionary Microbiology, 54(3):699–703. Lai S et al. (2004). An investigation of Legionnaires’ disease associated with the Ocean Monarch cruise liner in 2003 (abstract only), United Kingdom Health Protection Agency Annual Conference, 13–15 September 2004 (http://www.hpaconference.org.uk). Lambert MA, Moss CW (1989). Cellular fatty acid compositions and isoprenoid quinone contents of 23 Legionella species. Journal of Clinical Microbiology, 27:465–473. LeChevallier MW et al. (1988). Inactivation of biofilm bacteria. Applied and Environmental Microbiology, 54:2492–2499. Lee JV, Joseph C (on behalf of the PHLS Atypical Pneumonia Working Group) (2002). Guidelines for investigating single cases of Legionnaires’ disease. Communicable Disease and Public Health, 5:157–162. LEGIONELLA AND THE PREVENTION OF LEGIONELLOSIS
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LEGIONELLA AND THE PREVENTION OF LE
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LEGIONELLA AND THE PREVENTION OF LE
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Foreword Legionellosis is a collect
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Contents Foreword . . . . . . . . .
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Chapter 5 Cooling towers and evapor
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Chapter 9 Disease surveillance and
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Tables Table 1.1 Main characteristi
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Figure 8.1 Visible biofilm on inter
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Acknowledgements The World Health O
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• John Newbold, Health and Safety
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Executive summary Legionellosis is
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• Health-care facilities — Chap
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Chapter 1 Legionellosis Britt Horne
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Legionnaires’ disease is often in
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1.1.2 Pontiac fever Symptoms Pontia
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Table . Extrapulmonary nfect ons ca
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Proteins produced by the body’s i
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Aspiration may occur in patients wi
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Table . R sk factors for Legionella
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In the outbreak of Legionnaires’
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Table . Potent al treatments for d
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1.4.2 Species and serogroups associ
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Other causes of infection In Europe
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The interaction of virulent legione
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1.5.2 Surface structures involved i
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1.5.4 Host defence The host defence
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Chapter 2 Ecology and environmental
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L. pneumophila is thermotolerant an
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2.2.3 Environmental factors and vir
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Figure 2.1 Biofilm formation Biofil
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2.4 Sources of Legionella infection
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Chapter 3 Approaches to risk manage
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Table . Cool ng tower outbreaks Fac
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Even when a source reaches a state
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The WSP should be prepared in conju
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Identify control measures Control m
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F gure . Dec mal reduct on t mes fo
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Method Advantages D sadvantages Dos
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Validate effectiveness of water saf
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• clear statements of responsibil
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Chapter 4 Potable water and in-buil
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The remainder of this chapter provi
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4.3.1 Document and describe the sys
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Construction materials — risk fac
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Where temperature controls (discuss
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4.4.2 Monitor control measures This
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Chapter 5 Cooling towers and evapor
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5.1.1 Cross-flow cooling towers As
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water treatments (including chemica
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5.3 System assessment This section
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Spray drift — risk factors Even w
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The section on control measures for
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• periodic or continuous bleed-of
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Box . Po nts to be noted when clean
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In certain circumstances, samples m
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Table . Example documentat on for m
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Chapter 6 Health-care facilities Ma
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For 1999 and 2000, a total of 384 c
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6.3 System assessment This section
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Table . Type of colon zat on of wat
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6.4.1 Identify control measures Thi
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6.5.1 Prepare management procedures
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Until the situation is under contro
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Chapter 7 Hotels and ships Roisin R
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F gure . Detected and reported case
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Table . Rev ew of outbreaks (more t
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7.2 Water safety plan overview WSPs
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The risk of legionellosis is increa
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Kingdom to 66% in Spain (Starlinger
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Agency, Legionella Section, United
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Given the complexity of distributio
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Chapter 8 Natural spas, hot tubs an
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Spas “Natural spa”, denotes fac
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Rare cases of Legionnaires’ disea
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Process step P pework Water n hot t
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Hosepipes may sometimes be used to
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Hot tubs that are not effectively d
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Nutrients — control measures Bath
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Various additives may also be used
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• descriptions of any significant
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Table . Examples of m crob olog cal
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Chapter 9 Disease surveillance and
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Exposure histories allow cases to b
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F gure . Invest gat ng a s ngle cas
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Box . (cont nued) Since the incepti
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Country United Kingdom All reported
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F gure . Annual reported cases, - 0
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Training opportunities Trainees in
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Box . Example of terms of reference
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ecause doing anything more could un
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9.4 Case studies This section descr
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9.4.4 Concrete batcher process on a
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Chapter 10 Regulatory aspects David
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• validation of the effectiveness
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• operating conditions, such as t
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10.4.6 Outbreak investigation and n
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hot water (e.g. health-care facilit
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General prevent on Country DW Wp SB
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Country General prevent on DW Wp SB
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Chapter 11 Laboratory aspects of Le
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• detection of the bacterium in t
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Method Sens t v ty (%) PCR • Rapi
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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: Ingram JG, Plouffe JF (1994). Dange
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
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