Materiały źródłowe

• #1 Legionnaires’ disease – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/legionnaires-disease/symptoms-causes/syc-20351747

  Outbreaks of Legionnaires’ disease can be prevented by monitoring and cleaning water systems.

• #1 About Legionnaires’ Disease | Legionella | CDC

  https://www.cdc.gov/legionella/about/index.html

  To prevent Legionnaires’ disease, reduce the risk of Legionella growth and spread. […] Building owners and managers can use a water management program to help control Legionella. […] There are steps people can take to help protect themselves from waterborne germs in their home. […] To prevent growth and spread of Legionella, only use genuine windshield cleaner fluid and follow the vehicle manufacturer recommendations, if available.

• #1 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Overview | Occupational Safety and Health Administration

  https://www.osha.gov/legionnaires-disease

  Managing Legionella and preventing worker exposures and Legionellosis cases depend on implementing an effective water management program. These programs focus on describing water systems and their components, identifying areas where Legionella could grow, deciding where control measures are needed and how to monitor them, planning response actions when control measures fail, and monitoring and documenting water management activities. […] Guidance on preventing Legionella growth in manmade water systems through proper facility maintenance. Prevention focuses on design considerations, operations, proper maintenance schedules, and other controls to prevent Legionella growth in systems including, but not limited to, cooling towers, and HVAC systems.

• #1 Legionnaires’ disease

  https://www.ecdc.europa.eu/en/legionnaires-disease

  Leaflet for managers of tourist accommodation on how to reduce the risk of Legionnaires’ disease […] The main protective measure is to reduce risk of Legionella growth in places that produce aerosol droplets that can be breathed in. […] Regular checks for the presence of Legionella bacteria and appropriate control measures can help prevent cases of Legionnaires disease in places where people who may be at higher risk of the disease might be more likely to be exposed. These include tourist accommodation sites, hospitals and long-term healthcare facilities. Effective control measures against legionella bacteria include: Ensuring regular maintenance, cleaning, and disinfection of water systems, including plumbing systems, cooling towers, hot tubs, and decorative fountains. Maintaining cold-water systems below 20C, and hot-water systems above 50C to prevent bacterial growth. Ensuring proper water flow and circulation in water systems to minimize the risk of stagnant water. Disinfecting hot water systems with high levels of (50mg/l) chlorine for 24 hours after work on the system and water heaters, and before the beginning of every warm season. Regularly cleaning and disinfecting water filters, cooling towers and associated pipes used in air conditioning systems.

• #1 Legionnaires’ disease – what you must do – HSE

  https://www.hse.gov.uk/legionnaires/what-you-must-do/preventing-controlling-risk.htm

  You should first consider whether you can prevent the risk of legionella by looking at the type of water system you need. For example, identify whether it is possible to replace a wet cooling tower with a dry air-cooled system. […] The key point is to design, maintain and operate your water services under conditions that prevent or adequately control the growth and multiplication of legionella. […] It is important to maintain the cleanliness of your water system. The mechanisms and frequency for doing this will depend on the system you have and whether cleaning or disinfecting is being done routinely or because of a problem identified during monitoring. […] The frequency and method of routine cleaning and disinfecting should be identified within your risk assessment. This will take account of factors such as:

• #1 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Control Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/legionnaires-disease/control-prevention

  Non-chemical water treatment techniques such as ultraviolet light or ultrasonic waves have also shown the ability to kill Legionella bacteria under certain conditions. […] When Legionella hazards cannot be controlled with engineering and administrative controls and safe work practices, personal protective equipment (PPE) may also be needed to prevent worker exposures and infections. […] As a best practice, employers should provide appropriate PPE and encourage its use when workers perform any routine maintenance, cleaning, disinfection activities on water systems that may be contaminated with Legionella. […] In the event of a known (i.e., identified) or suspected Legionellosis outbreak, workers who may be exposed to aerosolized Legionella must wear respirators. […] One way to control Legionella growth in domestic hot water systems is to raise the water heater temperature to at least 70°C (158°F) for 24 hours and then flush each outlet for 20 minutes.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Prevention-of-Legionnaires-disease.aspx

  Prevention of Legionnaires disease involves regular cleaning and maintenance of water works. Some of the preventive measures are outlined here (1-5): […] Since the bacteria survives in warm contaminated water, the temperature of water in the system should be below 20C (68F) or above 60C (140F). […] There should be no stagnation of water as legionella thrives in water that is stagnant for long. […] Those who are at risk like smokers, elderly those with AIDS, cancers, chronic lung or kidney disease or diabetes need to avoid public water systems that could be contaminated like whirlpool spas, hot tubs etc. in hotels, resorts and cruise ships. […] Water cooling systems have several aspects that are regulated by legionella infection prevention guidelines. […] There needs to be regular inspections for microbial growth, leaks, algae, blockages or stagnations and splashing.

• #1 Legionnaires’ disease prevention | Health and wellbeing | Queensland Government

  https://www.qld.gov.au/health/conditions/all/prevention/legionnaires-prevention

  You can reduce the risks of legionella infection Legionnaires’ disease by taking some simple steps when installing and maintaining water pipes, plumbing fittings and some water filled appliances/fixtures such as hot water systems (including solar), rainwater tanks, bores, pools, spas and air conditioners. […] The following precautions will help reduce the risk: […] Hot water tanks are required by Queensland law to store water at 60C or more to reduce the risk of Legionella multiplying in the hot water system and plumbing. […] Each week flush all hot and mixed showers and taps that have not been used with hot water at full flow for at least 15 seconds. Flushing will help eliminate stagnant water and minimise the multiplication of bacteria that may be present. […] Maintain your hot water systems. Use a registered plumber and refer to manufacturers instructions or check the manufacturers website for information.

• #1 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Control Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/legionnaires-disease/control-prevention

  Water management programs that effectively prevent Legionella growth in water systems rely on control and prevention measures, including good system design, proper facility and equipment maintenance, and routine cleaning and disinfection. […] Preventing exposure to Legionella in the workplace starts with awareness about water systems in which the bacteria could grow, and continues with water system maintenance to prevent growth and checking for unexpected growth in case preventative measures fail. […] Specifically, effective maintenance and visual inspections should prevent scale buildup, sediment, and gradual water organism accumulation on structural surfaces (i.e., biofouling)—processes that support Legionella growth. […] Periodic biocide treatment in water systems is another way to prevent or reduce Legionella growth.

• #1 Prevention of Legionnaires’ Disease in the 21st Century by Advancing Science and Public Health Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5652436/

  In June 2017, the Centers for Medicaid and Medicare Services issued a requirement to reduce risk for infection with Legionella spp. in healthcare facilities. […] The increase has been widely recognized as likely to continue unabated in the absence of more effective prevention strategies. […] Supported by the Alfred P. Sloan Foundation, the first public health conference on Legionella spp. in 25 years identified gaping holes in our knowledge of prevention of infections with Legionella spp. and indicated the need for robust federally sponsored research. […] Collaboration is needed across scientific disciplines and agencies to fill gaps in our collective knowledge of modern water pathogens, weaknesses in our physical water infrastructure, and inadequacies of our existing diagnostic and regulatory approaches to effectively identify and control disease risks.

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Prevention-of-Legionnaires-disease.aspx

  Cooling towers should be operated and maintained with regular inspections at least monthly with applicable water treatment, regular microbiological monitoring and six monthly cleaning routines. […] Air conditioning systems similarly need to be efficient in designing, commissioning, operating, maintaining and cleaning. […] When not in use, evaporative coolers should be kept dry. […] Similar maintenance and cleaning routines are essential for hot and cold water systems, humidifiers, evaporative condensers, spas, misting machines, fountains, spray systems, fire extinguishers etc. […] Tap water used in these instruments can bring in the infections. Thus only sterile water should be used for these instruments. […] Weekly disinfection is important. […] These prevent contamination of water systems. […] Exposure to the disease may be prevented by reducing exposure to soil and mud while gardening. […] They need to wash hands after handling soil especially before eating or drinking.

• #1 Travel Advice: How to Avoid Legionnaires’ Disease on Holiday

  https://legionellacontrol.com/legionella/travel-advice-how-to-avoid-legionnaires-disease-on-holiday/

  Most people have heard of Legionnaires disease, but few would give it any thought in everyday life. […] When you consider that some milder cases may go unreported because those involved think they have flu rather than anything else, the numbers could be even higher. […] However, it makes sense to be aware of the symptoms of Legionnaires disease and to recognise where the risks may be higher. […] It is important to keep the following in mind no matter where you go on holiday. […] There are some simple steps you can take that can reduce the risks associated with exposure. […] For example, if you’re staying in a room or property with a shower, run the shower hot for a few minutes before using it; it’s best to minimise any spray, open any windows and leave the room while the shower is on.

• #1 Minimising the risk of a Legionella infection at home

  https://www.healthywa.wa.gov.au/Articles/J_M/Minimising-the-risk-of-a-Legionella-infection-at-home

  Portable evaporative units should be completely drained and cleaned at least once during hot weather, and left dry when not in use. […] Domestic plumbing systems must be installed and maintained correctly to ensure the risk of Legionella growth is minimised and to reduce the risk of scalding. […] Regularly flush hot/warm water pipe lines (for example showers, taps) to prevent water stagnating. […] Regularly clean shower heads. […] Consult a plumber if you have any concerns. […] Regular draining, cleaning and disinfection is recommended. […] Nebuliser bowls should be rinsed after each use, and the entire chamber and mask washed daily in warm water and dishwashing liquid. […] Humidifiers should be emptied, cleaned in warm water and dishwashing liquid and rinsed each day. […] Only distilled water or water that has been boiled and allowed to cool should be used in humidification devices. […] Regularly clean and disinfect your spa as per manufacturers recommendations to control the growth of Legionella bacteria.

• #1 Minimising the risk of a Legionella infection at home

  https://www.healthywa.wa.gov.au/Articles/J_M/Minimising-the-risk-of-a-Legionella-infection-at-home

  There are a few simple things you can do around the home to avoid or prevent conditions that allow Legionella to grow to high levels. […] They can be harmful to your health if you do not take some simple precautions. […] Always wear gloves. […] Wear a face mask to help avoid inhaling aerosols. […] Open bagged material with care to avoid inhaling airborne particles in the mix. […] Keep the mix damp while in use. […] Wash your hands thoroughly after use. […] Store potting mix in a cool place, out of the sun. […] Some simple steps should be followed to maintain your evaporative air conditioner. […] Disinfect the unit with a biocide (a substance that can control the growth of harmful organisms) such as chlorine-based household bleach. […] With all evaporative coolers always make sure the water supply is clean and fresh.

• #1 Preventing Legionnaires disease | Bassetlaw District Council

  https://www.bassetlaw.gov.uk/council-housing/repairs-home-improvements/preventing-legionnaires-disease/

  The risk of contracting the disease is low but it is good practice to take the following precautions: […] Flush through showers and taps for 10 minutes following a period of non-use, for example, after you have been on holiday or if a room is not in regular use. […] Keep all shower heads and taps clean and free from a build up of limescale, mould or algae growth. Regular bleaching and disinfecting every three months will help sterilise and kill any bacteria. […] As part of your landlord’s annual service and maintenance checks to your heating and hot water system, engineers will check the hot water setting and flow rate to ensure there is a reduced risk of Legionella bacteria forming. These settings are selected for your safety. We strongly advise that you do not change them.

• #1 Legionnaires’ disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/legionnaires-disease

  Spa pools require careful maintenance, disinfection and frequent cleaning because they provide ideal conditions for the growth of Legionella, which can be carried into the lungs by aerosols (tiny air particles) created by the spa pool jets. […] The correct use of spa pool water chemicals, good management of the disinfection, filtration and recirculation systems and regular cleaning of spa pool surfaces can keep spa pool water in a clean, safe and healthy condition. […] Fountains can create aerosols by splashing water, and are a particular risk if the water is warm or heated intermittently by submerged lighting. Regular draining, cleaning and disinfection is recommended. […] Nebulisers need regular cleaning in accordance with manufacturer instructions. […] Cases of Legionnaires’ disease have been linked to the use of potting mix. To minimise the risk of contracting Legionnaires disease from soil, compost or potting mix, take the following precautions: Wear a mask and gloves when handling soil, compost or potting mix.

• #1 Legionnaires’ disease prevention | Health and wellbeing | Queensland Government

  https://www.qld.gov.au/health/conditions/all/prevention/legionnaires-prevention

  Rainwater tanks need to be well designed and carefully cleaned and maintained to reduce the risk of Legionella. […] There have been no reported cases of Legionnaires disease caused by these appliances (built-in or portable), but there are some steps you can take to reduce risks: […] Domestic pools represent a low risk because they do not generate aerosols however Legionella can multiply in the jets, pipes and pumps of home pools and spas if biofilm (slimy growths of bacteria, protozoa, algae and fungi) is allowed to form. […] Reduce your exposure to potting mix dust by: […] After flooding, plumbing fittings may require cleaning to remove any matter that may lead to biofilm formation and allow Legionella to multiply. […] If in doubt, contact a licensed plumber or your local council.

• #1 Primary Prevention of Legionella Infections – MN Dept. of Health

  https://www.health.mn.gov/diseases/legionellosis/prevention.html

  Those at increased risk for developing Legionnaires disease include: […] According to CDC, implementing good maintenance strategies for water systems in buildings at increased risk is the best strategy for preventing Legionella infections.

• #1 5 Essential Strategies for Effective Legionnaires’ Prevention in Your Facility – Prevent Legionnaires

  https://preventlegionnaires.org/5-strategies-for-legionnaires-prevention/

  Legionella bacteria thrive in temperatures between 77°F and 113°F (25°C and 45°C). Therefore, maintaining appropriate temperature control is crucial for Legionnaires’ prevention. Hot water should be kept at a minimum of 140°F (60°C), while cold water should be maintained at or below 68°F (20°C). […] Regular risk assessments are essential for identifying and addressing potential sources of Legionella in your facility. A comprehensive risk assessment should include evaluating all water systems, identifying areas prone to stagnation, and assessing the effectiveness of current preventive measures. […] Training and awareness programs are vital for Legionnaires’ prevention. Educate facility staff about the risks associated with Legionella and the importance of maintaining water systems. […] By implementing these essential strategies, you can effectively manage and reduce the risk of Legionella outbreaks in your facility. Proactive maintenance, effective treatment, temperature control, regular assessments, and staff training are key components of a comprehensive Legionnaires’ prevention plan.

• #1 Legionella prevention in the workplace | ontario.ca

  http://www.ontario.ca/page/legionella-prevention-workplace

  Employers must take every precaution reasonable in the circumstances for the protection of workers. This includes protecting workers from infectious hazards, such as Legionella. […] As a best practice, employers should ensure that appropriate maintenance programs are in place to prevent workplace health hazards arising from Legionella bacteria. This includes maintaining water systems and ventilation systems in buildings to protect workers from the hazard of exposure to Legionella bacteria. […] To control hazards posed to workers when they are engaged in Legionella prevention employers must: ensure workers who participate in any sort of preventive maintenance and control program for equipment that may harbour Legionella bacteria (along with other potential risks) are provided with information, instruction and supervision to protect the health and safety of the worker.

• #1 Legionnaires’ disease | healthdirect

  https://www.healthdirect.gov.au/legionnaires-disease

  Legionnaires’ disease is a type of lung infection (pneumonia) caused by legionella. […] You can catch Legionnaires disease by breathing in water droplets or dust contaminated with legionella bacteria; it cannot be spread from person to person. […] It is important that you contact your doctor as soon as possible if you think that you have been exposed to legionella. […] You can reduce your chance of catching Legionnaires disease by managing environments where Legionella bacteria usually grow. […] You can prevent legionella pneumophila by making sure there are regular inspections, disinfection and maintenance of cooling towers and plumbing systems. […] You can prevent contamination with legionella longbeachae that may be in soil and potting mix by: following manufacturers warnings on potting mix labels, wetting the potting mix to reduce dust, wearing gloves and a mask, washing your hands after handling potting mix or soil. […] Quit smoking to help reduce your risk, as smoking increases the risk of infection for people exposed to airborne legionella bacteria. […] There is no vaccine available against Legionnaires disease.

• #1 Erythromycin prophylaxis for Legionnaire’s disease in immunosuppressed patients in a contaminated hospital environment – PubMed

  https://pubmed.ncbi.nlm.nih.gov/3942015/

  Between January 1 and June 30, 1983, immunosuppressive drugs were administered in 20 renal transplant recipients undergoing 23 rejection episodes and in 3 patients with renal failure secondary to systemic disease. […] In an attempt to decrease this high rate, a program of erythromycin prophylaxis was instituted for every new patient who received immunosuppressive chemotherapy until eradication of the organism from the water supply could be realized. […] We conclude that erythromycin effectively protects immunocompromised patients in an environment contaminated with L pneumophila.

• #1 Legionnaires’ Disease: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/legionnaires-disease-pro

  If doctors are suspicious of chest infections acquired abroad then erythromycin or doxycycline are preferable to amoxicillin. […] Legionella spp. are ubiquitous in water supplies and the role of hospital water supplies in the spread of nosocomial infection is unclear. Regular maintenance and testing of water systems, even in the absence of known infection, are generally recommended, especially in places like transplant units where patients are very vulnerable. […] Good surveillance also aids prevention. Detection of outbreaks and detection of clusters are important and secondary preventative measures can then be undertaken. A high level of awareness on the part of medical staff increases the chances of detection of individual or related cases.

• #1 Prevention of Legionnaires’ Disease in the 21st Century by Advancing Science and Public Health Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5652436/

  A dramatic shift in emphasis by public health officials from detection, investigation, and control of outbreaks of Legionnaires disease to primary prevention strategies is underway in the United States. […] Expansion of primary prevention efforts is occurring with remarkable speed and is marked by new public health guidance and policy aimed at ensuring adequacy of water systems management. […] The American Society of Heating, Refrigerating and Air-Conditioning Engineers approved an industry standard in 2015 and established minimum management requirements to reduce the risk for infection with Legionella spp., the bacteria that cause Legionnaires disease, in building water systems. […] In 2015, the American Industrial Hygiene Society also released specific guidance on control of Legionella spp. in engineered water systems and focused on validation of water management efforts and testing water for viable Legionella spp. counts as the key tool to validate effectiveness of these efforts.

• #1 Legionnaires’ Disease – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/legionnaires-disease.page

  There is no vaccine or medicine that can prevent Legionnaires disease. The best way to prevent it is through the proper maintenance of water systems where Legionella may grow. […] In NYC, building owners are required to register cooling towers. They also need to routinely test the water for the presence of Legionella. […] The Health Department investigates clusters of Legionnaires disease cases to find the source of the contamination in order to prevent other people from getting sick. When two or more confirmed cases of Legionnaires disease within a 12-month period are associated with the same building with a shared hot water system, the Health Department will conduct a building evaluation.

• #1 Prevention of Legionnaires’ Disease in the 21st Century by Advancing Science and Public Health Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5652436/

  With a growing national interest in a safe water supply, it is an opportune time for public health and medicine to come together with industrial hygiene, engineering, microbiology, and environmental protection to understand the problems and ensure effective risk management of Legionella spp. and other pathogens inhabiting our water systems.

• #2 Prevention of Legionnaires’ Disease in the 21st Century by Advancing Science and Public Health Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5652436/

  A dramatic shift in emphasis by public health officials from detection, investigation, and control of outbreaks of Legionnaires disease to primary prevention strategies is underway in the United States. […] Expansion of primary prevention efforts is occurring with remarkable speed and is marked by new public health guidance and policy aimed at ensuring adequacy of water systems management. […] The American Society of Heating, Refrigerating and Air-Conditioning Engineers approved an industry standard in 2015 and established minimum management requirements to reduce the risk for infection with Legionella spp., the bacteria that cause Legionnaires disease, in building water systems. […] In 2015, the American Industrial Hygiene Society also released specific guidance on control of Legionella spp. in engineered water systems and focused on validation of water management efforts and testing water for viable Legionella spp. counts as the key tool to validate effectiveness of these efforts.

• #2 How to Prevent Legionnaires Disease : Everything You Need to Know for Testing and Developing a Water Management Plan

  https://www.airpf.com/legionellosis-legionnaires-disease-prevention/

  Managing and maintaining your water supply properly is the most effective method in preventing Legionnaires disease in the home as well as other buildings. Regular inspection, cleaning, and disinfection of water systems help prevent Legionella bacteria from growing and multiplying. […] Preventing Legionella bacteria from growing and spreading through effective water management programs is the only way to avoid contracting the disease. […] The best bet for helping to prevent Legionnaires disease in your building is to learn about and follow ASHRAEs Standard 188. […] Most Legionella outbreaks occur in buildings that have large water systems such as hot tubs, cold/hot water tanks and heaters, large plumbing systems, cooling towers, and decorative water systems. […] 9 out of 10 Legionnaires disease outbreaks were caused by problems that were preventable with more effective water management systems.

• #2 Legionnaires’ disease – what you must do – HSE

  https://www.hse.gov.uk/legionnaires/what-you-must-do/preventing-controlling-risk.htm

  If you identify a risk that you are unable to prevent, you must introduce a course of action. This is called a written control scheme and it will help you manage the risk from legionella and implement effective control measures, by describing: […] You should: […] ensure that the release of water spray is properly controlled […] avoid water temperatures and conditions that favour the growth of legionella and other micro-organisms […] ensure water cannot stagnate anywhere in the system by keeping pipe lengths as short as possible or removing redundant pipework […] avoid materials that encourage the growth of legionella […] keep the system and the water in it clean […] treat water to either control the growth of legionella (and other microorganisms) or limit their ability to grow […] monitor any control measures applied […] keep records of these and other actions taken, such as maintenance or repair work.

• #2 Managing legionella in hot and cold water systems – HSE

  https://www.hse.gov.uk/healthservices/legionella.htm

  Legionnaires’ disease is a potentially fatal type of pneumonia, contracted by inhaling airborne water droplets containing viable legionella bacteria. […] If you run a care home or healthcare premises, it is likely that you will have residents or patients that are at higher risk of contracting the disease. […] Health and social care providers should carry out a full COSHH risk assessment of their hot and cold water systems, to: […] Where temperature is used to control the risk, hot water should be stored above 60C, hot water distribution should be above 50C and cold water storage and distribution should be below 20C. […] The primary method used to control the risk from legionella is water temperature control. […] A competent person should routinely check, inspect and clean the system, in accordance with the risk assessment.

• #2 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Control Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/legionnaires-disease/control-prevention

  Water management programs that effectively prevent Legionella growth in water systems rely on control and prevention measures, including good system design, proper facility and equipment maintenance, and routine cleaning and disinfection. […] Preventing exposure to Legionella in the workplace starts with awareness about water systems in which the bacteria could grow, and continues with water system maintenance to prevent growth and checking for unexpected growth in case preventative measures fail. […] Specifically, effective maintenance and visual inspections should prevent scale buildup, sediment, and gradual water organism accumulation on structural surfaces (i.e., biofouling)—processes that support Legionella growth. […] Periodic biocide treatment in water systems is another way to prevent or reduce Legionella growth.

• #2 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Control Prevention | Occupational Safety and Health Administration

  http://www.osha.gov/legionnaires-disease/control-prevention

  Another standard Legionella growth control method is to periodically chlorinate the system at the tank. […] Hyperchlorination can eradicate Legionella in cold water lines with significant contamination using the following procedure: Add chlorine to the cold water system, maintaining free residual chlorine levels between 20 to 50 ppm.

• #2 Legionnaire’s Disease Prevention I L8 Risk Management

  https://l8risk.co.uk/legionnaires-disease-prevention/

  Ensure water systems are used regularly to prevent water from becoming stagnant, which can promote bacterial growth. […] Conduct regular testing for Legionella bacteria, especially in high-risk environments like hospitals, nursing homes, and hotels. […] Identify potential sources of Legionella in your water system and assess the risk of contamination. […] Facilities such as hospitals, nursing homes, and hotels have a higher risk of Legionnaires disease outbreaks due to their complex water systems and vulnerable populations. These facilities should develop and implement comprehensive water management plans. […] Legionnaires disease prevention methods are proactive processes that require diligent maintenance, monitoring, and management of water systems. By implementing these prevention methods, building managers and facility operators can significantly reduce the risk of Legionella contamination and safeguard public health.

• #2 Minimising the risk of a Legionella infection at home

  https://www.healthywa.wa.gov.au/Articles/J_M/Minimising-the-risk-of-a-Legionella-infection-at-home

  Portable evaporative units should be completely drained and cleaned at least once during hot weather, and left dry when not in use. […] Domestic plumbing systems must be installed and maintained correctly to ensure the risk of Legionella growth is minimised and to reduce the risk of scalding. […] Regularly flush hot/warm water pipe lines (for example showers, taps) to prevent water stagnating. […] Regularly clean shower heads. […] Consult a plumber if you have any concerns. […] Regular draining, cleaning and disinfection is recommended. […] Nebuliser bowls should be rinsed after each use, and the entire chamber and mask washed daily in warm water and dishwashing liquid. […] Humidifiers should be emptied, cleaned in warm water and dishwashing liquid and rinsed each day. […] Only distilled water or water that has been boiled and allowed to cool should be used in humidification devices. […] Regularly clean and disinfect your spa as per manufacturers recommendations to control the growth of Legionella bacteria.

• #2 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Prevention-of-Legionnaires-disease.aspx

  Prevention of Legionnaires disease involves regular cleaning and maintenance of water works. Some of the preventive measures are outlined here (1-5): […] Since the bacteria survives in warm contaminated water, the temperature of water in the system should be below 20C (68F) or above 60C (140F). […] There should be no stagnation of water as legionella thrives in water that is stagnant for long. […] Those who are at risk like smokers, elderly those with AIDS, cancers, chronic lung or kidney disease or diabetes need to avoid public water systems that could be contaminated like whirlpool spas, hot tubs etc. in hotels, resorts and cruise ships. […] Water cooling systems have several aspects that are regulated by legionella infection prevention guidelines. […] There needs to be regular inspections for microbial growth, leaks, algae, blockages or stagnations and splashing.

• #2 How to Prevent Legionnaires Disease : Everything You Need to Know for Testing and Developing a Water Management Plan

  https://www.airpf.com/legionellosis-legionnaires-disease-prevention/

  The American Society of Heating, Refrigerating and Air-Conditioning Engineers (ASHRAE) formed a team in 2005 to devise a standard for managing risk associated with building water systems. […] Standard 188 is voluntary unless it is adopted by a government entity. […] Establish a water management program team to develop and implement a water management program according to the standard. […] Monitor what is happening outside of your building. […] Keep cold water cold and hot water hot. […] Monitor disinfectant levels. […] The CDC encourages healthcare facility leaders to use CDCs toolkit as a guide for developing their water management plan to work with healthcare providers to identify Legionnaires disease cases early. […] The risk of Legionnaires disease outbreaks at healthcare facilities is so high that the Centers for Medicare Medicaid Services issued a memo in June of 2017 requiring certified healthcare facilities to have a water management program to reduce the growth and spread of Legionella.

• #2 Preventing Legionnaires’ Disease

  https://cmmonline.com/articles/preventing-legionnaires-disease

  Protecting personnel and facilities from unseen bacteria and fungi is a daunting task for building managers as well as professional cleaning teams. […] Most commonly, bacteria-ridden organisms can live and be spread through a facility’s HVAC system, making commercial buildings at higher risk for the spread of diseases like Legionnaires’ disease. […] It is imperative that a facility manager, who is responsible for the operation of a building’s HVAC system, is educated about this danger. In 2015, the American Society of Heating, Refrigerating, and Air-Conditioning Engineers (ASHRAE) developed a new standard, ASHRAE 188, designed to prevent the growth and spread of Legionella. Here are five steps facilities can take to mitigate Legionella risks: […] 1. Recognize the most common places to find the bacterium. Two of the most common locations where Legionnaires’ disease-causing bacterium can be found are in cooling towers and large central air conditioning systems.

• #2 Public Health Efforts Keep Legionnaires’ Disease Risk Low | Article | The United States Army

  https://www.army.mil/article/283656/public_health_efforts_keep_legionnaires_disease_risk_low

  The CDC reports that since the 1976 outbreak, agencies around the world now have more stringent cleaning and hygiene standards for cooling towers and large-scale air-conditioning systems. […] The risk of Legionellosis is higher among persons over 50 and those with chronic lung disease, immune system disorders due to disease or medication, systemic malignancy, or an underlying illness such as diabetes, renal failure, or hepatic failure. […] There is no vaccine against Legionellosis, and none of the available pneumococcal vaccines protect against the Legionella bacteria. However, Legionnaires disease shares many of the same risk factors as other pneumonias, so getting a pneumococcal vaccine, as well as a respiratory syncytial virus, or RSV, vaccine, as recommended, may reduce the risk of severe Legionnaires disease.

• #2 Legionnaires’ Disease: Causes, Symptoms, and Treatment | Doctor

  https://patient.info/doctor/legionnaires-disease-pro

  Travel-associated LD is linked to stays in holiday accommodation where intermittent use of facilities, variable temperatures and seasonal fluctuations of water flow may increase the risk of bacterial multiplication and thus infection. Prevention needs to be a collaborative effort between health professionals, governments and the tourist industry and enormous progress has been made since the European Working Group for Legionella Infections (EWGLI) began in 1986 to coordinate such activities in Europe – as a result, a legionellosis surveillance network now connects 36 countries that report travel-associated cases to a computerised database in London. […] Travellers in the highest-risk groups must seek medical attention as soon as possible if they suspect they might have LD. The increasing number of whirlpool spas and hot tubs in hotels and cruise ships, and the difficulty in tracking outbreaks of Pontiac fever, emphasise the importance of adequate filtration and disinfection measures, coupled with strict application of bather capacity.

• #2 Travel Advice: How to Avoid Legionnaires’ Disease on Holiday

  https://legionellacontrol.com/legionella/travel-advice-how-to-avoid-legionnaires-disease-on-holiday/

  This flushes through the water pipes, any hoses and the showerhead itself, and helps to get rid of anything that might be in there before you use the shower. […] Remember that this advice is good to know regardless of whether you are staying in a hotel room or suite, a private house, a chalet, a B&B, or anywhere else provided as holiday accommodation. […] Any water source that could potentially put people in contact with aerosols and airborne droplets of water could lead to infection if it is not properly cleaned, maintained, and operated. […] However, being aware of the risks, where they are most likely to be, and of the simple steps you can take to reduce those risks, is a sensible approach. […] Given the fatality rate when someone does contract it, and the importance of seeking early medical advice, being more aware of your surroundings and flushing those taps and showers does make sense.

• #2 Legionnaires’ Disease Prevention and Protection | IQAir

  https://www.iqair.com/us/newsroom/legionnaires-disease-prevention?srsltid=AfmBOorYfg9kXE_BNAq_RFpppbSkYMy7n0-kv2NG8L-snbgrSvhZDhq7

  Take the following precautions to help limit the risk of Legionella exposure in the home: […] Set your water heater temperature to 140 degrees Fahrenheit. […] Maintain your water heater properly. […] Perform hot-water flushes. Running faucets and shower heads for at least 30 minutes at 140 degrees Fahrenheit or more can help kill Legionella. […] Maintain hot tubs carefully. Neglected hot tubs provide ideal conditions for growth and spread of Legionella. […] Use humidifiers with caution. […] Building owners and managers can: […] Determine if their buildings are at risk of Legionella growth. […] Follow the industry standard for building water management. […] Develop a water management program. […] By lowering our exposure to Legionella and recognizing the possible signs of an infection, we can help protect our own health. We can also take steps as homeowners or commercial property managers to keep ourselves and others safe. Fortunately, Legionnaires disease is an illness of human error that is preventable.

• #2 Centre for Health Protection – Legionnaires’ disease

  https://www.chp.gov.hk/en/healthtopics/content/24/2117.html

  Currently, there is no vaccine available for LD. It is important to operate and maintain properly designed man-made water systems to prevent LD. […] Members of the public should observe the following advice to reduce the risk of infection: Maintain good personal hygiene. Build up good body immunity by having a balanced diet, regular exercise, adequate rest, reducing stress, do not smoke and avoid alcohol consumption. Strainers in water taps and shower heads should be inspected, cleaned, descaled and disinfected regularly or at a frequency recommended by the manufacturer. If fresh water plumbing system is properly maintained, it is not necessary to install domestic water filters. Use of water filters is not encouraged as clogging occurs easily, and this can promote growth of microorganisms. In case water filters are used, the pore size should be 0.2 micrometer (m) and the filter needs to be changed periodically according to the manufacturers recommendations. Drain and clean water tanks of buildings at least quarterly. Drain or purge for at least 1 minute the infrequently used water outlets (e.g. water taps, shower heads, hot water outlets etc.) and stagnant points of the pipework weekly or before use. Seek and follow doctor’s professional advice regarding the use and maintenance of home respiratory devices and use only sterile water (not distilled or tap water) to clean and fill the reservoir. Clean and maintain the device regularly according to manufacturer’s instructions. After cleaning/disinfection, rinse the device with sterile water, cooled freshly boiled water or water filtered with 0.2 m filters. Never leave stagnant water in the device. Empty the water tank, keep all surfaces dry, and change the water daily.

• #2 Legionnaires’ disease and reducing the risks | SA Health

  https://www.sahealth.sa.gov.au/wps/wcm/connect/public+content/sa+health+internet/healthy+living/protecting+your+health/your+home/legionnaires+disease+and+reducing+the+risks

  Hot water storage tanks should be set to store water at 60oC or greater to reduce the risk. […] If it is necessary to lower the water temperature to 45oC to 50oC to reduce the risk of scalding, this can be achieved by installing water temperature controlling devices called thermostatic mixing valves near the outlets. […] All warm water taps that are not used on a daily basis should be flushed weekly. […] Spa pools require careful maintenance, disinfection and frequent cleaning because they provide ideal conditions for the growth of Legionella pneumophila. […] It is recommended that only distilled or preboiled (sterile) water is used in therapeutic nebulisers and humidifiers to reduce the risk of bacterial growth. […] Fountains can create aerosols by splashing water, and are a particular risk if the water is warm or heated intermittently by submerged lighting. Regular draining, cleaning and disinfection is recommended.

• #2 Legionnaires’ disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/legionnaires-disease

  Spa pools require careful maintenance, disinfection and frequent cleaning because they provide ideal conditions for the growth of Legionella, which can be carried into the lungs by aerosols (tiny air particles) created by the spa pool jets. […] The correct use of spa pool water chemicals, good management of the disinfection, filtration and recirculation systems and regular cleaning of spa pool surfaces can keep spa pool water in a clean, safe and healthy condition. […] Fountains can create aerosols by splashing water, and are a particular risk if the water is warm or heated intermittently by submerged lighting. Regular draining, cleaning and disinfection is recommended. […] Nebulisers need regular cleaning in accordance with manufacturer instructions. […] Cases of Legionnaires’ disease have been linked to the use of potting mix. To minimise the risk of contracting Legionnaires disease from soil, compost or potting mix, take the following precautions: Wear a mask and gloves when handling soil, compost or potting mix.

• #2 Primary Prevention of Legionella Infections – MN Dept. of Health

  https://www.health.mn.gov/diseases/legionellosis/prevention.html

  Those at increased risk for developing Legionnaires disease include: […] According to CDC, implementing good maintenance strategies for water systems in buildings at increased risk is the best strategy for preventing Legionella infections.

• #2 Centre for Health Protection – Legionnaires’ disease

  https://www.chp.gov.hk/en/healthtopics/content/24/2117.html

  In addition, immunocompromised persons should: use sterile water or boiled water for drinking, tooth brushing and mouth rinsing. avoid using humidifiers, or other mist- or aerosol-generating devices. if using humidifiers, or other mist- or aerosol-generating devices, fill the water tank with only sterile or cooled freshly boiled water, and not water directly from the tap. Besides, clean and maintain humidifiers/devices regularly according to manufacturers’ instructions. Never leave stagnant water in a humidifier/device. Empty the water tank, wipe all surfaces dry, and change the water daily.

• #2 Legionnaires’ Disease Safety and Prevention: What You Need to Know

  https://int-enviroguard.com/blog/legionnaires-disease-safety-and-prevention/

  In this post, we’ll cover everything you need to know about this disease – from legionnaires’ disease prevention to legionnaires’ disease in the workplace and everything in between. […] All employers that have workers in at-risk environments should ensure their people are outfitted with the appropriate PPE in situations where an outbreak could be possible. Since Legionnaires’ disease is often contracted by breathing in droplets of water that contain the legionella bacteria, a respirator is a key piece of safety equipment. […] According to OSHA, workers should wear a NIOSH-approved respirator that features a minimum 95 percent efficiency in removing 0.3-micron particles. This is equivalent to an N95 respirator. Chemical protective clothing is also key to Legionnaires’ disease prevention, especially for workers who are cleaning and disinfecting water systems.

• #2 Legionella prevention in the workplace | ontario.ca

  http://www.ontario.ca/page/legionella-prevention-workplace

  Employers must take every precaution reasonable in the circumstances for the protection of workers. This includes protecting workers from infectious hazards, such as Legionella. […] As a best practice, employers should ensure that appropriate maintenance programs are in place to prevent workplace health hazards arising from Legionella bacteria. This includes maintaining water systems and ventilation systems in buildings to protect workers from the hazard of exposure to Legionella bacteria. […] To control hazards posed to workers when they are engaged in Legionella prevention employers must: ensure workers who participate in any sort of preventive maintenance and control program for equipment that may harbour Legionella bacteria (along with other potential risks) are provided with information, instruction and supervision to protect the health and safety of the worker.

• #2 Legionella prevention in the workplace | ontario.ca

  http://www.ontario.ca/page/legionella-prevention-workplace

  Employers also have an obligation to report to the Ministry of Labour, Training and Skills Development (MLTSD) any cases of occupational illness in workers associated with workplace exposure to Legionella. […] The OHSA requires that a supervisor take all precautions reasonable in the circumstances for the protection of a worker. […] The OHSA requires workers to use or wear the equipment, protective devices or clothing that a workers employer requires to be used or worn. This may include situations when workers must use the equipment, protective devices or clothing the employer has required them to use or wear to be protected from the hazard of exposure to Legionella bacteria. […] Employers must ensure that indoor ventilation is adequate to protect the health and safety of workers and must ensure that a mechanical ventilation system is inspected by a qualified person every six months to ensure it is in good condition.

• #2 Legionellosis: symptoms, treatment, prevention – Institut Pasteur

  https://www.pasteur.fr/en/medical-center/disease-sheets/legionellosis

  Although there is no vaccine for Legionnaires’ disease, it is preventable, and some antibiotics are effective if taken early enough. […] Action needs to be taken to prevent the proliferation of Legionella. This includes: maintaining and cleaning fresh water systems and air conditioning systems, applying physical measures (adjusting temperatures) and chemical measures (biocides), preventing aerosol emissions, and reducing stagnant water. […] Doctors must be on their guard to detect cases of Legionnaires’ disease.

• #2 Legionnaires’ Disease – NYC Health

  https://www.nyc.gov/site/doh/health/health-topics/legionnaires-disease.page

  There is no vaccine or medicine that can prevent Legionnaires disease. The best way to prevent it is through the proper maintenance of water systems where Legionella may grow. […] In NYC, building owners are required to register cooling towers. They also need to routinely test the water for the presence of Legionella. […] The Health Department investigates clusters of Legionnaires disease cases to find the source of the contamination in order to prevent other people from getting sick. When two or more confirmed cases of Legionnaires disease within a 12-month period are associated with the same building with a shared hot water system, the Health Department will conduct a building evaluation.

• #2 Prevention of Legionnaires’ Disease in the 21st Century by Advancing Science and Public Health Practice

  https://pmc.ncbi.nlm.nih.gov/articles/PMC5652436/

  With a growing national interest in a safe water supply, it is an opportune time for public health and medicine to come together with industrial hygiene, engineering, microbiology, and environmental protection to understand the problems and ensure effective risk management of Legionella spp. and other pathogens inhabiting our water systems.

• #3 About Legionnaires’ Disease – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/basics.html

  Depending on environmental conditions, Legionella organisms can multiply and spread from many types of human-made water systems such as hot tubs, showerheads, sink faucets, decorative fountains and water features, hot water tanks and heaters, large complex plumbing systems, and cooling towers (structures containing water and a fan as part of centralized cooling systems for buildings or industrial processes). […] The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread in building water systems and devices through good maintenance strategies. These strategies include monitoring water temperatures and disinfectant levels and preventing stagnant water conditions. […] Building owners and managers should develop and implement a water management program using ASHRAE (American Society of Heating, Refrigerating and Air-Conditioning Engineers) standards.

• #3 5 Essential Strategies for Effective Legionnaires’ Prevention in Your Facility – Prevent Legionnaires

  https://preventlegionnaires.org/5-strategies-for-legionnaires-prevention/

  Legionella bacteria thrive in temperatures between 77°F and 113°F (25°C and 45°C). Therefore, maintaining appropriate temperature control is crucial for Legionnaires’ prevention. Hot water should be kept at a minimum of 140°F (60°C), while cold water should be maintained at or below 68°F (20°C). […] Regular risk assessments are essential for identifying and addressing potential sources of Legionella in your facility. A comprehensive risk assessment should include evaluating all water systems, identifying areas prone to stagnation, and assessing the effectiveness of current preventive measures. […] Training and awareness programs are vital for Legionnaires’ prevention. Educate facility staff about the risks associated with Legionella and the importance of maintaining water systems. […] By implementing these essential strategies, you can effectively manage and reduce the risk of Legionella outbreaks in your facility. Proactive maintenance, effective treatment, temperature control, regular assessments, and staff training are key components of a comprehensive Legionnaires’ prevention plan.

• #3 Legionnaires’ disease

  https://www2.hse.ie/conditions/legionnaires-disease/

  The best way to prevent Legionnaires’ disease is by taking proper care of any water supply where the bacteria can grow. […] Let water run through shower heads or taps that are not in use once a week for at least 5-10 minutes. […] The water that runs through should be a temperature of: […] 50 degrees Celsius or higher for hot water taps […] 20 degrees Celsius or lower for cold water taps. […] This is because the bacteria that causes Legionnaires’ disease grows best in water temperatures between 20 and 45 degrees Celsius. […] Regularly maintain and clean your showers, shower heads and water taps to avoid a build up of dirt.

• #3 Legionnaires’ Disease Safety and Prevention: What You Need to Know

  https://int-enviroguard.com/blog/legionnaires-disease-safety-and-prevention/

  Routine maintenance and cleaning of water systems, especially in environments where people tend to be more at risk of developing severe disease (i.e., hospitals, nursing homes, etc.). […] Routinely treating water systems with biocide to prevent or decrease the risk of legionella growth. […] Water systems can also be treated in a non-chemical fashion, using ultraviolet light or ultrasonic waves – two practices that have demonstrated the ability to kill the legionella bacteria under the right conditions. […] And because transmission is preventable with the right mix of PPE and other preventative measures, now is the time to revisit your site-specific safety plan in at-risk environments.

• #3 Preventing Legionnaires disease | Bassetlaw District Council

  https://www.bassetlaw.gov.uk/council-housing/repairs-home-improvements/preventing-legionnaires-disease/

  The risk of contracting the disease is low but it is good practice to take the following precautions: […] Flush through showers and taps for 10 minutes following a period of non-use, for example, after you have been on holiday or if a room is not in regular use. […] Keep all shower heads and taps clean and free from a build up of limescale, mould or algae growth. Regular bleaching and disinfecting every three months will help sterilise and kill any bacteria. […] As part of your landlord’s annual service and maintenance checks to your heating and hot water system, engineers will check the hot water setting and flow rate to ensure there is a reduced risk of Legionella bacteria forming. These settings are selected for your safety. We strongly advise that you do not change them.

• #3 Preventing Legionnaires’ disease | Business.gov.nl

  https://business.gov.nl/regulation/legionella/

  You must take steps to prevent the (further) growth of Legionella bacteria, such as regularly flushing the pipes in your building. […] You must have your water checked at least twice a year by a certified sampler. If there are more than 100 colony-forming units of the bacteria per litre (cfu/l), you must take action. […] You must also keep a logbook in which you register which measures you have taken and when. […] If you use a wet cooling tower to cool your building or manufacturing process, you must notify your municipality via the online service counter. Wet cooling towers increase the risk of spreading Legionella bacteria, as they release droplets of water into the air.

• #3 Legionella Infection Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/965492-treatment

  Patients with Legionnaires disease do not require contact or respiratory isolation (person-to-person transmission has never been demonstrated). Standard precautions are recommended. […] For water births, the colonization of tap water with Legionella can be reduced by installation of a filter system into the supply hose of the birthing tub. […] Strategies the Centers for Disease Control and Prevention (CDC) recommend to prevent healthcare-associated (HCA) Legionnaires disease include the following: Maintain a high index of suspicion for the diagnosis of HCA Legionnaires disease, and perform appropriate laboratory tests for Legionnaires disease. […] Facilities with transplantation programs should consider routine Legionella cultures of water samples from the potable water systems as part of the facilities comprehensive program to prevent and control HCA Legionnaires disease.

• #3 Preventing Legionnaires’ disease | Business.gov.nl

  https://business.gov.nl/regulation/legionella/

  Strict prevention rules apply for some businesses and institutions where the risk of infection with Legionnaires disease is higher. These priority institutions include: hospitals, healthcare institutions (care homes, mental health centres, specialised care), saunas, swimming pools and establishments with pools on their premises, such as wellness centres and sex clubs, hotels, BB’s, and holiday rental apartments that accommodate more than 5 guests, asylum seekers’ centres. […] You must take mandatory measures to prevent infection. […] You must ask a certified company to conduct a risk analysis. This analysis shows where in your business or institution Legionella bacteria are growing or may start to grow. […] Based on the risk analysis, you must ask a BRL 6010 certified company to draw up a Legionella management plan. This sets out the measures you must take to prevent the growth of Legionella bacteria.

• #3 Legionnaires’ Disease Prevention and Protection | IQAir

  https://www.iqair.com/us/newsroom/legionnaires-disease-prevention?srsltid=AfmBOorYfg9kXE_BNAq_RFpppbSkYMy7n0-kv2NG8L-snbgrSvhZDhq7

  Take the following precautions to help limit the risk of Legionella exposure in the home: […] Set your water heater temperature to 140 degrees Fahrenheit. […] Maintain your water heater properly. […] Perform hot-water flushes. Running faucets and shower heads for at least 30 minutes at 140 degrees Fahrenheit or more can help kill Legionella. […] Maintain hot tubs carefully. Neglected hot tubs provide ideal conditions for growth and spread of Legionella. […] Use humidifiers with caution. […] Building owners and managers can: […] Determine if their buildings are at risk of Legionella growth. […] Follow the industry standard for building water management. […] Develop a water management program. […] By lowering our exposure to Legionella and recognizing the possible signs of an infection, we can help protect our own health. We can also take steps as homeowners or commercial property managers to keep ourselves and others safe. Fortunately, Legionnaires disease is an illness of human error that is preventable.

• #3 What Is Legionnaires’ Disease and How Can I Protect Myself? – The New York Times

  https://www.nytimes.com/2022/09/21/well/live/legionnaires-disease.html

  You can reduce your risk of Legionnaires’ at home by regularly deep cleaning shower heads, faucets, hot tubs and humidifiers. There is no current guidance about how often individual households need to do this, but if you think you might be at risk, it’s fairly easy to kill Legionella bacteria: For your shower or faucet, start by detaching the shower head or the end piece of the faucet that contains a mesh screen disk. Scrub off the limescale and other residue. Then soak the piece in boiling water or a chemical solution to help kill the bacteria. For hot tubs, use chemicals specifically designed for disinfection, and for your humidifier, use either diluted bleach or a hydrogen peroxide solution. For your car, the C.D.C. recommends undiluted windshield cleaner fluid, which contains a mixture of antifreeze, solvent and detergents that are inhospitable to bacterial growth.

• #3 Centre for Health Protection – Legionnaires’ disease

  https://www.chp.gov.hk/en/healthtopics/content/24/2117.html

  In addition, immunocompromised persons should: use sterile water or boiled water for drinking, tooth brushing and mouth rinsing. avoid using humidifiers, or other mist- or aerosol-generating devices. if using humidifiers, or other mist- or aerosol-generating devices, fill the water tank with only sterile or cooled freshly boiled water, and not water directly from the tap. Besides, clean and maintain humidifiers/devices regularly according to manufacturers’ instructions. Never leave stagnant water in a humidifier/device. Empty the water tank, wipe all surfaces dry, and change the water daily.

• #3 Public Health Efforts Keep Legionnaires’ Disease Risk Low | Article | The United States Army

  https://www.army.mil/article/283656/public_health_efforts_keep_legionnaires_disease_risk_low

  The CDC reports that since the 1976 outbreak, agencies around the world now have more stringent cleaning and hygiene standards for cooling towers and large-scale air-conditioning systems. […] The risk of Legionellosis is higher among persons over 50 and those with chronic lung disease, immune system disorders due to disease or medication, systemic malignancy, or an underlying illness such as diabetes, renal failure, or hepatic failure. […] There is no vaccine against Legionellosis, and none of the available pneumococcal vaccines protect against the Legionella bacteria. However, Legionnaires disease shares many of the same risk factors as other pneumonias, so getting a pneumococcal vaccine, as well as a respiratory syncytial virus, or RSV, vaccine, as recommended, may reduce the risk of severe Legionnaires disease.

• #3 Legionella Infection Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/965492-treatment

  Some experts have recommended to culture the tap water of pediatric hospitals, especially to sample the higher risk areas (eg, NICU, PICU, transplant units) for Legionella. Children with hospital-acquired pneumonia in hospitals with positive surveillance cultures should undergo Legionella testing. […] Additionally, it has been recommended that transplant recipients boil their water, cool it, and store it for drinking.

• #3 Back to Basics: Control and Prevention of Legionella in Water Systems – EHS Daily Advisor

  https://ehsdailyadvisor.blr.com/2024/05/back-to-basics-control-and-prevention-of-legionella-in-water-systems/

  Employers should provide appropriate PPE and encourage its use when workers perform any routine maintenance, cleaning, or disinfection activities on water systems that may be contaminated with Legionella. […] In the event of a known or suspected Legionellosis outbreak, workers who may be exposed to aerosolized Legionella must wear respirators.

• #3 Legionnaires’ disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/legionnaires-disease

  Store bags of potting mix in a cool dry place. When stored in the sunlight, the temperature inside the bag can increase, creating an ideal environment for Legionella bacteria to grow. […] Open bags in a well-ventilated space. […] Open bags of composted potting mix slowly, directing the opening away from the face to avoid inhaling the mix. Wet the soil to reduce dust when potting plants. […] Water gardens and composts gently, using a low-pressure hose. […] Avoid breathing in droplets of water from dripping pot plants, including hanging baskets, and when watering plants.

• #3 Legionnaires’ disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/legionnaires-disease

  Legionella, the bacteria that causes Legionnaires disease, is common in the environment, especially in fresh water and soil. There are easy steps that everyone can take to prevent infection. […] The risk of Legionnaires disease can be reduced by ensuring the growth of Legionella bacteria in systems such as spas, hot water systems and cooling towers is controlled. […] People can also take care to avoid exposure to the bacteria from other sources, such as potting mix and water sources in the home. […] Government regulations set out how to maintain and treat cooling towers, water delivery systems in hospital and aged care facilities and public spas to prevent the Legionella bacteria growing. […] Domestic plumbing systems must be properly installed and maintained to avoid growth of Legionella.

• #3 Home – Prevent Legionnaires

  https://preventlegionnaires.org/

  Studies show the primary source of legionella bacteria and Legionnaires’ disease outbreaks is the public drinking water supply. […] The best solution for preventing Legionnaires’ disease is effectively treating the water in our public water system to prevent the growth of legionella bacteria. […] Stop legionella bacteria from entering the public water supply. […] Replace aging public water infrastructure systems to reduce microbial risks. […] Invest in research to better understand and prevent all cases of Legionnaires’ disease.

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