A review of legionnaires’ disease and public water systems – Scientific considerations, uncertainties and recommendations

2022 ◽  
Vol 240 ◽  
pp. 113906
Author(s):  
Jessie A. Gleason ◽  
Perry D. Cohn
Keyword(s):  
Water Systems ◽  
Legionnaires Disease ◽  
Public Water Systems

scholarly journals Highlighting the Potency of Biosurfactants Produced by Pseudomonas Strains as Anti-Legionella Agents

2018 ◽  
Vol 2018 ◽  
pp. 1-15 ◽  
Author(s):  
Clémence Loiseau ◽  
Emilie Portier ◽  
Marie-Hélène Corre ◽  
Margot Schlusselhuber ◽  
Ségolène Depayras ◽  
...  
Keyword(s):  
Legionella Pneumophila ◽  
Close Association ◽  
Water Systems ◽  
Antagonistic Activity ◽  
Reverse Phase Hplc ◽  
Reverse Phase ◽  
Free Living ◽  
Legionnaires Disease ◽  
Culture Supernatants ◽  
Multispecies Biofilms

Legionella pneumophila, the causative agent of Legionnaires’ disease, is a waterborne bacterium mainly found in man-made water systems in close association with free-living amoebae and multispecies biofilms. Pseudomonas strains, originating from various environments including freshwater systems or isolated from hospitalized patients, were tested for their antagonistic activity towards L. pneumophila. A high amount of tested strains was thus found to be active. This antibacterial activity was correlated to the presence of tensioactive agents in culture supernatants. As Pseudomonas strains were known to produce biosurfactants, these compounds were specifically extracted and purified from active strains and further characterized using reverse-phase HPLC and mass spectrometry methods. Finally, all biosurfactants tested (lipopeptides and rhamnolipids) were found active and this activity was shown to be higher towards Legionella strains compared to various other bacteria. Therefore, described biosurfactants are potent anti-Legionella agents that could be used in the water treatment industry although tests are needed to evaluate how effective they would be under field conditions.

scholarly journals An approach for developing a national estimate of waterborne disease due to drinking water and a national estimate model application

2006 ◽  
Vol 4 (S2) ◽  
pp. 201-240 ◽  
Author(s):  
Michael Messner ◽  
Susan Shaw ◽  
Stig Regli ◽  
Ken Rotert ◽  
Valerie Blank ◽  
...  
Keyword(s):  
Drinking Water ◽  
Environmental Protection Agency ◽  
Water System ◽  
Credible Interval ◽  
The United States ◽  
Water Systems ◽  
Epidemiologic Studies ◽  
Incidence Rates ◽  
Waterborne Disease ◽  
Public Water Systems

In this paper, the US Environmental Protection Agency (EPA) presents an approach and a national estimate of drinking water related endemic acute gastrointestinal illness (AGI) that uses information from epidemiologic studies. There have been a limited number of epidemiologic studies that have measured waterborne disease occurrence in the United States. For this analysis, we assume that certain unknown incidence of AGI in each public drinking water system is due to drinking water and that a statistical distribution of the different incidence rates for the population served by each system can be estimated to inform a mean national estimate of AGI illness due to drinking water. Data from public water systems suggest that the incidence rate of AGI due to drinking water may vary by several orders of magnitude. In addition, data from epidemiologic studies show AGI incidence due to drinking water ranging from essentially none (or less than the study detection level) to a rate of 0.26 cases per person-year. Considering these two perspectives collectively, and associated uncertainties, EPA has developed an analytical approach and model for generating a national estimate of annual AGI illness due to drinking water. EPA developed a national estimate of waterborne disease to address, in part, the 1996 Safe Drinking Water Act Amendments. The national estimate uses best available science, but also recognizes gaps in the data to support some of the model assumptions and uncertainties in the estimate. Based on the model presented, EPA estimates a mean incidence of AGI attributable to drinking water of 0.06 cases per year (with a 95% credible interval of 0.02–0.12). The mean estimate represents approximately 8.5% of cases of AGI illness due to all causes among the population served by community water systems. The estimated incidence translates to 16.4 million cases/year among the same population. The estimate illustrates the potential usefulness and challenges of the approach, and provides a focus for discussions of data needs and future study designs. Areas of major uncertainty that currently limit the usefulness of the approach are discussed in the context of the estimate analysis.

Computational framework for evaluating risk trade-offs in costs associated with Legionnaires’ Disease risk, energy, and scalding risk for hospital hot water systems

2021 ◽  
Author(s):  
Ashley Heida ◽  
Alexis Mraz ◽  
Mark Hamilton ◽  
Mark Weir ◽  
Kerry A Hamilton
Keyword(s):  
Legionella Pneumophila ◽  
Disease Risk ◽  
Disease Outbreaks ◽  
Febrile Illness ◽  
Water Systems ◽  
Hot Water ◽  
Computational Framework ◽  
Trade Offs ◽  
Pontiac Fever ◽  
Legionnaires Disease

Legionella pneumophila are bacteria that when inhaled cause Legionnaires’ Disease (LD) and febrile illness Pontiac Fever. As of 2014, LD is the most frequent cause of waterborne disease outbreaks due...

Waterborne epidemics in Finland in 1998-1999

2001 ◽  
Vol 43 (12) ◽  
pp. 67-71 ◽  
Author(s):  
I. T. Miettinen ◽  
O. Zacheus ◽  
C-H. von Bonsdorff ◽  
T. Vartiainen
Keyword(s):  
Drinking Water ◽  
Surface Water ◽  
Water Source ◽  
Water Systems ◽  
Contaminated Water ◽  
Public And Private ◽  
Water Plant ◽  
Public Water Systems

Fourteen waterborne epidemics occurred in Finland during 1998-1999. About 7,300 illness cases were registered in these outbreaks. All except one of the waterborne epidemics were associated with undisinfected groundwaters. An equal number of waterborne epidemics occurred in public and private water systems, but most cases of illness occurred in public water systems. The three largest epidemics comprised 6,700 illness cases. Insufficient purification treatment unable to remove Norwalk-like viruses caused the only waterborne epidemic in a surface water plant. The main reasons for groundwater outbreaks were floods and surface runoffs which contaminated water. Norwalk-like viruses caused eight and Campylobacter three of the outbreaks. In two cases the epidemic ceased by the exhaustion of susceptible persons in the exposed community but in most cases it was terminated by changing the water source, boiling the drinking water, and starting chlorination.

Washing and Waxing Public Water Systems

Opflow ◽  
2008 ◽  
Vol 34 (5) ◽  
pp. 32-33
Author(s):  
Robert Spon
Keyword(s):  
Water Systems ◽  
Public Water Systems

scholarly journals Evaluation of Legionella spp. Colonization in Residential Buildings Having Solar Thermal System for Hot Water Production

2020 ◽  
Vol 17 (19) ◽  
pp. 7050
Author(s):  
Michele Totaro ◽  
Anna Laura Costa ◽  
Lorenzo Frendo ◽  
Sara Profeti ◽  
Beatrice Casini ◽  
...  
Keyword(s):  
Cold Water ◽  
Disease Risk ◽  
Residential Buildings ◽  
Water Systems ◽  
Hot Water ◽  
Solar Thermal ◽  
Water Production ◽  
Systems Maintenance ◽  
Legionnaires Disease ◽  
Cold Water Temperature

Despite an increase of literature data on Legionella spp. presence in private water systems, epidemiological reports assert a continuing high incidence of Legionnaires’ disease infection in Italy. In this study, we report a survey on Legionella spp. colonization in 58 buildings with solar thermal systems for hot water production (TB). In all buildings, Legionella spp. presence was enumerated in hot and cold water samples. Microbiological potability standards of cold water were also evaluated. Legionella spp. was detected in 40% of the buildings. Moreover, we detected correlations between the count of Legionella spp. and the presence of the optimal temperature for the microorganism growth (less than 40 °C). Our results showed that cold water was free from microbiological hazards, but Legionella spp., was detected when the mean cold water temperature was 19.1 ± 2.2 °C. This may considered close to the suboptimal value for the Legionella growth (more then 20 °C). In conclusion, we observed the presence of a Legionnaires’ disease risk and the need of some strategies aimed to reduce it, such as the application of training programs for all the workers involved in water systems maintenance.

scholarly journals Economies of Size Among Municipal Water Authorities in Pennsylvania

1973 ◽  
Vol 5 (2) ◽  
pp. 1-6
Author(s):  
Arthur B. Daugherty ◽  
J. Dean Jansma
Keyword(s):  
Rural Areas ◽  
Small Towns ◽  
Water Systems ◽  
Construction Costs ◽  
Water Utility ◽  
Suburban Communities ◽  
Economies Of Size ◽  
Public Water Systems ◽  
Number Of Customers ◽  
Per Capita Consumption

Water utilities are being subjected to progressively greater economic pressures. The demand for water is increasing, due to both a growing number of customers and rising per capita consumption. Consequently, many utilities are faced with declining reserves of water, necessitating additional investment to develop sources of supply. Frequently, new or enlarged facilities to treat, store and distribute the larger volume of water are required. Public policies, also, are promoting the extension or development of public water systems to serve sparsely populated suburban communities, small towns, and rural areas. All these changes affecting the demand for water, combined with rising construction costs, are causing water utility costs to skyrocket.

Experiences of the First 16 Hospitals Using Copper-Silver Ionization forLegionellaControl: Implications for the Evaluation of Other Disinfection Modalities

2003 ◽  
Vol 24 (8) ◽  
pp. 563-568 ◽  
Author(s):  
Janet E. Stout ◽  
Victor L. Yu
Keyword(s):  
Decision Making ◽  
Evaluation Criteria ◽  
Evaluation Process ◽  
Water Systems ◽  
Evidence Based ◽  
Disinfection Methods ◽  
Legionnaires Disease ◽  
Hospital Acquired

AbstractBackground and Objectives:Hospital-acquired legionnaires' disease can be prevented by disinfection of hospital water systems. This study assessed the long-term efficacy of copper-silver ionization as a disinfection method in controllingLegionellain hospital water systems and reducing the incidence of hospital-acquired legionnaires' disease. A standardized, evidence-based approach to assist hospitals with decision making concerning the possible purchase of a disinfection system is presented.Design:The first 16 hospitals to install copper-silver ionization systems forLegionelladisinfection were surveyed. Surveys conducted in 1995 and 2000 documented the experiences of the hospitals with maintenance of the system, contamination of water withLegionella, and occurrence of hospital-acquired legionnaires' disease. All were acute care hospitals with a mean of 435 beds.Results:All 16 hospitals reported cases of hospital-acquired legionnaires' disease prior to installing the copper-silver ionization system. Seventy-five percent had previously attempted other disinfection methods including superheat and flush, ultraviolet light, and hyperchlorination. By 2000, the ionization systems had been operational from 5 to 11 years. Prior to installation, 47% of the hospitals reported that more than 30% of distal water sites yieldedLegionella. In 1995, after installation, 50% of the hospitals reported 0% positivity, and 43% still reported 0% in 2000. Moreover, no cases of hospital-acquired legionnaires' disease have occurred in any hospital since 1995.Conclusions:This study represents the final step in a proposed 4-step evaluation process of disinfection systems that includes (1) demonstrated efficacy ofLegionellaeradication in vitro using laboratory assays, (2) anecdotal experiences in preventing legionnaires' disease in individual hospitals, (3) controlled studies in individual hospitals, and (4) validation in confirmatory reports from multiple hospitals during a prolonged time (5 to 11 years in this study). Copper-silver ionization is now the only disinfection modality to have fulfilled all four evaluation criteria.

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