Legionnaires' Disease in Hospitals
Hospital-acquired Legionnaires' disease usually originates in hospital water systems. Legionella bacteria not only persists in hot water tanks, it is often found in the biofilm through the entire hospital water system.
Conditions within water systems that promote legionella colonisation include water temperature, configuration and age of the hot water tank, and plumbing materials.
Legionnaires' disease infections, and subsequent fatality rates, caused by nosocomial Legionellosis are much higher in hospitals and healthcare facilities.
An estimated 10 to 15 thousand people contract Legionnaires' disease in the US each year; 5 to 15% of these cases prove to be fatal.
An additional unknown number are infected with Legionella bacterium and have mild symptoms or no illness at all.
Additionally, Legionellosis is frequently misdiagnosed as common pneumonia.
The occurrence of Legionnaires' disease, and subsequent fatality rates, caused by nosocomial Legionellosis are much higher in hospitals and healthcare facilities than are observed elsewhere.
In many parts of the world there is strong legislation to ensure that this entirely avoidable disease is prevented from coming into contact with high-risk members of the population.
In the USA the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) recommends a Risk Minimization Plan for all healthcare facilities "to reduce the potential for organisational-acquired illness including managing pathogenic biological agents in cooling towers, domestic hot water, and other aerosolising water systems.
The UK's Health and Safety Executive (HSE) also produce excellent guidance concerning the control and management of legionella risks in their Approved Code of Practice (ACOP) L8 and HSG 274 Paets 1, 2 and 3 documents.
"The risk of hospital-acquired Legionnaires' disease can be minimised by control measures directed at the water distribution system.
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