How is Legionella infection prevented?

Updated: Nov 13, 2018
  • Author: Mobeen H Rathore, MD, CPE, FAAP, FIDSA; Chief Editor: Russell W Steele, MD  more...
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Answer

See the list below:

  • Patients with Legionnaires disease do not require contact or respiratory isolation (person-to-person transmission has never been demonstrated). Standard precautions are recommended. [1]

  • 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.

    • Maintain potable water at the outlet at temperatures not suitable for the growth of Legionella species.

    • Cooling towers should receive routine maintenance, and only sterile water should be used to fill and rinse respiratory therapy devices.

    • Initiate an investigation for the source of Legionella organisms when one case of Legionnaires disease is identified in an inpatient transplant recipient or when 2 cases occurring within 6 months of each other are identified in transplant recipients who visited an outpatient unit during the 2-10 months before the onset of illness.

    • If the water system is implicated, decontaminate the system by superheating water to 71-77°C, and maintain until distal sites are flushed. If thermal shock is not possible, use shock chlorination as an alternative. [37]

  • 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. [38]

  • Additionally, it has been recommended that transplant recipients boil their water, cool it, and store it for drinking. [39]


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