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What is Legionella bacteria & Legionnaires' Disease?
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Legionellosis is a collective term for diseases caused by legionella bacteria including the most serious Legionnaires' disease, as well as the similar but less serious conditions of Pontiac fever and Lochgoilhead fever. Legionnaires' disease is a potentially fatal form of pneumonia and everyone is susceptible to infection. The risk increases with age but some people are at higher risk including:
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people over 45 years of age
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smokers and heavy drinkers
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people suffering from chronic respiratory or kidney disease
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diabetes, lung and heart disease
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anyone with an impaired immune system
The bacterium Legionella pneumophila and related bacteria are common in natural water sources such as rivers, lakes and reservoirs, but usually in low numbers. They may also be found in purpose-built water systems such as cooling towers, evaporative condensers, hot and cold water systems and spa pools.
If conditions are favourable, the bacteria may grow increasing the risks of Legionnaires' disease and it is therefore important to control the risks by introducing appropriate measures outlined in Legionnaires' disease - The Control of Legionella bacteria in water systems (L8).
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Where does it come from?
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Legionella bacteria are widespread in natural water systems, eg rivers and ponds. However, the conditions are rarely right for people to catch the disease from these sources. Outbreaks of the illness occur from exposure to legionella growing in purpose-built systems where water is maintained at a temperature high enough to encourage growth, eg cooling towers, evaporative condensers, hot and cold water systems and spa pools used in all sorts of premises (work and domestic).
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How do people get it?
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People contract Legionnaires' disease by inhaling small droplets of water (aerosols), suspended in the air, containing the bacteria. Certain conditions increase the risk from legionella if:
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the water temperature in all or some parts of the system may be between 20-45 °C, which is suitable for growth
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it is possible for breathable water droplets to be created and dispersed eg aerosol created by a cooling tower, or water outlets
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water is stored and/or re-circulated
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there are deposits that can support bacterial growth providing a source of nutrients for the organism eg rust, sludge, scale, organic matter and biofilms
Cases of Legionnaires' disease are often the result of infections caught in the UK, but a number of cases occur abroad. Useful advice on travel can be found from the European Working Group for Legionella Infections (PDF)(EWGLI).
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HSG274 Part 1; The control of legionella bacteria in evaporative cooling systems
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HSG274 Part 2; The control of legionella bacteria in hot and cold water systems
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HSG274 Part 3; The control of legionella bacteria in other risk systems
Health Technical Memorandum 04-01: Safe water in healthcare premises