Legionella And the Prevention of Legionellosis 1st Edition by Bartram, Chartier, Lee ISBN 9241562978 978-9241562973

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Product details: 

ISBN 10:  9241562978 
ISBN 13: 978-9241562973

Author:  J. Bartram, Y. Chartier,  J.V. Lee

Water is the major natural reservoir for legionellae, and the bacteria are found worldwide in many different natural and artificial aquatic environments, such as cooling towers, water systems in hotels homes, ships and factories, respiratory therapy equipment, fountains misting devices and spa pools.

This book provides a comprehensive overview on the sources, ecology and laboratory diagnosis of legionella. Guidance is provided on risk assessment and risk management of susceptible environments. The necessary measures to prevent, or adequately control, the risk from exposure to legionella bacteria are identified for each identified environment. Outbreaks of legionellosis generally cause a high level of morbidity and mortality in the people affected and as such the suspicion of an outbreak warrants immediate action. The policies and practice for outbreak management and the institutional roles and responsibilities of an outbreak control team are reviewed.

This book will be useful to all those concerned with legionella and health, including environmental and public health officers, health care workers, the travel industry, researchers and special interest groups.

Table of contents: 

Chapter 1 Legionellosis

1.1 Types of disease
1.1.1 Legionnaires’ disease
1.1.2 Pontiac fever
1.1.3 Extrapulmonary syndromes
1.2 Prevalence and risk factors
1.2.1 Community-acquired pneumonia
1.2.2 Nosocomial infections
1.2.3 Sporadic cases of pneumonia
1.2.4 Rates of mortality and survival
1.3 Treatment of Legionnaires’ disease
1.4 Types of organism causing disease
1.4.1 Taxonomy
1.4.2 Species and serogroups associated with disease
1.5 Virulence and pathogenicity
1.5.1 Overview and life-cycle
1.5.2 Surface structures involved in pathogenicity
1.5.3 Virulence factors
1.5.4 Host defence
1.5.5 Transmission

Chapter 2 Ecology and environmental sources of Legionella

2.1 Natural sources of Legionella
2.2 Factors affecting growth of Legionella
2.2.1 Influence of temperature
2.2.2 Effect of other microorganisms
2.2.3 Environmental factors and virulence
2.3 Biofilms
2.3.1 Biofilm composition
2.3.2 Biofilm formation
2.3.3 Effect of biofilms on bacteria growth
2.3.4 Risk factors for biofilm growth
2.4 Sources of Legionella infection
2.4.1 Disease spread via aerosols and inhalation
2.4.2 Disease spread via soil

Chapter 3 Approaches to risk management

3.1 Environmental exposure and disease
3.1.1 Cooling tower outbreaks
3.2 Health-based targets
3.3 Water safety plans
3.3.1 System assessment
3.3.2 Monitoring
3.3.3 Management and communication
3.4 Surveillance

Chapter 4 Potable water and in-building distribution systems

4.1 Background
4.2 Water safety plan overview
4.3 System assessment
4.3.1 Document and describe the system
4.3.2 Assess hazards and prioritize risks
4.4 Monitoring
4.4.1 Identify control measures
4.4.2 Monitor control measures
4.5 Management and communication
4.5.1 Prepare management procedures
4.5.2 Establish documentation and communication procedures

Chapter 5 Cooling towers and evaporative condensers

5.1 Background
5.1.1 Cross-flow cooling towers
5.1.2 Counterflow evaporative condensers and cooling towers
5.1.3 Links to outbreaks of legionellosis
5.2 Water safety plan overview
5.3 System assessment
5.3.1 Document and describe the system
5.3.2 Assess hazards and prioritize risks
5.4 Monitoring
5.4.1 Identify control measures
5.4.2 Monitor control measures
5.5 Management and communication
5.5.1 Develop supporting programs
5.5.2 Prepare management procedures
5.5.3 Establish documentation and communication procedures
5.5.4 Verification
5.6 Surveillance

Chapter 6 Health-care facilities

6.1 Background
6.1.1 Surveillance data on nosocomial Legionnaires’ disease
6.2 Water safety plan overview
6.3 System assessment
6.3.1 Document and describe the system
6.3.2 Assess hazards and prioritize risks
6.4 Monitoring
6.4.1 Identify control measures
6.4.2 Monitor control measures
6.5 Management and communication
6.5.1 Prepare management procedures
6.5.2 Establish documentation and communication procedures
6.5.3 Verification

Chapter 7 Hotels and ships

7.1 Background
7.1.1 European initiatives
7.1.2 Hotel-associated cases
7.1.3 Ship-associated cases
7.2 Water safety plan overview
7.3 System assessment
7.3.1 Document and describe the system
7.3.2 Assess hazards and prioritise risks
7.4 Monitoring
7.4.1 Identify control measures
7.4.2 Monitor control measures
7.5 Surveillance

Chapter 8 Natural spas, hot tubs and swimming pools

8.1 Background
8.2 Water safety plan overview
8.3 System assessment
8.3.1 Assemble the team
8.3.2 Document and describe the system
8.3.3 Assess hazards and prioritize risks
8.4 Monitoring
8.4.1 Identify control measures
8.4.2 Monitor control measures
8.5 Management and communication
8.5.1 Establish documentation and communication procedures
8.5.2 Verification
8.6 Surveillance

Chapter 9 Disease surveillance and public health management of outbreaks

9.1 Surveillance systems
9.1.1 Standardized case definitions
9.1.2 Defined datasets
9.2 International surveillance of legionellosis
9.2.1 Effect of improved surveillance
9.3 Management of outbreaks
9.3.1 Confirmation of an outbreak
9.3.2 Outbreak control team
9.3.3 Policies and practices
9.3.4 Roles and responsibilities
9.3.5 Engineering and environmental investigations
9.3.6 High-profile outbreaks
9.4 Case studies
9.4.1 Community outbreak — England
9.4.2 Nosocomial outbreak — Israel
9.4.3 Hot tub outbreak — Austria
9.4.4 Concrete batcher process on a construction site — UK

Chapter 10 Regulatory aspects

10.1 Existing guidelines and regulations for risk prevention
10.2 Legionella testing
10.3 Scope of regulations
10.4 Designing regulations
10.4.1 Managerial responsibilities, registration and notification
10.4.2 System assessment and design
10.4.3 Operational monitoring and verification
10.4.4 Documentation of management plans and record keeping
10.4.5 Surveillance and audit
10.4.6 Outbreak investigation and notification of disease
10.5 Outbreak impact and economic consequences

Chapter 11 Laboratory aspects of Legionella

11.1 Legionella biology and staining
11.1.1 Biology
11.1.2 Staining
11.2 Diagnostic methods
11.2.1 Diagnosing legionellosis using culture media
11.2.2 Detecting Legionella antigens
11.2.3 Diagnosing legionellosis using nucleic acid detection
11.2.4 Diagnosing patients with health-care associated pneumonia
11.3 Analysing environmental samples for Legionella
11.3.1 Standards for Legionella detection and recovery
11.3.2 Ensuring safety during environmental sampling
11.4 Legionella speciation and serology typing
11.4.1 Identifying different Legionella species
11.4.2 Identifying Legionella colonies
11.4.3 Identifying appropriate sampling sites
11.4.4 Collecting environmental samples
11.4.5 Sample preparation and isolation
11.4.6 Interpreting results

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