1887

Chapter 83 : Control of in Drinking Water Systems: Impact of Monochloramine

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Ebook: Choose a downloadable PDF or ePub file. Chapter is a downloadable PDF file. File must be downloaded within 48 hours of purchase

Buy this Chapter
Digital (?) $15.00

Preview this chapter:
Zoom in
Zoomout

Control of in Drinking Water Systems: Impact of Monochloramine, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555817985/9781555812300_Chap83-1.gif /docserver/preview/fulltext/10.1128/9781555817985/9781555812300_Chap83-2.gif

Abstract:

and -like organisms live as facultative intracellular parasites of amoebae in the biofilm that covers the inside of tanks and pipes in water systems. Recent investigations, discussed in this chapter, indicate that it is possible to prevent 90% of drinking-water-associated Legionnaires' disease (community acquired as well as nosocomial; sporadic disease as well as outbreaks) through the use of monochloramine for residual municipal water disinfection. Monochloramine (combined chlorine) is formed when ammonia and free chlorine are mixed in water in the correct ratio. Recent research has shown that monochloramine may be considerably more effective against and -like organisms than free chlorine. An interesting hypothesis is that monochloramine may also be better at killing the amoebae that serve as hosts to and -like organisms. To this author's knowledge, monochloramine is the only disinfectant that has been shown to reduce the incidence of Legionnaires' disease when used at the municipal level. This finding is not just important for control of nosocomial infections. More than 75% of cases of Legionnaires' disease acquire their infection in the community. Residual disinfection of municipal drinking water with monochloramine seems an inexpensive and efficient way to prevent many of these cases. In addition, supplemental injection of monochloramine may become one of the preferred methods for control of and -like organisms in hospitals, hotels, and similar institutions.

Citation: Kool J. 2002. Control of in Drinking Water Systems: Impact of Monochloramine, p 411-418. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch83

Key Concept Ranking

Chlorine Dioxide
0.5801282
Legionella pneumophila
0.4839744
0.5801282
Highlighted Text: Show | Hide
Loading full text...

Full text loading...

Figures

Image of FIGURE 1
FIGURE 1

Average free residual chlorine concentration as measured in patient room tap water and proportion of sites positive for in 11 San Antonio hospitals. Each dot represents one hospital; a regression line is shown. Reprinted from ( ) with permission of the publisher.

Citation: Kool J. 2002. Control of in Drinking Water Systems: Impact of Monochloramine, p 411-418. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch83
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 2
FIGURE 2

Potable water-associated nosocomial Legionnaires' disease outbreaks identified through literature review in the United States, by year. Solid bars represent hospitals supplied with free chlorine-containing water; the shaded bar is the hospital that was supplied with monochloramine-containing water. Reprinted from The Lancet ( ) with permission of the publisher. © by The Lancet Ltd., 1999.

Citation: Kool J. 2002. Control of in Drinking Water Systems: Impact of Monochloramine, p 411-418. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch83
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of FIGURE 3
FIGURE 3

Geographical distribution of hospitals with reported Legionnaires' disease outbreaks associated with potable water and of randomly selected control hospitals. Some overlapping points were dispersed to improve legibility. Reprinted from The Lancet ( ) with permission of the publisher. © by The Lancet Ltd., 1999.

Citation: Kool J. 2002. Control of in Drinking Water Systems: Impact of Monochloramine, p 411-418. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch83
Permissions and Reprints Request Permissions
Download as Powerpoint

References

/content/book/10.1128/9781555817985.chap83
1. Adeleke, A.,, J. Pruckler,, R. Benson,, T. Rowbotham,, M. Halablab,, and B. Fields. 1996. Legionella-Like amebal pathogens: phylogenetic status and possible role in respiratory-disease. Emerg. Infect. Dis. 2:225230.
2. Bartlett, J. G.,, R. F. Breiman,, L. A. Man-dell,, and T. M. J. File. 1998. Community-acquired pneumonia in adults: guidelines for management. The Infectious Diseases Society of America. Clin. Infect. Dis. 26:811838.
3. Biurrun, A.,, L. Caballero,, C. Pelaz,, E. Leon,, and A. Gago. 1999. Treatment of a Legionella pneumophila-colonized water distribution system using copper-silver ionization and continuous chlorination. Infect. Control Hosp. Epidemiol. 20:426428.
4. Centers for Disease Control and Prevention. 1997. Guidelines for prevention of nosocomial pneumonia. Morb. Mortal. Wkly. Rep. 46:179.
5. Centers for Disease Control and Prevention. 1997. Sustained transmission of nosocomial Legionnaires disease—Arizona and Ohio. Morb. Mortal. Wkly Rep. 46:416421.
6. Chen, X.,, and P. S. Stewart. 1996. Chlorine penetration into artificial biofilm is limited by a reaction-diffusion interaction. Environ. Sci. Technol. 30:20782083.
7. Dice, J. 1985. Denver's seven decades of experience with chloramination. J. Am. Water Works Assoc. 77:34.
8. Environmental Protection Agency. 1998. National primary drinking water regulations: disinfectants and disinfection byproducts; final rule. Fed. Regist. 63:6938969476.
9. Fiore, A.E.,, J.C. Butler,, T.G. Emori,, and R. P. Gaynes. 1999. A survey of methods used to detect nosocomial legionellosis among participants in the National Nosocomial Infections Surveillance System. Infect. Control Hosp. Epidemiol. 20:412416.
10. Fiore, A. E.,, J. L. Kool,, J. Carpenter,, and J. C. Butler. 1997. Eradicating Legionella from hospital water—reply. JAMA 278:14041405.
11. Helms, C. M.,, R. M. Massanari,, R. P. Wenzel,, M. A. Pfaller,, N. P. Mover,, and N. Hall. 1988. Legionnaires' disease associated with a hospital water system. A five-year progress report on continuous hyperchlorination. JAMA 259:24232427.
12. Hoebe, C. J.,, J. J. Cluitmans,, and J. H. Wag-envoort. 1998. Two fatal cases of nosocomial Legionella pneumophila pneumonia associated with a contaminated cold water supply. Eur. J. Clin. Microbiol. Inject. Dis. 17:740.
13. Kilvington, S.,, and J. Price. 1990. Survival of Legionella pneumophila within cysts of Acanth-amoeba polyphaga following chlorine exposure. J. Appl. Bacteriol. 68:519525.
14. Kirmeyer, G. J.,, G. W. Foust,, G. L. Pierson,, J. J. Simmler,, and M. W. LeChevallier. 1993. Optimizing Chloramine Treatment. American Water Works Research Foundation, Denver, Colo.
15. Kool, J. L. 10 May, 2000. Preventing Legionnaires' disease. Ph.D. dissertation. University of Amsterdam, Amsterdam, The Netherlands.
16. Kool, J. L.,, D. Bergmire-Sweat,, J. C. Butler,, E. W. Brown,, D. J. Peabody,, D. S. Massi,, J. C. Carpenter,, J. M. Pruckler,, R. F. Benson,, and B. S. Fields. 1999. Hospital characteristics associated with colonization of water systems by Legionella and risk of nosocomial Legionnaires' disease: a cohort study of 15 hospitals. Inject. Control Hosp. Epidemiol. 20:798805.
17. Kool, J. L.,, J. C. Carpenter,, and B. S. Fields. 1999. Effect of monochloramine disinfection of municipal drinking water on risk of nosocomial Legionnaires' disease. Lancet 353:272211.
18. Kool, J. L.,, A. E. Fiore,, C. M. Kioski,, E. W. Brown,, R. F. Benson,, J. M. Pruckler,, C. Glasby,, J. C. Butler,, G. D. Cage,, J. C. Carpenter,, R. M. Mandel,, B. England,, and R. F. Breiman. 1998. More than 10 years of unrecognized nosocomial transmission of legionnaires' disease among transplant patients. Inject. Control Hosp. Epidemiol. 19:898904.
19. Landeen, L. K.,, M. T. Yahya,, and C. P. Gerba. 1989. Efficacy of copper and silver ions and reduced levels of free chlorine in inactivation of Legionella pneumophila. Appl. Environ. Microbiol. 55:30453050.
20. LeChevallier, M. W.,, C. D. Cawthon,, and R. G. Lee. 1988. Inactivation of biofilm bacteria. Appl. Environ. Microbiol. 54:2492.
21. Lee, T. C.,, R. M. Vickers,, V. L. Yu,, and M. M. Wagener. 1993. Growth of 28 Legionella species on selective culture media: a comparative study. J. Clin. Microbiol. 31:27642768.
22. Liu, Z.,, J. E. Stout,, L. Tedesco,, M. Boldin,, C. Hwang,, W. F. Diven,, and V. L. Yu. 1994. Controlled evaluation of copper-silver ionization in eradicating Legionella pneumophila from a hospital water distribution system. J. Inject. Dis. 169: 919922.
23. Marston, B. J.,, H. B. Lipman,, and R. F. Breiman. 1994. Surveillance for Legionnaires' disease. Risk factors for morbidity and mortality. Arch. Intern. Med. 154:24172422.
24. McNally, C.,, B. Hackman,, B. S. Fields,, and J. F. Plouffe. 2000. Potential importance of legionella species as etiologies in community acquired pneumonia. Diagn. Miaobiol. Inject. Dis. 38:7982.
25. Nafziger, D. A. 1997. Successful chlorination for Legionella at Henry Ford Hospital. Infect. Dis. Clin. Pract. 7:118.
26. Rohr, U.,, M. Senger,, F. Selenka,, R. Turley,, and M. Wilhelm. 1999. Four years of experience with silver-copper ionization for control of legionella in a German university hospital hot water plumbing system. Clin. Inject. Dis. 29: 15071511.
27. Stout, J. E.,, Y. S. Lin,, A. M. Goetz,, and R. R. Muder. 1998. Controlling Legionella in hospital water systems: experience with the superheat-and-flush method and copper-silver ionization. Inject. Control. Hosp. Epidemiol. 19: 911914.
28. Stout, J. E.,, V. L. Yu,, P. Muraca,, J. Joly,, N. Troup,, and L. S. Tompkins. 1992. Potable water as a cause of sporadic cases of community-acquired legionnaires' disease. N. Engl. J. Med. 326:151155.

Tables

Generic image for table
TABLE 1

Characteristics of 32 hospitals with drinking water-associated Legionnaires' disease outbreaks, 42 control hospitals, and their municipal water suppliers

Citation: Kool J. 2002. Control of in Drinking Water Systems: Impact of Monochloramine, p 411-418. In Marre R, Abu Kwaik Y, Bartlett C, Cianciotto N, Fields B, Frosch M, Hacker J, Lück P (ed), . ASM Press, Washington, DC. doi: 10.1128/9781555817985.ch83

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error