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Chapter 71 : Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships

Authors: Jaana Kusnetsov1, Marjo Tiittanen1, Silja Mentula2, Hannele Jousimies-Somer2
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Affiliations: 1: Laboratory of Environmental Microbiology, National Public Health Institute (KTL), FIN-70701 Kuopio, Finland; 2: Department of Bacteriology, National Public Health Institute (KTL), FIN-00300 Helsinki, Finland
Content Type: Monograph
Publication Year: 2002

Category: Bacterial Pathogenesis

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Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships, Page 1 of 2

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Abstract:

Water systems contaminated with legionellae cause outbreaks and sporadic cases of . Legionellae are ubiquitous in water systems. In most clinical cases the source of infection can be confirmed only by using typing methods that discriminate between the patient and the environmental isolates. Water samples were analyzed using isolation standard method ISO 11731, completed by additional concentration with centrifugation (6,000 X g, 10 min). The legionella concentrations varied from 5 to 2,000 CFU/liter; the highest concentration was found in the tap water sample. The strains were serogroup 1. The thermophilic heterotrophic bacteria concentration was highest (3.0 X 10 CFU/liter) in the tap water sample that contained the highest legionella counts. The mesophilic bacteria content was the highest in the legionella positive shower sample (5.9 X 10 CFU/liter). The case of the 61-year-old man was detected only by the urinary antigen method. Therefore, conclusive evidence of the source of this particular infection could not be confirmed. Since the incubation time for legionella infection can vary from 2 to 10 days, it is possible that the infection was contracted elsewhere, such as the patient's home.

Citation: Kusnetsov J, Tiittanen M, Mentula S, Jousimies-Somer H. 2002. Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships, p 349-352. 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.ch71
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Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships
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Citation: Kusnetsov J, Tiittanen M, Mentula S, Jousimies-Somer H. 2002. Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships, p 349-352. 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.ch71
/content/10.1128/9781555817985.chap71.fig71-1
FIGURE 1

concentrations (bars) and temperature (dots) in hot water samples taken from (a) circulating water, (b) shower, and (c) tap water before the control procedure.

10.1128/9781555817985/fig71-1_thmb.gif
10.1128/9781555817985/fig71-1.gif
Image of FIGURE 1
FIGURE 1

concentrations (bars) and temperature (dots) in hot water samples taken from (a) circulating water, (b) shower, and (c) tap water before the control procedure.

Citation: Kusnetsov J, Tiittanen M, Mentula S, Jousimies-Somer H. 2002. Hot Water Systems with Low Concentrations of Legionellae May Be a Risk on Cruise Ships, p 349-352. 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.ch71
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References

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1. Finnish Standards Association. 1987. Determination of Available Chlorine in Water. Titrimetricmethod. SFS 3004. Finnish Standards Association SFS, Helsinki, Finland.
2.Health and Safety Executive. 1998. The control of legionellosis in hot and cold water systems. Health and Safety Executive C130 998, United Kingdom.
3.International Organization for Standardization. 1998. Water quality-detection and enumeration of legionella. ISO11731. International Organization for Standardization, Geneva, Switzerland.
4. Jernigan, D.,, J. Hoiman,, M. Cetron,, C. Ge-nese,, P. Nuorti,, B. Fields,, R. Benson,, R. Carter,, P. Edelstein,, I. Guerrero,, S. Paul,, H. Lipman,, and R. Breiman. 1996. Outbreak of legionnaires' disease among cruise ship passangers exposed to a contaminated whirlpool spa. Lancet 347: 494– 499.
5. Ministry of Environment. 1987. Suomen Rakentamismääräyskokoelma D1. RT RakMK-20728. Ministry of Environment, Helsinki, Finland.
6. Nowicki, M.,, N. Bornstein,, B. Jaulhac,, Y. Piemont,, H. Monteil,, and J. Fleurette,. 1993. Rapid detection of legionellae in clinical and environmental samples by polymerase chain reaction, p. 179– 181. In J. M. Barbaree,, R. F. Breiman,, and A. P. Dufour (ed.), Legionella: Current Status and Emerging Perspectives. American Society for Microbiology, Washington, D.C.
7. PHLS Communicable Disease Surveillance Centre on behalf of the European Working Group for Legionella Infections. 2000. Legionnaires' disease, Europe, 1999. Wkly. Epidemiol. Rec. 43: 347– 352.
8. Reasoner, D.,, and E. Geldreich. 1985. A new medium for the enumeration and subculture of bacteria from potable water. Appl. Environ. Microbiol. 46: 1– 7.

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