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Management of Legionella in Water Systems


Washington (DC): National Academies Press (US); .
ISBN-13: 978-0-309-49947-7ISBN-10: 0-309-49947-X

Legionnaires' disease, a pneumonia caused by the Legionella bacterium, is the leading cause of reported waterborne disease outbreaks in the United States. Legionella occur naturally in water from many different environmental sources, but grow rapidly in the warm, stagnant conditions that can be found in engineered water systems such as cooling towers, building plumbing, and hot tubs. Humans are primarily exposed to Legionella through inhalation of contaminated aerosols into the respiratory system. Legionnaires' disease can be fatal, with between 3 and 33 percent of Legionella infections leading to death, and studies show the incidence of Legionnaires' disease in the United States increased five-fold from 2000 to 2017. Management of Legionella in Water Systems reviews the state of science on Legionella contamination of water systems, specifically the ecology and diagnosis. This report explores the process of transmission via water systems, quantification, prevention and control, and policy and training issues that affect the incidence of Legionnaires' disease. It also analyzes existing knowledge gaps and recommends research priorities moving forward.


This activity was supported by the Alfred P. Sloan Foundation under Grant No. G-2016-7288; Centers for Disease Control and Prevention under Contract No. 200-2011-38807, TO# 59; Department of Veterans Affairs under Contract No. VA250-16-C-0012; and Environmental Protection Agency under Contract No. EP-C-14-005, TO#22 and EP-C-14-005/68HE0C18F0876. Any opinions, findings, conclusions, or recommendations expressed in this publication are those of the author(s) and do not necessarily reflect the views of the organizations or agencies that provided support for the project.

Suggested citation:

National Academies of Sciences, Engineering, and Medicine. 2020. Management of Legionella in Water Systems. Washington, DC: The National Academies Press. http://doi.org/10.17226/25474.

Digital Object Identifier: http://doi.org/10.17226/25474

Library of Congress Control Number: 2019954617

Cover credit: Kyoko Kurosawa

Additional copies of this report are available from the National Academies Press, 500 Fifth Street, NW, Keck 360, Washington, DC 20001; (800) 624-6242 or (202) 334-3313; http://www.nap.edu/.

Printed in the United States of America

Copyright 2020 by the National Academy of Sciences. All rights reserved.
Bookshelf ID: NBK555109PMID: 32200596DOI: 10.17226/25474


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