Legionella

Legionellosis or Legionnaire's Disease is caused by a waterborne bacterium Legionella that grows best in slow-moving or still, warm water. The primary route of exposure is aerosolization, most commonly from evaporative cooling towers or showerheads. A common source of Legionella in commercial buildings is from poorly placed or maintained evaporative cooling towers, which often release aerosolized water that may enter nearby ventilation intakes. Outbreaks in medical facilities and nursing homes, where patients are immuno-suppressed and immuno-weak, are the most commonly reported cases of Legionellosis. More than one case has involved outdoor fountains in public attractions. The presence of Legionella in commercial building water supplies is highly under-reported, as healthy people require heavy exposure to acquire infection.

Legionella testing typically involves collecting water samples and surface swabs from evaporative cooling basins, shower heads, faucets, and other locations where warm water collects. The samples are then cultured and colony forming units (cfu) of Legionella are quantified as cfu/Liter.
Legionella is a parasite of protazoans such as amoeba, and thus requires conditions suitable for both organisms. The bacterium forms a biofilm which is resistant to chemical and antimicrobial treatments, including chlorine. Remediation for Legionella outbreaks in commercial buildings vary, but often include very hot water flushes (160 °F; 70 °C), sterilization of standing water in evaporative cooling basins, replacement of shower heads, and in some cases flushes of heavy metal salts. Preventative measures include adjusting normal hot water levels to allow for 120°F at the tap, evaluating facility design layout, removing faucet aerators, and periodic testing in suspect areas.