Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Antonios Papadakis, Dimosthenis Chochlakis, Vassilios Sandalakis, Maria Keramarou, Yannis Tselentis and Anna Psaroulaki
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Antonios Papadakis: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Dimosthenis Chochlakis: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Vassilios Sandalakis: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Maria Keramarou: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Yannis Tselentis: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Anna Psaroulaki: Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece

IJERPH, 2018, vol. 15, issue 4, 1-15

Abstract: Several Travel-associated Legionnaires’ disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to better comprehend the colonization and to calculate the risk to human health of these sites. From July 2000–November 2017, the public health authorities of the Island of Crete (Greece) inspected 119 hotels associated with TALD, as reported through the European Legionnaires’ Disease Surveillance Network. Five hundred and eighteen samples were collected from decorative fountain ponds, showers near pools and spas, swimming pools, spa pools, garden sprinklers, drip irrigation systems (reclaimed water) and soil. Of those, 67 (12.93%), originating from 43 (35.83%) hotels, tested positive for Legionella ( Legionella pneumophila serogroups 1, 2, 3, 6, 7, 8, 13, 14, 15 and non-pneumophila species ( L. anisa , L. erythra , L. taurinensis , L. birminghamensis , L. rubrilucens ). A Relative Risk (R.R.) > 1 ( p < 0.0001) was calculated for chlorine concentrations of less than 0.2 mg/L (R.R.: 54.78), star classification (<4) (R.R.: 4.75) and absence of Water Safety Plan implementation (R.R.: 3.96). High risk (≥10 4 CFU/L) was estimated for pool showers (16.42%), garden sprinklers (7.46%) and pool water (5.97%).

Keywords: Legionella; recreational water systems; risk; water safety plan; hotel (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2018
References: View complete reference list from CitEc
Citations: View citations in EconPapers (3)

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