1. Legionella Awareness Phil Land H 2 O Chemicals Ltd 11 May 2011

2. Background American Legion Convention 1976 Philadelphia, Bell Vue Stratford Hotel 182 cases with 29 deaths Discovered by Dr Joseph McDade Bacteria common in water and soil

3. How legionella multiplies Favourable pH & temperature 20 – 45  C Ideal is 37  C (human body) Key nutrients are free iron & L cysteine Biofilm protection Stagnation provides time for multiplication

4. Single Bacteria

5. Facts About Legionnaires’ Disease Between 400-550 cases in the last couple of years Under reporting is believed to occur Legionella Pneumophila accounts for most cases At least 50 other species are known

6. Legionnaires’ disease in residents of England and Wales by category of exposure 1980- 2009 Data from HPA

7. Infection and symptoms Inhalation of bacteria as an aerosol Incubation period 2-10 days Sometimes difficult to diagnose severe pneumonia: dry cough, diarrhoea, vomiting, breathing difficulty, high fever, chills, headache, some become confused or delirious Fatality rate is about 12% Can be treated effectively with antibiotics

8. Legionella colonising Amoeba

9. Susceptibility of Individuals Increasing age Gender Smoking Existing respiratory disease Illness Treatment (dialysis or immunosuppressant drugs)

10. Types of System Cooling systems (if applicable) Domestic water services Hot water systems Cold water systems Spa Baths Other systems

11. Examples of contamination

12. Cold Water Storage Tanks

13. CWST internal contamination

14. Showers

15. Tower Packing

16. Before & After

18. What can you do to control legionella?

19. System of Control Comply with the relevant legislation Follow the ACoP L8 ‘The control of legionella bacetria in water systems’ Carry out Legionella Risk Assessments and review existing ones at least every 2 years Robust monitoring and cleaning programmes Comprehensive, accurate and up to date records

20. Any Questions?