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Legionella Control

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What is Legionnaires Disease?
Where does it come from?
What are the symptoms of Legionnaires Disease?
How is Legionnaires Disease Diagnosed?
Who is most at risk?
What is the Treatment?
What are the Responsibilities of Building Occupiers?
Design and Construction of Water-Cooling Systems
Water Treatment of Water-Cooling Systems
Contractors
Operating and Maintenance Manuals
What are Council’s Responsibilities?
What happens if an outbreak occurs?
Legislation
Fact Sheets in Different Languages

What is Legionnaires Disease?
Legionnaires' disease is an infection of the lung caused by the Legionella bacteria. This bacteria causes a type of pneumonia which can be fatal. It usually takes 2 to 10 days for the symptoms to develop after inhaling the bacteria.

Legionella presents in two forms:
  • Legionella pneumonia (Legionnaires' disease); and
  • A mild flu-like illness (Pontiac fever).

Where does it come from?
Legionella bacteria is found naturally in low levels in the environment. In the absence of effective treatment Legionella can breed to high numbers in water cooling systems (cooling towers), warm water systems or water heaters, shower heads, spa pools or potting mix. The most common way Legionnaires’ disease is contracted is by breathing air contaminated with Legionella. Air is contaminated when aerosols containing Legionella are released. The aerosol needs to be very small so that it can penetrate deeply into the lung.

Legionnaires’ disease is not transmitted from person to person.

What are the symptoms of Legionnaires Disease?
A general feeling of being unwell usually occurs in the first 24 to 48 hours.
Common symptoms include:
  • A sudden high temperature (fever)
  • Stomach cramps and diarrhea
  • Dry cough
  • Aches and pains in the muscles
  • Chills
  • Feeling confused
  • Headaches

Not all of the symptoms need to be present for diagnosis. People with these symptoms should see their doctor immediately.

How is Legionnaires Disease Diagnosed?
Specialised laboratory tests are necessary to establish a definite diagnosis of Legionnaires’ disease. Gram stains can be made from secretions from normally sterile sites such as lung tissue, pleural fluid, trans-tracheal aspirate, bronchial lavage, lung biopsy, or sputum from the lower respiratory tract.

Who is most at risk?
  • older people, with existing health problems such as a respiratory disease.
  • people who are taking drugs which suppress the immune system, e.g. liver or kidney transplant patients.
  • heavy smokers and heavy drinkers.

What is the Treatment?
Treatment is with an antibiotic. For those people with serious symptoms such as severe difficulty in breathing and respiratory failure, admission to hospital may be required.

Time of treatment can vary, but normal expected time is 10 to 14 days. Rehabilitation therapy may be needed.

Note: Legionnaires’ disease is a notifiable disease under the Public Health Act.

What are the Responsibilities of Building Occupiers?
The proper installation, maintenance and cleaning of systems is a legal requirement under the Public Health Act and Microbial Control Regulation. Building occupiers who fail to meet these requirements are liable to heavy fines or even imprisonment. Systems can be inspected at any time.

Design and Construction of Water-Cooling Systems
Location of air intakes should be carefully planned. They should be placed well away from exhaust discharges and cooling-towers to avoid cross-contamination. They should also be away from pedestrian areas.

All air intakes should be above the ground to make sure that dust, rain and small animals don’t get into them.

Ductwork should be graded to prevent water collection and should be thoroughly cleaned before the system begins operating.

Installation of the system must he reported to local government authorities, so that a local register of systems can be kept up to date.

Water Treatment of Water-Cooling Systems
All water-cooling systems may be operated only if they are equipped with a process of disinfection certified by a competent person and only if the process is in continuous operation.

Contractors
Only competent contractors should be engaged to install, operate and maintain regulated systems. The Department of Fair Trading licenses contractors who undertake this work.

Operating and Maintenance Manuals
All regulated systems are required to be equipped with an operating and maintenance manual. The manuals must include all details of inspections and servicing performed. Manuals and records must be kept on site and be available for inspection by an authorised officer on demand.

What are Council’s Responsibilities?
Local councils are required to keep a register of water-cooling and warm-water systems installed on premises in their area. It is your responsibility to ensure that the council is provided with the necessary information.

What happens if an outbreak occurs?
The Legionnaires’ Disease Emergency Management Plan prepared by the NSW Health Department will be put into action if an outbreak occurs. You may be required to submit a water sample to an Environmental Health Officer from the Department, or local council, or alternatively, such authorised officer may take a water sample for scientific analysis.

Legislation
DOC Public Health Act 1991, Part 4, Microbial Control
DOC Public Health (Microbial Control) Regulation 2000
PDF Public Health (Microbial Control) Amendment (Miscellaneous) Regulation 2003
PDF Code of Practice for the Control of Legionnaire’s Disease

Fact Sheets Translated in Different Languages
PDF Arabic
PDF Chinese



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