5.1 Water systems may be inspected (see Section 7) and tested (see Section 8) for legionella under three circumstances (1) in the absence of reported legionellosis (see 5.2); (2) when a single legionellosis case has been reported (see 5.3); and (3) when two or more legionellosis cases are reported in a limited time period and geographic region (see 5.4). Following are factors building owners and operators need to understand when considering testing water systems for legionella in the absence of illness (see 5.2) and for single legionellosis cases (see 5.3). Refer also to the CDC 2003 Guidelines for Preventing Health-Care Associated Pneumonia, and the CDC 2000 Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients, and the WHO Legionella and the Prevention of Legionellosis. Detection of legionella in a water system is not sufficient to identify the system as a health hazard. However, failure to detect legionella does not indicate, conclusively, that the bacterium is not present (see 6.2.4) or that the water system may not pose a potential health hazard. Methods to detect legionella vary in sensitivity and specificity (see 6.2), and laboratories vary in their skill and experience in the isolation and identification of legionella. Isolation of apparently identical legionellae from clinical and environmental samples (see 6.2.1, 6.6.2.4, and Section 8) may suggest that a water system was the source of the legionella responsible for a patient's infection (see 5.3.2). However, cases of Legionnaires' disease due to different legionella serogroups or species need not necessarily have different sources of exposure because a system may be contaminated by more than one legionella. Timely inspection, testing, and treatment of possible legionella sources may reduce legal liabilities for facility owners and operators. Refer also to the APHA Public Health Law Manual.
5.2 Environmental Testing for Legionella in the Absence of Illness:
5.2.1 Concerned employers, building owners and operators, facility managers, and others seek to prevent real and potential health hazards, if possible. Water system operators may identify undesirable situations by monitoring routinely for legionella and may be able to implement control measures before the bacterium reaches an amount sufficient to cause human illness (see 6.2.4.2). The CDC 2000 Guidelines for Preventing Opportunistic Infections Among Hematopoietic Stem Cell Transplant Recipients advises that because transplant recipients are at much higher risk for disease and death from legionellosis compared with other hospitalized persons, periodic culturing for legionella in water samples from a center's potable water supply could be regarded as part of an overall strategy for the prevention of Legionnaires' disease in transplant centers and oth......
军团菌病是一种由嗜肺军团菌和相关细菌引起的感染。军团菌病的严重程度从轻度发热(庞蒂亚克热)到一种可能致命的肺炎(军团菌病),可以影响任何人,但主要影响那些由于年龄、疾病、免疫抑制和其他危险因素(如吸烟)而易感的人。军团菌是医院获得性肺炎的重要病原体,尤其是免疫功能低下的患者。军团菌也可引起社区获得性肺炎,住院率高。军团病被认为是旅行相关肺炎的一种主要形式。...
这也是为什么军团菌病的暴发流行往往与建筑物水管有关。由于水压的变化,水龙头、淋浴、涡流浴、泡泡浴、人工喷泉等容易形成气溶胶,从而导致军团菌的传播。可引起呼吸道疾病军团菌可引起急性呼吸道传染病,统称为军团菌病。根据临床表现的不同,军团菌病可以分为军团菌肺炎和庞蒂亚克热。...
1嗜肺军团菌人最易感染的是嗜肺军团菌血清I型,非典型性肺炎常伴随有全身症状,10%的肺炎是由嗜肺军团菌血清I型引起的。在血清学诊断中,间接免疫荧光法是唯一的标准技术。临床上军团菌感染主要有两种表现形:肺炎型和庞蒂亚克热型。前驱症状:乏力、头痛、全身肌肉酸痛,于1~2日内突然发热,可达40℃以上,多呈稽留热。病程早期即可出现多系统受累症状,为本病的突出特点。...
Copyright ©2007-2022 ANTPEDIA, All Rights Reserved
京ICP备07018254号 京公网安备1101085018 电信与信息服务业务经营许可证:京ICP证110310号