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

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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
    Public Health Authority of Heraklion, 71201 Heraklion, Crete, Greece
    These authors contributed equally to this work.)

  • Dimosthenis Chochlakis

    (Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
    Regional Laboratory of Public Health, School of Medicine, 71110 Heraklion, Crete, Greece
    These authors contributed equally to this work.)

  • 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
    Regional Laboratory of Public Health, School of Medicine, 71110 Heraklion, Crete, Greece)

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%).

Suggested Citation

  • Antonios Papadakis & Dimosthenis Chochlakis & Vassilios Sandalakis & Maria Keramarou & Yannis Tselentis & Anna Psaroulaki, 2018. "Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels," IJERPH, MDPI, vol. 15(4), pages 1-15, March.
    • Handle: RePEc:gam:jijerp:v:15:y:2018:i:4:p:598-:d:138094
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    Citations

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    Cited by:

    1. Annalisa Lombardi & Tonia Borriello & Elvira De Rosa & Fabiana Di Duca & Michele Sorrentino & Ida Torre & Paolo Montuori & Ugo Trama & Francesca Pennino, 2023. "Environmental Monitoring of Legionella in Hospitals in the Campania Region: A 5-Year Study," IJERPH, MDPI, vol. 20(8), pages 1-17, April.
    2. Luna Girolamini & Silvano Salaris & Jessica Lizzadro & Marta Mazzotta & Maria Rosaria Pascale & Tiziana Pellati & Sandra Cristino, 2020. "How Molecular Typing Can Support Legionella Environmental Surveillance in Hot Water Distribution Systems: A Hospital Experience," IJERPH, MDPI, vol. 17(22), pages 1-17, November.

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