Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires' disease in the U.S. However, many infections are not diagnosed or reported, so this number may be higher. More illness is usually found in the summer and early fall, but it can happen any time of year.

Water sampling is an important procedure to be conducted in both private and public buildings. Bacteriological water sampling for Legionella and fecal coliform should be conducted at least quarterly to ensure the water supply is potable and meets with the Canadian Drinking Water Guidelines.

Water sampling is critical to determining whether Legionnaires' disease bacteria (LDB) are present and at what levels. Water sampling for Legionella bacteria should be part of a quality control quality assurance (QA/QC) for all buildings where water supplies are subject to the growth and proliferation of this bacteria.

In public buildings drinking water can become contaminated as a result of cross connections. In facilities that have cooling towers or stagnent water legionella bacteria can survive and become airborne resulting in disease.

Legionella bacteria are associated with two distinct illnesses: Legionnaires' disease, which is characterized by fever, myalgia, cough, pneumonia, and Pontiac fever, a milder illness without pneumonia.

Legionnaires' disease has an incubation period (the time from exposure to the onset of symptoms) of 2 to 10 days. Severity ranges from a mild cough and low fever to rapidly progressive pneumonia, coma, and death. Not all individuals with Legionnaires' disease experience the same symptoms.

Early symptoms include slight fever, headache, aching joints and muscles, lack of energy or tiredness, and loss of appetite.

Sample of Leptospirosis Bacteria

• High fever (102º to 105º F, or 39º to 41º C)
• Cough (dry at first, later producing phlegm)
• Difficulty in breathing or shortness of breath
• Chills
• Chest pain
• Common gastrointestinal symptoms include vomiting, diarrhea

The Centers of Disease Control and Prevention (CDC) first identified Legionella pneumophila in 1977 as the cause of an outbreak of pneumonia that caused 34 deaths at a 1976 American Legion Convention in Philadelphia. L. pneumophila had undoubtedly caused previous pneumonia outbreaks, but the organism's slow growth and special growth requirements prevented earlier discovery. The species of Legionella that have been associated with cases of Legionnaires' disease are called Legionnaires' disease bacteria (LDB).

Other species of Legionella cause legionellosis but L. pneumophila causes the majority of cases.

L. pneumophila is also implicated in wound infections, pericarditis, and endocarditis without the presence of pneumonia.

Water sampling should be carried out as a component of a due diligence in ensuring the publics health. Water sampling should be conducted for both chemical paramaters and biological agents including legionella and E. coli bacteria.

Legionnaires' disease sampling requires a site assessment to determine potential souces which include but are not limited to the following areas within buildings: domestic water heaters, faucets and showers, cooling towers, humidifiers, swamp coolers, and spas, and any location where there is the potential of stagnant water.

Water Sample Analysis Equipment

• Nursing homes and extended care facilities
• Hospitals
• Schools
• Daycares
• Community Care Facilities
• Residential Home Care Facilities
• Pre School Facilities
• Public Facilities
• Cruise Ships
• Busineses
• Grow ops and clandestine lab operations.