Legionnaires' disease is a serious, sometimes lethal pneumonia. The name of this illness originated from an outbreak of severe pneumonia among attendees at an American Legion convention in Philadelphia, Pennsylvania, in 1976. The Pennsylvania Department of Health reports one of the highest annual incidence rates by state. Numerous healthcare facilities have reported outbreaks of healthcare-acquired legionnaires' disease, with transmission consistently linked to the hot water distribution system. Preventing healthcare-acquired legionnaires' disease depends upon identifying possible sources where Legionella growth could occur and instituting control measures. Health departments and public agencies have issued infection prevention guidelines to prevent outbreaks. Proactive culturing for Legionella in the hot water distribution system before cases of healthcare-acquired legionnaires' disease are discovered is an evidence-based method of prevention. Superheating and flushing or hyperchlorinating the hot water distribution system are short-term approaches to terminate an outbreak. Long-term systemic water treatment with copper-silver ionization, chlorine dioxide, or monochloramine has also been effective in controlling Legionella.
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