{"id":15237,"date":"2019-08-15T12:11:34","date_gmt":"2019-08-15T10:11:34","guid":{"rendered":"https:\/\/www.kwrwater.nl\/?p=15237"},"modified":"2019-08-19T16:47:57","modified_gmt":"2019-08-19T14:47:57","slug":"us-committee-recommends-strong-legionella-management-measures-comparable-to-those-in-the-netherlands","status":"publish","type":"post","link":"https:\/\/www.kwrwater.nl\/en\/actueel\/us-committee-recommends-strong-legionella-management-measures-comparable-to-those-in-the-netherlands\/","title":{"rendered":"US committee recommends strong Legionella management measures, comparable to those in the Netherlands"},"content":{"rendered":"<div class=\"post_intro\">\n<p>Every year, 52,000 to 70,000 Americans are afflicted by Legionnaires\u2019 disease, a pneumonia caused by certain <em>Legionella<\/em> species. This is the conclusion of a research committee of the National Academy of Sciences, Engineering and Medicine, of which KWR <em>Legionella<\/em> expert, Paul van der Wielen, was also a member. The committee was set up after an increased incidence of the disease was observed between 2012 and 2017. The committee\u2019s report now recommends measures that are very similar to the <em>Legionella<\/em> management measures that are already applied to buildings, drinking water installations and cooling towers in the Netherlands. One point of concern is that the widely used urine antigen test does not detect all types of <em>Legionella<\/em> infections.<\/p>\n<\/div>\n<p><!--more--><\/p>\n<p><img loading=\"lazy\" decoding=\"async\" class=\"alignnone\" src=\"https:\/\/www.kwrwater.nl\/wp-content\/uploads\/2019\/08\/Group-Photo-300x197.jpg\" alt=\"De commissie die het onderzoek naar Legionella heeft uitgevoerd\" width=\"536\" height=\"352\" \/><\/p>\n<p><em>The Legionella research committee<\/em><\/p>\n<p>An expert committee of the prestigious National Academy of Sciences, Engineering and Medicine in the United States today published a report after almost two years of research, in which KWR\u2019s <em>Legionella<\/em> expert, Paul van der Wielen, also participated. Here are some of the highlights:<\/p>\n<ul>\n<li>The report estimates that 52,000 to 70,000 people are afflicted every year by Legionnaires\u2019 disease. This is ten times higher than the reported incidence.<\/li>\n<li>When water contains more than 5 x 104 Colony Forming Units of <em>Legionella<\/em> per litre, this is cause for serious public health concern, and actions need to be taken to reduce these numbers in the water system.<\/li>\n<li>The committee recommends that hot-water heater temperatures in all types of buildings be kept above 60\u00b0C, and the hot-water temperatures to distal points (far from the heaters) in the drinking water installation not be allowed to drop below 55\u00b0C.<\/li>\n<li>The committee recommends mandatory monitoring for <em>Legionella<\/em> in public buildings.<\/li>\n<li>The committee also wants to see mandatory <em>Legionella<\/em> management plans for all public buildings, including hotels, businesses, schools, apartments and government buildings.<br \/>\nCooling towers need to be registered and monitored.<\/li>\n<li>And a new design for cooling towers is required to improve <em>Legionella<\/em> control.<\/li>\n<\/ul>\n<h2>Impetus: increased incidence of Legionnaires\u2019 in US<\/h2>\n<p>The expert committee was set up in 2017, when it became clear that the incidence of Legionnaires\u2019 in the United States had increased sharply between 2012 and 2017: Legionnaires\u2019 disease afflicts more people in the US than all other waterborne diseases, while the country\u2019s Safe Drinking Water Act has no controlling effect on <em>Legionella<\/em>.<\/p>\n<h2>KWR expertise used<\/h2>\n<p>The committee\u2019s mission was to establish an overview of the current scientific knowledge regarding <em>Legionella<\/em>, and to draw on that knowledge to develop recommendations for <em>Legionella<\/em> management in the US. The committee comprised 12 American and Canadian experts, together with KWR <em>Legionella<\/em> expert, Paul van der Wielen, the only non-North American member; Prof. Joan Rose (Michigan State University and <a href=\"https:\/\/www.kwrwater.nl\/en\/actueel\/joan-rose-appointed-kwr-honorary-fellow\/\">KWR Honorary Fellow<\/a>) chaired the committee. Van der Wielen contributed his expertise primarily in the area of microbial ecology, <em>Legionella<\/em> sources and the legal and regulatory frameworks in European countries. KWR has provided advice regarding <em>Legionella<\/em> in the US on other occasions, including in <a href=\"https:\/\/www.kwrwater.nl\/en\/projecten\/kwr-to-advise-the-state-michigan-flint-research-dispute\/\">Flint<\/a>.<\/p>\n<h2>Comparison with the Dutch situation<\/h2>\n<p>The committee\u2019s conclusions are of course aimed at the US. In Europe, by comparison, several measures have already been taken. For instance, <em>Legionella<\/em> threshold limits have already been established here for drinking water and cooling towers. Moreover, the temperature management now being recommended in the US is already in force here, as is the obligation to have a management plan and to monitor <em>Legionella<\/em> in priority buildings. The US recommendations concerning the cooling towers however go further than today\u2019s Dutch policy: here, only cooling towers put into service after 1 January 2010 need to be registered.<\/p>\n<h2>Limited reported incidence of the disease<\/h2>\n<p>The American study also showed that the incidence of Legionnaires\u2019 disease is much higher than the reported cases. The reason for this is that the most frequently used diagnostic test (urine antigen test) only detects<em> L. pneumophila<\/em> serogroup 1, so that cases with <em>L. pneumophila<\/em> serogroup 2-14 are often missed. In addition, the test is only conducted in hospitals, so that only patients with serious symptoms are tested. This aspect is also relevant in Europe where the same test is used, so that here the true of Legionnaires\u2019 Disease incidence is much higher than the reported incidence.<\/p>\n<h2>More information<\/h2>\n<p>The complete report can be found on the <a href=\"http:\/\/dels.nas.edu\/Report\/Management-Legionella-Water-Systems\/25474\">National Academy of Sciences, Engineering and Medicine website<\/a>, where it can be downloaded. The page also offers a link to a short version of the report and the possibility of watching the webinar on the report\u2019s presentation.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Every year, 52,000 to 70,000 Americans are afflicted by Legionnaires\u2019 disease, a pneumonia caused by certain Legionella species. This is the conclusion of a research committee of the National Academy of Sciences, Engineering and Medicine, of which KWR&#8230;<\/p>\n","protected":false},"author":8,"featured_media":15216,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[9],"tags":[],"class_list":["post-15237","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-news","gtag-international","gtag-public-health","gtag-inspection","gtag-cooling-towers","gtag-infectious-diseases","gtag-plant-engineering","gtag-standard-setting","gtag-microbial-activity","gtag-year-review-2019"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v24.2 - https:\/\/yoast.com\/wordpress\/plugins\/seo\/ -->\n<title>US committee recommends strong Legionella management measures, comparable to those in the Netherlands - KWR<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/www.kwrwater.nl\/en\/actueel\/us-committee-recommends-strong-legionella-management-measures-comparable-to-those-in-the-netherlands\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"US committee recommends strong Legionella management measures, comparable to those in the Netherlands - KWR\" \/>\n<meta property=\"og:description\" content=\"Every year, 52,000 to 70,000 Americans are afflicted by Legionnaires\u2019 disease, a pneumonia caused by certain Legionella species. 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