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CDC Legionella toolkit

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ii Foreword Legionnaires' disease is a serious type of pneumonia caused by bacteria, called Legionella, that live in water. Legionella can make people sick when they inhale contaminated water from building water systems that are not adequately maintained. Unfortunately, Legionnaires' disease is on the rise in the United States. To reverse this trend, we are asking for your help to manage the risk of exposure to Legionella from water in your building. Your building may need a water management program to reduce the risk for Legionnaires' disease associated with your building water system and devices. This water management program should identify areas or devices in your building where Legionella might grow or spread to people so that you can reduce that risk. Legionella water management programs are now an industry standard for large buildings in the United States (ASHRAE 188: Legionellosis: Risk Management for Building Water Systems June 26, 2015. ASHRAE: Atlanta). This toolkit will help you develop and implement a water management program to reduce your building's risk for growing and spreading Legionella. If you already have a program, this toolkit will help you assess and strengthen it. Included are practical resources to help you ensure that your water management program is comprehensive, effective, and in line with industry standards. This toolkit also highlights special considerations for healthcare facilities. Because building water systems vary in their design and complexity, examples in this toolkit are only meant to help you understand the process. You should develop a water management program to reduce Legionella growth and spread that is specific to your building. We welcome your feedback on this toolkit by emailing RDB@cdc.gov. For additional information about Legionnaires' disease, visit www.cdc.gov/legionella. This toolkit can also be found online at www.cdc.gov/legionella/WMPtoolkit. Nancy Messonnier, MD, CAPT USPHS Director, National Center for Immunization and Respiratory Diseases U.S. Centers for Disease Control and Prevention Patrick Breysse, PhD Director, National Center for Environmental Health/Agency for Toxic Substances and Disease Registry U.S. Centers for Disease Control and Prevention 2000 2001 2002 2003 2004 2005 2006 2007 2008 2009 2010 2011 2012 2013 2014 Reported cases/100,000 pop Legionnaires' Disease Is On The Rise 2000–2014* * National Notifiable Diseases Surveillance System Year 0 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.8 In the United States, reported cases of Legionnaires' disease have increased by nearly four times since 2000. More illness occurs in the summer and early fall but can happen any time of year.

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