I need your advice. My condominium association has received a proposal from a company to check our water for Legionella on a quarterly basis. As far as I know, we have had no cases. My inclination is to say no, but I want to consult an expert.
The brief answer to your query is don’t culture buildings unless the building houses a high risk group of individuals (chronic lung disease, immunosuppressive illnesses, illnesses requiring chemotherapy/transplant rejection meds/corticosteroids).
The rationale is:
- Miniscule attack rate. Please see the article by Pedro-Botet on Coming of the 3rd Plague. We do recommend that convalescent care facilities housing a notable number of debilitated patients culture their water supply once a year. See Seenivisan, J Amer Geriatrics Society 2005
- Maintenance measures directed at water supplies colonized with legionella are not evidence-based; in fact data from our lab shows that virtually all recommendations involving maintenance do not affect Legionella colonization.
So, what should the residents of your condominium association do to prevent Legionella infection?
1) Smokers should quit smoking.
2) High risk groups should not drink tap water. Tap water should be boiled, then cooled and refrigerated for drinking for high-risk patients. See Singh, Transplant Infect Dis 2004