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- Legionella is a type of bacteria that can't be seen with a regular microscope, are rod-shaped, and stain pink or red under a microscope. (“Gram-negative”). It needs oxygen to survive ("aerobic") and lives inside other cells ("intracellular"). There are many different types of this bacteria, called "serogroups" – over 15 in total.
- You can find Legionella bacteria in freshwater like lakes and rivers. They often live inside tiny single-celled organisms called "protozoa." This is where they hang out and multiply.
- Legionella bacteria can stick together with other bacteria to form "biofilms." These are like slimy layers that protect the bacteria. Biofilms make it hard to kill Legionella with antibiotics, chlorine (like in swimming pools), or even high temperatures.

Legionella lives in many natural water sources like lakes, streams and rivers.
When we take water from these places to use in our homes and buildings, Legionella can sometimes come along with it.
Even if your water is treated, it might not completely get rid of Legionella. While public water utilities must provide safe drinking water; tap water is not sterile, meaning it might have germs in it. Small amounts of this bacteria can slip through the system and end up in your pipes.

When nearby construction (jackhammering) and problems like breaks, leaks or flooding damage the pipes, dirt and bacteria/germs can also get into the water




Legionella grows best in water that is warm, between 68- and 122-°F.
When the water is too hot or too cold, the bacteria cannot grow as well.
However, many buildings keep their water at just the right temperature for Legionella to thrive.
This can lead to the bacteria growing in your pipes and coming out of faucets, showerheads and other water outlets.




When water from these places turns into tiny droplets or mist, it can carry Legionella germs. If you breathe in (inhale) these droplets, you might get sick.
- The main way people get infected with Legionella is by breathing in tiny water droplets that contain the bacteria. These droplets can come from things like mist from power washers, fountains, hot tubs, or showerheads.
- Once inside the body, the bacteria are eaten by special cells called "macrophages." These cells are supposed to kill bacteria, but Legionella is tricky. It can create a protective shell around itself inside the macrophage, which protects it from being destroyed. (1)
While most healthy people won't get sick from it, Legionella can cause serious illness for people over 50, with lung issues, or conditions that weaken the immune system. Legionellosis, the illness caused by legionella, can lead to pneumonia, and has a 10-25 percent fatality rate for those who are affected.

Graphic of the human body with arrows to locations of symptoms of legionellosis.
Signs and Symptoms of Legionellosis:
- Flu-like illness: Cough, high fever, muscle aches, tiredness, headache and malaise
- Respiratory symptoms: Shortness of breath, chest pain and chest discomfort
- Gastrointestinal symptoms: Diarrhea, nausea and vomiting
- Mental changes: Confusion, disorientation and balance problems
- Other symptoms: Excessive sweating, loss of appetite and stomach pain
To learn more visit: https://www.cdc.gov/drinking-water/prevention/preventing-waterborne-germs-at-home.html
Laws and Regulations:
https://ltc.health.mo.gov/archives/13387
https://health.mo.gov/Legionella.pdf
What Can I Do?


- WICRA: Water Infection Control Risk Assessment:
- Completed
- Accurate
- Updated regularly
- Flow Diagram: How does the water flow in your building?
- Incoming
- Heaters
- Recirculation pumps
- Tempering valves
- Sanitary Sewer
- Policies and Procedures: What are you doing for water management?
- Control Limits and Ranges:
- Temperature Range
- Disinfectant parameters
- Flushing protocols
- Water Quality Data:
- Legionella Testing
- Disinfectant parameters
- Temperatures
- Corrective Action Documentation:
- What did you do to correct:
- Low temperature
- Inadequate disinfectant levels?
- Work orders for Water Systems Maintenance:
- Ice machines
- Hot water Heaters
- Water fixtures
- Plumbing repairs
- Water disruptive activities
- Meeting: Annually and as needed.
