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Open AccessArticle

Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels

Department of Clinical Microbiology and Microbial Pathogenesis, School of Medicine, University of Crete, Voutes—Staurakia, 71110 Heraklion, Crete, Greece
Public Health Authority of Heraklion, 71201 Heraklion, Crete, Greece
Regional Laboratory of Public Health, School of Medicine, 71110 Heraklion, Crete, Greece
Author to whom correspondence should be addressed.
These authors contributed equally to this work.
Int. J. Environ. Res. Public Health 2018, 15(4), 598;
Received: 7 February 2018 / Revised: 22 March 2018 / Accepted: 22 March 2018 / Published: 26 March 2018
(This article belongs to the Special Issue Recreational Water Illnesses)
Several Travel-associated Legionnaires’ disease (TALD) cases occur annually in Europe. Except from the most obvious sites (cooling towers and hot water systems), infections can also be associated with recreational, water feature, and garden areas of hotels. This argument is of great interest to better comprehend the colonization and to calculate the risk to human health of these sites. From July 2000–November 2017, the public health authorities of the Island of Crete (Greece) inspected 119 hotels associated with TALD, as reported through the European Legionnaires’ Disease Surveillance Network. Five hundred and eighteen samples were collected from decorative fountain ponds, showers near pools and spas, swimming pools, spa pools, garden sprinklers, drip irrigation systems (reclaimed water) and soil. Of those, 67 (12.93%), originating from 43 (35.83%) hotels, tested positive for Legionella (Legionella pneumophila serogroups 1, 2, 3, 6, 7, 8, 13, 14, 15 and non-pneumophila species (L. anisa, L. erythra, L. taurinensis, L. birminghamensis, L. rubrilucens). A Relative Risk (R.R.) > 1 (p < 0.0001) was calculated for chlorine concentrations of less than 0.2 mg/L (R.R.: 54.78), star classification (<4) (R.R.: 4.75) and absence of Water Safety Plan implementation (R.R.: 3.96). High risk (≥104 CFU/L) was estimated for pool showers (16.42%), garden sprinklers (7.46%) and pool water (5.97%). View Full-Text
Keywords: Legionella; recreational water systems; risk; water safety plan; hotel Legionella; recreational water systems; risk; water safety plan; hotel
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Papadakis, A.; Chochlakis, D.; Sandalakis, V.; Keramarou, M.; Tselentis, Y.; Psaroulaki, A. Legionella spp. Risk Assessment in Recreational and Garden Areas of Hotels. Int. J. Environ. Res. Public Health 2018, 15, 598.

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