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Legionella: A Key Organism in Water Management

A special issue of Water (ISSN 2073-4441). This special issue belongs to the section "Water and One Health".

Deadline for manuscript submissions: 30 June 2025 | Viewed by 5664

Special Issue Editor


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Guest Editor
Public Health Unit, University of Rome “Foro Italico”, 00135 Rome, Italy
Interests: recreational waters; disinfection; surveillance; monitoring; hygiene; public health; biotechnology; innovation
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Special Issue Information

Dear Colleagues,

Legionella is a key organism in water management, environmental microbiology, and public health. Since the Legionella pneumophila outbreak, occurring in the late Summer 1976 in Philadelphia, advances have been made in this field across the world, involving new methods for improving detection, technologies for disinfection, advances in diagnostic and therapies of Legionnaires’ disease, and also guidelines, recommendations, and official policies. Water contamination and disease epidemiology are related to the urbanization processes and management of water on a global scale. This Special Issue will recognize contributions from different disciplines, reporting advances in water management and public health tools aimed at controlling exposure risks and disease prevention, but also microorganism biology, methods, epidemiological studies, or regulations. People are closely connected to the health of water in buildings on both a local and global scale. The question of different Legionella species and their characteristics or the roles they play in their environment and/or in diseases represent a main focus. A wide range of proposals can be submitted, from Legionella’s role in biofilm and ecological niches to clinical issues with an epidemiological impact. Legionella issues can be addressed through different disciplines including epidemiology, microbiology, chemistry, physics, and engineering, as well as integrating seemingly unrelated ones such as economics, sociology, communication, public health and health systems, management and policies, narrative medicine, or humanities. Synergies between researchers with very different skills and backgrounds are welcome, especially if aiming to bring issues into a One Health dimension, facing water-related topics using an experimental or reviewing approach.

Prof. Dr. Vincenzo Romano Spica
Guest Editor

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Keywords

  • monitoring
  • surveillance
  • water
  • health policy
  • epidemiology
  • disinfection
  • water management
  • water safety plan
  • water in buildings
  • Legionellosis

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Published Papers (3 papers)

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Research

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11 pages, 1663 KiB  
Article
An Innovative Device for the Hot Water Circuit in Hospitals to Save Energy Without Compromising the Safety and Quality of Water: Preliminary Results
by Sara Vincenti, Mario Cesare Nurchis, Federica Boninti, Martina Sapienza, Matteo Raponi, Fabio Pattavina, Carlo Pesaro, Carlo D’Alonzo, Gianfranco Damiani and Patrizia Laurenti
Water 2025, 17(5), 692; https://doi.org/10.3390/w17050692 - 27 Feb 2025
Viewed by 334
Abstract
Legionella colonization of water systems represents a potential hazard for humans within healthcare facilities. It is possible to contain its spread through continuous disinfection systems and the correct management and maintenance of the systems. The hygienic and sanitary quality of the water cannot [...] Read more.
Legionella colonization of water systems represents a potential hazard for humans within healthcare facilities. It is possible to contain its spread through continuous disinfection systems and the correct management and maintenance of the systems. The hygienic and sanitary quality of the water cannot be ignored in an evaluation of the management and energy costs. The Fondazione Policlinico Universitario A. Gemelli IRCCS in Rome has installed the “ME.SI. MR ACS” (MEthod of SavIngs Maximum eneRgy for hot water) device, which allows the system to activate, when necessary, avoiding continuous water recirculation. The objectives of this study are to evaluate the health and hygiene quality of the hospital water network and to evaluate the thermal and electrical energy savings and chlorine dioxide consumption, with and without this device in operation. This study involved three phases of microbiological sampling in the facility under study: ME.SI. MR ACS device installed but not running, with the boilers’ setpoint temperature at 60 °C; device running with the boilers’ setpoint temperature at 60 °C; and device in operation with the boilers’ setpoint temperature at 45 °C. The microbiological analyses were carried out in accordance with the ISO standard. The data show a constant absence of Legionella spp. in all samples. The application of ME.SI. MR ACS on the hot water recirculation circuit leads to a reduction in the daily consumption of electrical and thermal energy of 68.6% and 48.6%, respectively, for a savings of approximately EUR 23,000/year per circuit. Furthermore, with the device in operation, there is a 50% reduction in the chlorine dioxide consumption with a savings of EUR 11,500/year. ME.SI. MR ACS guarantees thermal and electrical energy savings associated with a reduction in chlorine dioxide consumption, maintaining the hygienic and sanitary quality of the water network. Full article
(This article belongs to the Special Issue Legionella: A Key Organism in Water Management)
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24 pages, 2321 KiB  
Article
Legionnaires’ Disease Surveillance and Public Health Policies in Italy: A Mathematical Model for Assessing Prevention Strategies
by Vincenzo Romano Spica, Paola Borella, Agnese Bruno, Cristian Carboni, Martin Exner, Philippe Hartemann, Gianluca Gianfranceschi, Pasqualina Laganà, Antonella Mansi, Maria Teresa Montagna, Osvalda De Giglio, Serena Platania, Caterina Rizzo, Alberto Spotti, Francesca Ubaldi, Matteo Vitali, Paul van der Wielen and Federica Valeriani
Water 2024, 16(15), 2167; https://doi.org/10.3390/w16152167 - 31 Jul 2024
Cited by 1 | Viewed by 2450
Abstract
Legionella is the pathogen that causes Legionnaires’ disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to [...] Read more.
Legionella is the pathogen that causes Legionnaires’ disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to assess the effectiveness and efficiency of different Legionella monitoring and control strategies to inform government requirements to prevent community-acquired Legionnaires’ disease in non-hospital buildings. This simulation model was built using comprehensive data from multiple scientific and field-based sources. It is a tool for estimating the relative economic and human costs of monitoring and control efforts targeting either L. pneumophila or Legionella species and was designed to analyze the potential application of each approach to specific building classes across Italy. The model results consistently showed that targeting L. pneumophila is not only sufficient but preferable in optimizing total cost (direct and economic) for similar human health benefits, even when stress-tested with extreme inputs. This cost–benefit analytical tool allows the user to run different real-life scenarios with a broad range of epidemiological and prevalence assumptions across different geographies in Italy. With appropriate modifications, this tool can be localized and applied to other countries, states, or provinces. Full article
(This article belongs to the Special Issue Legionella: A Key Organism in Water Management)
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Review

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14 pages, 1663 KiB  
Review
The Case for Monitoring for Legionella pneumophila in Drinking Water Distribution Systems
by Mark W. LeChevallier
Water 2025, 17(4), 475; https://doi.org/10.3390/w17040475 - 8 Feb 2025
Viewed by 1130
Abstract
As cases of Legionnaires’ disease increase worldwide, there is uncertainty on whether water management plans should focus on the measurement of Legionella species or specifically on L. pneumophila. This paper makes the case that for public water systems and buildings, the target [...] Read more.
As cases of Legionnaires’ disease increase worldwide, there is uncertainty on whether water management plans should focus on the measurement of Legionella species or specifically on L. pneumophila. This paper makes the case that for public water systems and buildings, the target organism should be L. pneumophila, as it is the overwhelming cause of illness, has simple methods for analysis, and remediation procedures avoid unnecessary costs that produce little public health benefit. A review of 930 outbreaks in the United States from 1973 through 2023 showed that there was no public health justification to require public water systems or public buildings (other than healthcare facilities) to monitor or manage for any other species of Legionella other than L. pneumophila. Full article
(This article belongs to the Special Issue Legionella: A Key Organism in Water Management)
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