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The 2016 Model Aquatic Health Code (MAHC), Second Edition was released on July 15, 2016 ( MAHC is national guidance that can be voluntarily adopted by state and local jurisdictions to minimize the risk for illness and injury at public aquatic facilities through facility design, construction, operation, maintenance, and management.
2016: MMWR. Morbidity and Mortality Weekly Report
Joao C S Cruz, Sonia I Maffioli, Alice Bernasconi, Cristina Brunati, Eleonora Gaspari, Margherita Sosio, Elizabeth Wellington, Stefano Donadio
A screening program on a limited number of strains belonging to the Actinoallomurus genus yielded a series of new angucyclinones. NMR and MS analyses established that these compounds are characterized by an unusual lactone ring and present up to four halogens per molecule, with one congener representing the first natural product containing a trichloromethyl substitution on an aromatic system. Remarkably, this family of metabolites seems to be produced by phylogenetically distinct Actinoallomurus isolates. Because of the unique structural features and wide distribution among Actinoallomurus, we have designated these angucyclinones as allocyclinones...
May 25, 2016: Journal of Antibiotics
P Borella, A Bargellini, P Marchegiano, E Vecchi, I Marchesi
The waterborne healthcare-associated infections are mainly sustained by Legionella and Pseudomonas spp. Various water factors and plumbing characteristics, and the interaction with other water microorganisms are considered to be predictive of Legionella contamination. It is therefore mandatory to organize plans of surveillance, prevention and control in order to avoid disease appearance in immunosuppressed patients, with higher risk of death. Guidelines for the prevention of Legionnaires' disease have been published, benefiting those who face this problem, but definitive standardized solutions do not exist yet...
March 2016: Annali di Igiene: Medicina Preventiva e di Comunità
K P Luzhetsky, O V Dolgikh, O Yu Ustinova, A M Krivtsov
The study covered genetically determined lipid metabolism disorders due to oral intake of technogenic hyperchlorination drinkable water products. Findings are that overweight and obese children in a main group appeared to have serum chloroform level 2.3 times higher than that in a reference group. In oral intake of hyperchlorination drinkable water products, the study revealed main genes having polymorphism associated with endocrine disorders: overweight and obesity--APOE, PPARG, HTR2A, characterizing antioxidant system state--SOD2 and detoxication--SULTA...
2015: Meditsina Truda i Promyshlennaia Ekologiia
Jennifer L Murphy, Michael J Arrowood, Xin Lu, Michele C Hlavsa, Michael J Beach, Vincent R Hill
Cyanuric acid (CYA) is a chlorine stabilizer used in swimming pools to limit UV degradation of chlorine, thus reducing chlorine use and cost. However, CYA has been shown to decrease the efficacy of chlorine disinfection. In the event of a diarrheal incident, CDC recommends implementing 3-log10 inactivation conditions for Cryptosporidium (CT value = 15 300 mg·min/L) to remediate pools. Currently, CYA's impact on Cryptosporidium inactivation is not fully determined. We investigated the impact of multiple concentrations of CYA on C...
June 16, 2015: Environmental Science & Technology
J R Cope, A Prosser, S Nowicki, M W Roberts, J M Roberts, D Scheer, C Anderson, A Longsworth, C Parsons, D Goldschmidt, S Johnston, H Bishop, L Xiao, V Hill, M Beach, M C Hlavsa
The incidence of recreational water-associated outbreaks in the United States has significantly increased, driven, at least in part, by outbreaks both caused by Cryptosporidium and associated with treated recreational water venues. Because of the parasite's extreme chlorine tolerance, transmission can occur even in well-maintained treated recreational water venues (e.g. pools) and a focal cryptosporidiosis outbreak can evolve into a community-wide outbreak associated with multiple recreational water venues and settings (e...
December 2015: Epidemiology and Infection
Giovanni Battista Orsi, Matteo Vitali, Lucia Marinelli, Veronica Ciorba, Daniela Tufi, Angela Del Cimmuto, Paolo Ursillo, Massimo Fabiani, Susi De Santis, Carmela Protano, Carolina Marzuillo, Maria De Giusti
BACKGROUND: To control the presence of Legionella in an old hospital water system, an integrated strategy of water disinfection-filtration was implemented in the university hospital Umberto I in Rome. METHODS: Due to antiquated buildings, hospital water system design and hospital extension (38 buildings), shock hyperchlorination (sodium hypochlorite, 20-50 ppm of free chlorine at distal points for 1-2 h) followed by continuous hyperchlorination (0.5-1.0 mg/L at distal points) were adopted, and microbiological and chemical monitoring of the water supply was carried out in the university hospital (December 2006-December 2011)...
2014: BMC Infectious Diseases
Jennifer L Murphy, Charles N Haas, Michael J Arrowood, Michele C Hlavsa, Michael J Beach, Vincent R Hill
The ability of chlorine dioxide (ClO2) to achieve 2-log inactivation of Cryptosporidium in drinking water has been documented. No studies have specifically addressed the effects of ClO2 on C. parvum oocyst infectivity in chlorinated recreational water venues (e.g., pools). The aim of this research was to determine the efficacy of ClO2 as an alternative to existing hyperchlorination protocols that are used to achieve a 3-log inactivation of Cryptosporidium in such venues. To obtain a 3-log inactivation of C...
May 20, 2014: Environmental Science & Technology
Haluk Erdoğan, Hande Arslan
Legionnaires' disease (LD) is a systemic infection caused by Legionella species especially colonized in the water systems. Hotels are common locations in which waterwork-associated sporadic or epidemic legionellosis can be detected. The aim of this study was to evaluate a small Legionella outbreak emerged in a recently opened 600-bed hotel in Alanya, a touristic county in Mediterranean part of Turkey. A 66 years old male patient who stayed in this hotel opened on May 15th, 2009, was admitted to our hospital on May 21st, 2009 with the complaints of high fever, headache and diarrhea lasting for three days...
April 2013: Mikrobiyoloji Bülteni
Vincent Chi-Chung Cheng, Samson Sai-Yin Wong, Jonathan Hon-Kwan Chen, Jasper Fuk-Woo Chan, Kelvin Kai-Wang To, Rosana Wing-Shan Poon, Sally Cheuk-Ying Wong, Kwok-Hung Chan, Josepha Wai-Ming Tai, Pak-Leung Ho, Thomas Ho-Fai Tsang, Kwok-Yung Yuen
BACKGROUND: The environmental sources associated with community-acquired or nosocomial legionellosis were not always detectable in the mainland of China and Hong Kong, China. The objective of this study was to illustrate the control measures implemented for nosocomial and community outbreaks of legionellosis, and to understand the environmental distribution of legionella in the water system in Hong Kong, China. METHODS: We investigated the environmental sources of two cases of legionellosis acquired in the hospital and the community by extensive outbreak investigation and sampling of the potable water system using culture and genetic testing at the respective premises...
December 2012: Chinese Medical Journal
L Teare, S Millership
This report describes a risk assessment and subsequent actions following isolation of Legionella pneumophila serogroup 1 in the water supply to a birthing pool during a planned maintenance programme. A literature search for cases of neonatal legionellosis identified 24 reports of cases among babies aged <2 months, two of which were associated with water births. On this basis, the pool was closed until Legionella spp. were undetectable. Control proved difficult as hyperchlorination failed, and a filter fitted to the thermostatic mixer tap supplying the pool slowed filling so much that additional taps were required to achieve a satisfactory flow rate...
September 2012: Journal of Hospital Infection
Margaret M Williams, Tai-Ho Chen, Tim Keane, Nadege Toney, Sean Toney, Catherine R Armbruster, W Ray Butler, Matthew J Arduino
BACKGROUND: Healthcare-associated outbreaks and pseudo-outbreaks of rapidly growing mycobacteria (RGM) are frequently associated with contaminated tap water. A pseudo-outbreak of Mycobacterium chelonae-M. abscessus in patients undergoing bronchoscopy was identified by 2 acute care hospitals. RGM was identified in bronchoscopy specimens of 28 patients, 25 of whom resided in the same skilled nursing facility (SNF). An investigation ruled out bronchoscopy procedures, specimen collection, and scope reprocessing at the hospitals as sources of transmission...
September 2011: Infection Control and Hospital Epidemiology
Yusen E Lin, Janet E Stout, Victor L Yu
Hospital-acquired Legionnaires' disease is directly linked to the presence of Legionella in hospital drinking water. Disinfecting the drinking water system is an effective preventive measure. The efficacy of any disinfection measures should be validated in a stepwise fashion from laboratory assessment to a controlled multiple-hospital evaluation over a prolonged period of time. In this review, we evaluate systemic disinfection methods (copper-silver ionization, chlorine dioxide, monochloramine, ultraviolet light, and hyperchlorination), a focal disinfection method (point-of-use filtration), and short-term disinfection methods in outbreak situations (superheat-and-flush with or without hyperchlorination)...
February 2011: Infection Control and Hospital Epidemiology
I Marchesi, P Marchegiano, A Bargellini, S Cencetti, G Frezza, M Miselli, P Borella
We report our ten-year experience of hyperchlorination, thermal shock, chlorine dioxide, monochloramine, boilers and point-of-use filters for controlling legionella contamination in a hospital hot water distribution system. Shock disinfections were associated with a return to pre-treatment contamination levels within one or two months. We found that chlorine dioxide successfully maintained levels at <100 cfu/L, whilst preliminary experiments gave satisfactory results with monochloramine. No contamination was observed applying point-of-use filters and electric boilers at temperatures of >58°C and no cases of nosocomial legionellosis were detected in the ten-year observation period...
January 2011: Journal of Hospital Infection
Marina Tesauro, Annalisa Bianchi, Michela Consonni, Fabrizio Pregliasco, Maria Gabriella Galli
The aim of this study was to identify the most effective disinfection protocol to reduce the presence of Legionella pneumophila in the water system of two Italian hospitals. From 2004 to 2009, 271 samplings of hot water were carried out in 11 hospital units to detect the presence of L. pneumophila. Additionally, water samples collected from one boiler outlet and the hot water recirculation were tested. From 2004 to 2009, L. pneumophila was present in 37% of the samples. Of these, 68.3% and 18.8% were positive for serogroups 2-14 and 1, respectively...
2010: Annali Dell'Istituto Superiore di Sanità
Joana Costa, Milton S da Costa, António Veríssimo
Traditional geothermally heated therapeutic spas, widely distributed in Europe, use water that is not disinfected. The colonization of therapeutic spas by Legionella spp. has been reported and several outbreaks and sporadic cases of legionellosis have been associated with the use of these facilities. We tested the effectiveness of hyperchlorination and the combination of hyperchlorination and ultraviolet light (UV) disinfection against legionellae which were persistently detected in the water used to supply the therapeutic spa...
January 2010: Research in Microbiology
Joan M Shields, Michael J Arrowood, Vincent R Hill, Michael J Beach
Cyanuric acid is used to stabilize free chlorine to reduce photodegradation in outdoor swimming pools. While there have been numerous studies examining its effect on the disinfection rates of bacteria and viruses, it is not known whether cyanuric acid can significantly impact the effectiveness of hyperchlorination for inactivating Cryptosporidium oocysts present in fecally-contaminated swimming pools. This study examined the effect of cyanuric acid on the disinfection rate of Cryptosporidium parvum under swimming pool hyperchlorination conditions (20 mg/ml free chlorine)...
March 2009: Journal of Water and Health
M T García, B Baladrón, V Gil, M L Tarancon, A Vilasau, A Ibañez, C Elola, C Pelaz
AIMS: To study the persistence of Legionella over time in different disinfected facilities and analysing whether failures in bacterial eradication could be the result of a decrease in the susceptibility of the persistent strains to subsequent treatments. METHODS AND RESULTS: A long-term environmental surveillance was carried out in three different facilities associated with cases of Legionnaires' disease (a hospital, a fishing boat and a hotel). Despite several hyperchlorination episodes, amplified fragment length polymorphism, pulsed field gel electrophoresis-SfiI and arbitrarily primed polymerase chain reaction methods demonstrated that a specific clone of L...
September 2008: Journal of Applied Microbiology
B Casini, P Valentini, A Baggiani, F Torracca, S Frateschi, L Ceccherini Nelli, G Privitera
This paper describes the results of a five-year monitoring programme applied to the water distribution system of the University Hospital of Pisa (Italy). The purpose of the programme was to evaluate the efficacy of an integrated water safety plan in controlling Legionella spp. colonisation of the potable water system. The impact of the safety plan on the ecology of legionella in the water network was evaluated by studying the genetic variability and the chlorine susceptibility of the strains isolated prior to, and throughout, the application of continuous chlorine dioxide treatment...
June 2008: Journal of Hospital Infection
Anna Pianetti, Luigia Sabatini, Barbara Citterio, Elivio Sisti, Lucia Pierfelici, Francesca Bruscolini
The aim of this study was to evaluate the efficacy of copper and silver ions and of free chlorine in different combinations and concentrations (0.4 to 0.8-0.04 to 0.08 mg/l Cu(2+) Ag(+); 0.4 to 0.8-0.04 to 0.08-0.2 mg/l Cu(2+) Ag(+) Cl; 0.4 to 0.8-0.04 to 0.08-2 mg/l Cu(2+) Ag(+) Cl; 0.4 to 0.8-0.04 to 0.08-4 mg/l Cu(2+) Ag(+) Cl; 2-20 mg/l Cl), in inactivating Legionella pneumophila in drinking and distilled water after a contact time of 24-hours. Treatment with chlorine alone at 20 mg/l concentration was found to be the most effective treatment leading to complete killing of bacteria within 4 minutes in all water samples...
January 2008: Igiene e Sanità Pubblica
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