Abstract
Legionella is an environmental pathogen that is responsible for respiratory disease and is a common causative agent of water-related outbreaks. Due to their ability to survive in a broad range of environments, transmission of legionellosis is possible from a variety of sources. Unfortunately, a disproportionate amount of research that is devoted to studying the occurrence of Legionella in environmental reservoirs is aimed toward cooling towers and premise plumbing. As confirmed transmission of Legionella has been linked to many other sources, an over-emphasis on the most common sources may be detrimental to increasing understanding of the spread of legionellosis. This review aims to address this issue by cataloguing studies which have examined the occurrence of Legionella in less commonly investigated environments. By summarizing and discussing reports of Legionella in fresh water, ground water, saltwater, and distribution system drinking water, future environmental and public health researchers will have a resource to aid in investigating these pathogens in relevant sources.
Highlights
Since their discovery as the causative agent of Legionnaire’s disease in 1976 [1], bacteria of the Legionella genus have become a major source of drinking water-related disease outbreaks [2]
Though numerous transmission sources have been implicated in the spread of legionellosis, transmission is thought to occur primarily through the inhalation of cells, commonly via aerosolized water from engineered systems [7]
Despite the known presence of Legionella in a multitude of environments, to date, a large portion of legionellosis epidemiological studies and monitoring programs have been focused on transmission that is linked to premise plumbing or cooling towers [9,10,11,12,13,14]
Summary
Since their discovery as the causative agent of Legionnaire’s disease in 1976 [1], bacteria of the Legionella genus have become a major source of drinking water-related disease outbreaks [2]. Despite the known presence of Legionella in a multitude of environments, to date, a large portion of legionellosis epidemiological studies and monitoring programs have been focused on transmission that is linked to premise plumbing or cooling towers [9,10,11,12,13,14]. As these other reservoirs have lower reported contribution to human disease, it could be inferred that less studied sources of contamination are unimportant from a public health perspective. The information that is provided may prove useful in further investigations on Legionella presence and concentrations in a variety of sources and in the determination of potential public health ramifications due to their occurrence
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