Science Books & Films: Book Review
Legionellae Control in Health Care Facilities: A Guide for Minimizing Risk

From Science Books & Films (Nov. 96), American Association for the Advancement of Science.  Reprinted with permission. Reviewed by Zafar M. Iqbal, Toxicology-Cancer, TCCI, Chicago, IL.

C,T*
Those who attended the American Legion's Pennsylvania Chapter convention held in the Bellevue-Stratford Hotel in Philadelphia, July 21-24, 1976, made public health history out of the tragedy that struck some of them (34 deaths and 221 taken ill, including 72 who did not attend the convention, but were in the vicinity).  The illness came to be known as Legionnaires' disease, a mysterious affliction that was later traced to a previously unknown bacterium appropriately named Legionella, which was found in the water system of the hotel building.  This bacterium was believed to have been transmitted largely by inhalation of airborne droplets of contaminated water.  As it turned out, the bacterium was not really new, because it was found in frozen samples from a previously unresolved 1965 incident at a Washington DC, hospital in which 81 inpatients had mysteriously developed pneumonia, with 14 deaths.  In the past 20 years, major scientific and medical advances have been made against Legionnaires' disease.  At least 39 different species of bacteria have since been identified, each with more than one serogroup, and each serogroup with a number of subtypes.  L. pneumophila and one of its serogroups (with at least 50 subtypes) seem responsible for most cases of this disease so far.  Considerable epidemiological evidence is now available, with a lot known about preventive measures necessary to eliminate the very source of the bacterial contamination.  Freije's slim handbook deals with practical preventive measures and safety practices against Legionella, particularly in health care facilities.  Apart from the fact that visitors and inpatients in such facilities may be relatively more susceptible and more at risk than the general population, most of the measures and practices can also be applied to domestic water systems and cooling towers and other facilities.  This book, with health care facilities and professionals in mind, describes how to evaluate the risk of Legionella in a facility and what actions to take to deal with it, from preventive measures (such as collecting water and air samples and initiating decontamination and disinfection procedures) and routine maintenance (using sample logs, etc) to emergency and outbreak response.  The volume contains basic background information on the bacterium and the epidemiology of the disease, as well as clinical concerns, together with adequate documentation (48 references and about 100 bibliographical listings), a number of figures and tables, and even a concise practical handout for physicians, nurses, and those connected with infection control.  One of the four appendices is a detailed "Source Directory," listing contacts for environmental laboratories (in the United States and abroad) for sample analyses, case investigators and disinfection control personnel, tower consultants, suppliers, specialist attorneys, professional societies, and trade associations.  This book offers a practical, "Action-based" approach to one of the more insidious problems that a health care facility could ever face.  The information is presented in a clear and concise manner, and the book is easy to read and follow and has quite a few appropriate references for further reading.  With a usefulness that goes beyond just health care facilities, the book is well worth reading.  I recommend it. 

Ordering information

Add 1 to basket | Buy 1 now

If you do not want to order the book by credit card through our secure online system, you may order by check, purchase order, or credit card (Visa, MC, Amex, or Discover) by telephone, fax, or the postal service. Include shipping of $4 to USA, $6 to Canada, or $12 to all other countries (total per order, no matter how many copies). Please order by telephone if you would like Next-day or 2nd-day air (USA only).  Contact:

HC Information Resources Inc.
Order Center, Room 115
PO Box 2109
Fallbrook CA 92088-2109
USA
Tel: 1-800-801-8050 (USA/CAN) or 1-760-494-3063
Fax: 1-800-290-1967 (USA/CAN) or 1-619-839-3166
hcinfo@hcinfo.com