<i>Legionella pneumophila</i> occurrence in reduced-occupancy buildings in 11 cities during the COVID-19 pandemic

Dowdell, Katherine S.; Healy, Hannah Greenwald; Joshi, Sayalee; Grimard-Conea, Marianne; Pitell, Sarah; Song, Yang; Ley, Christian; Kennedy, Lauren C.; Vosloo, Solize; Huo, Linxuan; Haig, Sarah-Jane; Hamilton, Kerry A.; Nelson, Kara L.; Pinto, Ameet; Prévost, Michèle; Proctor, Caitlin R.; Raskin, Lutgarde; Whelton, Andrew J.; Garner, Emily; Pieper, Kelsey J.; Rhoads, William J.

doi:10.1039/d3ew00278k

Cited by 10 publications

(7 citation statements)

References 126 publications

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“…61 Disagreements between Legiolert and DNA-based methods have been reported, particularly for samples with low concentrations of L. pneumophila as measured by Legiolert. 8 The lower limit of detection for Legiolert as compared to our mip qPCR assay might explain the discrepancy in the results. The Legiolert method can detect L. pneumophila concentrations as low as 1.0 MPN/100 mL (10 MPN L −1 ), while our L. pneumophila mip qPCR LOD was determined to be 10 gc mL −1 [10 000 gc L −1 ], accounting for multiple concentration and dilution steps.…”

Section: Resultsmentioning

confidence: 74%

“…64,65 The recovery of the entire microbial community may take longer, 66 and variations in initial concentrations of DWPI, and thus relative risks are likely. 8 Flushing for re-occupancy may serve to strategically limit building occupants' exposure to easily dislodged biofilms and scale. However, if undertaken, it likely needs to occur closely to building occupation to maintain water quality.…”

Section: Resultsmentioning

confidence: 99%

“…The closure of schools, businesses, and other buildings across the United States due to the coronavirus (COVID-19) pandemic resulted in little to no occupancy in many buildings. 1–10 This was concerning because drinking water quality in buildings can deteriorate during periods of stagnation, with the accumulation of heavy metals and bacterial growth causing potential health risks. 10–12 The primary focus of this study was to better understand changes to cold and hot water chemistry and microbiology in a large residential building after extensive periods of stagnation and flushing.…”

Section: Introductionmentioning

confidence: 99%

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Water quality during extended stagnation and flushing in a college residential hall

Angert,

Ley,

et al. 2023

Environ. Sci.: Water Res. Technol.

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Section: Resultsmentioning

confidence: 74%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Water quality during extended stagnation and flushing in a college residential hall

Angert,

Ley,

et al. 2023

Environ. Sci.: Water Res. Technol.

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“…The COVID-19 pandemic brought additional concerns about OPs in building water due to low water use (31). Although most studies focused only on Legionella pneumophila (32–34), one study reported Mycobacterium avium complex up to 10 5 gene copies per liter in stagnant building plumbing water (16).…”

Section: Introductionmentioning

confidence: 99%

Source-to-Tap Investigation of the Occurrence of Nontuberculous Mycobacteria in a Full-Scale Chloraminated Drinking Water System

Dowdell,

Potgieter,

Olsen

et al. 2024

Preprint

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Nontuberculous mycobacteria (NTM) in drinking water are a significant public health concern. However, an incomplete understanding of the factors that influence the occurrence of NTM in drinking water limits our ability to characterize risk and prevent infection. This study sought to evaluate the influence of season and water treatment, distribution, and stagnation on NTM in drinking water. Samples were collected source-to-tap in a full-scale, chloraminated drinking water system approximately monthly from December 2019 to November 2020. NTM were characterized using culture-dependent (plate culture with matrix-assisted laser desorption ionization-time of flight mass spectrometry [MALDI-TOF MS] isolate analysis) and culture-independent methods (quantitative PCR and genome resolved metagenomics). Sampling locations included source waters, three locations within the treatment plant, and five buildings receiving water from the distribution system. Building plumbing samples consisted of first draw, five-minute flush, and full flush cold-water samples. As the study took place during the COVID-19 pandemic, the influence of reduced water usage in three of the five buildings was also investigated. The highest concentrations of NTM source-to-tap were found in the summer first draw building water samples (107gene copies/L), which also had the lowest chloramine concentrations. Flushing was found to be effective for reducing NTM and restoring disinfectant residuals, though flush times necessary to improve water quality varied by building. Clinically-relevant NTM species, includingMycobacterium avium, were recovered via plate culture, with increased occurrence observed in buildings with higher water age. Four of five NTM metagenome-assembled genomes were identified to the species level and matched identified isolates.

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“…The majority (78%) of culture-positive samples had low residual chlorine levels (≤0.1 mg/L). 16 Few case studies illustrated challenges faced in managing Legionella risk during and after the pandemic. Recent reports show that short-term flushing (distal water stagnation for 24 h) reduces Legionella levels, but no significant benefit is seen after distal water stagnation for one month.…”

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confidence: 99%

Resurgence of Legionella: A Post-COVID-19 Concern

Das,

Chaudhry

2024

ACS EST Water

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The COVID-19 pandemic has dealt a heavy blow to every continent globally. Most fatalities during the pandemic were due to subsequent bacterial infections; however, Legionella and SARS-CoV-2 co-infections were relatively rare yet significant. COVID-19 pandemic countermeasures (e.g., social distancing, mask wearing, etc.) appeared to be effective at reducing the occurrence of infections that were transmitted from person to person (e.g., pneumococcal disease). Conversely, these nonpharmaceutical interventions might marginally impact environmentally transmitted pathogens, such as Legionella pneumophila. In addition, it is suggested that COVID-19-associated stagnation may increase the incidence of legionellosis. Herein, we addressed the significant concern of whether Legionella is making a post-COVID-19 comeback. Few post-COVID Legionella studies collectively indicate a spike in Legionella activity associated with extended water stagnations due to the COVID-19 lockdown. In addition, surveillance data from a few countries (e.g., European Union countries) depicted a significant upward trend in the incidence of legionellosis especially after the pandemic restrictions had been eased. In the future, well-planned environmental surveys and global disease surveillance are required to monitor this respiratory pathogen in the post-COVID-19 landscape. Facility managers may develop robust water management programs and continue to adhere to them to detect and remediate Legionella within building water systems.

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Legionella pneumophila occurrence in reduced-occupancy buildings in 11 cities during the COVID-19 pandemic

Abstract: In spring 2020, numerous buildings were closed or operated at reduced occupancies to slow the spread of COVID-19. An unintended consequence of these social distancing measures was a reduction in...

Cited by 10 publications

References 126 publications

Water quality during extended stagnation and flushing in a college residential hall

Water quality during extended stagnation and flushing in a college residential hall

Source-to-Tap Investigation of the Occurrence of Nontuberculous Mycobacteria in a Full-Scale Chloraminated Drinking Water System

Resurgence of Legionella: A Post-COVID-19 Concern

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