Legionnaires' disease outbreak investigation toolbox

Download Page

Examples of environmental sites for sampling for Legionellae provided by [1]

Site

Approximate number of samples

Volume

of samples

General potable water system

Incoming water pipe(s)

2

10 litres

Water softener (pre and post)

2

1 litre

Preheater (discharge side)

1

1 litre

Primary heater (discharge side)

1

1 litre

Circulating pumps

2

1 litre

Holding tanks (cold water, discharge side)

2

1 litre

Expansion tank for hot water

1

1 litre

Back drain on sprinkler system(s)

2

1 litre

Fireline where it branches off main system

1

1 litre

Water used for respiratory therapy equipment

2

≥1 litre

Outlets in patients' rooms

4

1 litre

Air compressor system

Vacuum water source

1

≥100 ml

Positive pressure equipment side

Condensate from tank(s)

3

≥100 ml

Water separator(s) directly off compressors

4

≥100 ml

Water source(s) near air intake(s)

4

≥100 ml

Air samples where patients were ill with legionellosis

3

n.a.

Potable water final distribution outlets

Haemodialysis water source

Before or after demineralizer

1

≥100 ml

Intensive care units

Respiratory therapy (patients' room)

2

1 litre

Cardiac

2

1 litre

Services with different geographical locations

7

1 litre

Icemaker (entry water) and ice 

≥1 litre

Air-conditioning system

Air handling unit serving area where disease occurred

2

≥100 ml

Cooling towers

Return from heat exchanger to water (spray/trough

and gutter) distribution or pond (sump)

2

≥1 litre

Water supply

1

1 litre

Hot tubs

Pool and balance tank (if fitted)

1

1 litre

Jets and pipes

1

swab

Other

Decorative fountain

1

1 litre

Creeks, ponds, sites of stagnant water

4

1 litre

n.a. = not applicable

Source: Adapted from Barbaree et al., 1987



  1. BARTRAM J. (2007) Legionella and the prevention of legionellosis WHO, Geneva ISBN 92 4 156297 http pdf