Legionnaires Testing Requirements

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In cases of suspected or confirmed Legionnaires’ disease, the preferred diagnostic tests are culture of lower respiratory secretions (sputum or bronchoalveolar lavage) on selective media and the Legionella urinary antigen test. These tests can detect the presence of legionnaires testing requirements in a patient for days to weeks after recovery from an episode of Legionellosis. A position statement from the Council of State and Territorial Epidemiologists recommends that laboratory personnel not reject lower respiratory specimens during a work-up for Legionnaires’ disease based on quality issues such as low white blood cell count or contamination with other microorganisms.

Hospitals and other healthcare settings have special requirements to prevent Legionella growth in potable water systems. These include VHA MD-15161 standards for hematopoietic stem cell transplant and solid organ transplant patients, New York City and State regulations for hospitals with cooling towers, and other requirements for monitoring and control in certain facilities.

Meeting Legionnaires Testing Requirements: Ensuring Compliance and Safety

Many VHA facilities also require a risk assessment for the building’s water system based on risk factors, the presence of building units associated with higher risks (e.g., transplant units), and past cases of healthcare-associated legionellosis. The assessment includes a schematic of the hot and cold water systems in the facility, an analysis of the risk and hazards associated with each, and an evaluation of the effectiveness of controls.

Many VHA buildings have complex plumbing and design that make it difficult to manage the controls that are required to reduce the likelihood of Legionella growth in premise water systems. In these cases, it is best to hire a professional who can handle all aspects of the assessment and testing for the building.

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