Legionella : state of the art 30 years after its recognition State of the Art 30 Years after Its Recognition

The newest Legionella volume is a summary of the most current research and investigation in the field. Orginally presented in Chicago at the 6th International Conference on Legionella, the contributions included are written by experts and cover all aspects of this organism. This book is a comprehensive reference source, offering 131 chapters that are divided into four general subject areas for easy use. The four sections cover clinical and diagnostic information, epidemiology, basic microbiology and pathogenesis, and environmental detection and control. All chapters are appropriately referenced and incorporate both extensive reviews and smaller research reports.

Table of Contents I. Clinical and Diagnostic Aspects of Legionnaires’ Disease 1. Clinical Features of Legionnaires’ Disease: a Selective Review, Paul H. Edelstein 2. Treatment of Legionnaires’ Disease, Jorge Roig and Jordi Rello 3. Diagnostics and Clinical Disease Treatment: Usefulness of Microbiological Diagnostic Methods for Detection of Legionella Infections, Paul Christian Lück, Jürgen Herbert Helbig, Heike von Baum, and Reinhard Marre 4. Hospital and Community-Acquired Legionella Pneumonia: Two Faces of the Same Disease? M. L. Pedro-Botet, L. Mateu, N. Sopena, S. Roure, I. Casas, M. García-Núñez, C. Rey-Joly, and M. Sabrià 5. Risk Factors for Mortality by Legionnaires’ Disease (1983-2005), N. Sopena, M. L. Pedro-Botet, L. Mateu, S. Roure, I. Casas, M. Esteve, S. Ragull, C. Rey-Joly, and M. Sabrià 6. Trends Observed in Legionnaires’ Disease in a Hospital in Catalonia, Spain, 1983 – 2005, I. Casas, M. L. Pedro-Botet, N. Sopena, M. Esteve, L. Mateu, S. Roure, M. García-Núñez, C. Rey-Joly, and M. Sabrià 7. Community-Acquired Pneumonia in Human Immunodefiency Virus Infected Patients: Comparative Study of Streptococcus pneumoniae and Legionella pneumophila Serogroup 1, M. L. Pedro-Botet, N. Sopena, A. García-Cruz, L. Mateu, S. Roure, M. J. Dominguez, I. Sanchez, C. Rey-Joly, and M. Sabrià 8. Nosocomial Legionella Infection in the County of Copenhagen, 2000 – 2004, Jette M. Bangsborg, Jens Otto Jarløv, and Søren A. Uldum 9. A Question of Time: a Short Review of Data on the Incubation Period between Exposure and Symptom Onset for Legionnaires’ Disease, Thomas W. Armstrong 10. Severe Legionnaires’ Disease Successfully Treated with Levofloxacin and Azithromycin, M. L. Pedro-Botet, N. Sopena, C. Tural, A. García-Cruz, L. Mateu, S. Ragull, M. García-Núñez, S. Roure, C. Rey-Joly, and M. Sabrià 11. In Vitro Activities of Various Antibiotics against Legionella pneumophila, A. Seher Birteksöz, Z. Zeybek, and Aysin Çotuk 12. Detection of Legionella pneumophila DNA in Serum Samples from Patients with Legionnaires’ Disease, Bram M. W. Diederen, Caroline M. A. de Jong, Faïcal Marmouk, Jan A. J. W. Kluytmans, Marcel F. Peeters, and Anneke van der Zee 13. Specific Detection of Legionella in Samples from Patients with Community-Acquired Pneumonia by PCR and a Colorimetric Detection System (Reverse Dot Blot), Jörn Kircher, Alexander Kirchhoff, and Arndt Rolfs 14. Transcription-Mediated Amplification Assay for Detection of Legionella pneumophila in Samples from Patients with Community-Acquired Pneumonia, Marie K. Hudspeth, Kathleen Clark-Dickey, Elizabeth M. Marlowe, Laura G. Schindler, Karen Campbell, and James T. Summersgill 15. Detection of Legionella spp. and Legionella pneumophila-Specific DNA in Respiratory Secretions by PCR-Enzyme-Linked Immunosorbent Assay, Diane S. J. Lindsay, William H. Abraham, Alistair W. Brown, and Giles F. S. Edwards 16. Serological versus Sequence-Based Methods for Legionella Identification, Beatriz Baladrón, Virginia Gil, and Carmen Pelaz 17. Serologic Study of an Outbreak of Legionnaires’ Disease: Variation of Sensitivity Associated with the Subgroup of Legionella pneumophila sg1 Antigen Used and Evidence of Concurrent Reactivity to Other Atypical Pneumonia Agents, Sverker Bernander, Berndt E. B. Claesson, Eva Hjelm, Nils Svensson, and Martin Hjorth 18. Serotyping of Legionella pneumophila in Epidemiological Investigations: Limitations and Ways Out for Being a Helpful Tool in the Era of Genotyping, Jürgen H. Helbig and Paul Christian Lück 19. Duopath Legionella: a New Immunochromatographic Test for Simultaneous Identification of Legionella pneumophila and Legionella Species, Jürgen H. Helbig, Paul Christian Lück, Britta Kunz, and Andreas Bubert 20. Antigenic Diversity among Legionella Species of a 19-Kilodalton Peptidoglycan-Associated Lipoprotein Determined by Reactivity Patterns to Monoclonal Antibodies, Jin Hee Moon, Jin Ah Yang, Hee Sun Sim, Dae Won Park, Jang Wook Sohn, Hae Kyung Lee, Mi Yeon Park, and Min Ja Kim 21. Evaluation of a New Rapid Immunochromatographic Test using Peptidoglycan-Associated Lipoprotein for Detection of Legionella Antigen in Urine Samples from Adults with Pneumonia, Jang Wook Sohn, Hee Sun Sim, Hye Won Jeong, Dae Won Park, Hee Jin Cheong, Woo Ju Kim, Sun Ae Kim, Young Sik Cho, and Min Ja Kim 22. Rapid Identification of Legionella pneumophila, Legionella anisa, and Legionella taurinensis with Latex Agglutination Reagents, Monique Reyrolle, C. Ratat, J. Freney, M. Leportier, S. Jarraud, and J. Etienne 23. Clinical Presentation, Laboratory Diagnosis, and Treatment of Legionnaires’ Disease, David R. Murdoch, Thomas J. Marrie, and Paul H. Edelstein II. Epidemiology and Strain Typing Methods 24. Legionnaires’ Disease in Europe 1995 – 2004: a Ten-Year Review, Carol Joseph and Kate D. Ricketts 25. Typing of Legionella pneumophila and Its Role in Elucidating the Epidemiology of Legionnaires’ Disease, Timothy G. Harrison, Norman K. Fry, Baharak Afshar, William Bellamy, Nita Doshi, and Anthony Underwood 26. Effect of Legionella Testing Patterns on the Apparent Epidemiology of Legionnaires’ Disease in Australia, Graham Tallis, Agnes Tan, and Norbert Ryan 27. 25 Years of Surveillance for Legionnaires’ Disease in England and Wales: Why No Improvement? K. D. Ricketts, C. A. Joseph, T. G. Harrison, J. V. Lee, and F. C. Naik 28. Epidemiological Surveillance of Seropositive Legionellosis Cases in Korea During 1999 – 2002, Hae Kyung Lee, Soo Jin Baek, Yong In Ju, Jae June Bae, Man Suck Park, and Mi-Yeoun Park 29. Prevalence of Legionnaires’ Disease and Investigation of Risk Factors: Results of an Italian Multicentric Study, Paola Borella, Stefania Boccia, Erica Leoni, Franca Zanetti, Isabella Marchesi, Annalisa Bargellini, Maria Teresa Montagna, Daniela Tatò, Sara Montegrosso, Francesca Pennino, Vincenzo Romano-Spica, Giovanna Stancanelli, and Stefania Scaltriti 30. Seroprevalence of Antibodies to Legionella pneumophila in Northern Italy, R. Cosentina, S. Malandrin, P. Valentini, E. Sfreddo, L. Pirrotta, O. Mercuri, and O. Di Marino 31. A Seroepidemiological Study of Legionella pneumophila Antibodies in Spanish Patients: A 13-Year Retrospective Study, Sebastian Crespi, Albert Torrents, and Miguel A. Castellanos 32. Risk Differences of Legionnaires’ Disease Associated with Travel in Spain, 1999 to 2004, Ricardo Casas, Rosa Cano, Carmen Martin, and Salvador Mateo 33. Persistence and Genotypic Stability of Legionella in a Potable Water System in a Hotel over a 20-Month Period, M. García-Núñez, J. Ferrer, S. Ragull, E. Junyent, E. Sagrista, A. Soler, I. Sanchez, M. L. Pedro-Botet, N. Sopena, and M. Sabria 34. 10 Years of Legionella Surveillance: Change of Legionella Subtype Preceded Epidemic of Nosocomial Legionnaires’ Disease, Klaus Weist, Christian Brandt, Christian Lück, Jutta Wagner, Tim Eckmanns, and Henning Rüden 35. Representative Survey of the Scope of Legionnaires’ Disease and of Diagnostic Methods and Transmission Control Practices in Germany, Tim Eckmanns, Mona Poorbiazar, Henning Rüden, and Lüder Fritz 36. Distribution of Legionella pneumophila Genotypes in Patients and Environmental Sources, Ed P. F. Yzerman, Jacob P. Bruin, Jeroen W. den Boer, Linda P. Verhoef, and Kim W. van der Zwaluw 37. Molecular Comparison of Isolates from a Recurring Outbreak of Legionnaires’ Disease Spanning 22 Years, Robert F. Benson, Claressa E. Lucas, Ellen W. Brown, Karen D. Cowgill, and Barry S. Fields 38. Sequence-Based Typing of Legionella pneumophila as an Aid in Investigation of Hospital-Acquired Legionnaires’ Disease, Faiz Fendukly and Sverker Bernander 39. Legionnaires’ Disease Associated with Death after Near Drowning in Lake Water, Jaana Kusnetsov, Satu Pastila, Silja Mentula, and Diane Lindsay 40. Is Use of Potting Mix Associated with Legionella longbeachae Infection? Results from a Case Control Study in South Australia, Bridget O’Connor, Judy Carman, Kerena Eckert, and Graeme Tucker 41. Epidemiological Typing of Legionella pneumophila in the Absence of Isolates, Norman K. Fry, Baharak Afshar, Timothy G. Harrison, and Günther Wewalka 42. Online Identification of Legionella Species by DNA Sequence Analysis: the Macrophage Infectivity Potentiator Gene as an Example, Norman K. Fry, Baharak Afshar, William Bellamy, Anthony Underwood, Timothy Harrison, and Rodney M. Ratcliff 43. Pulsed-Field Gel Electrophoresis Analysis and Sequence-Based Typing of Legionella pneumophila Serogroup 1 Isolates from Japan, Junko Amemura-Maekawa, Fumiaki Kura, Bin Chang, and Haruo Watanabe 44. Development of an Online Tool for European Working Group for Legionella Infections Sequence-Based Typing Including Automatic Quality Assessment and Data Submission, Anthony P. Underwood, William Bellamy, Baharak Afshar, Norman K. Fry, and Timothy G. Harrison III. Microbiology, Pathogenesis, Immunology, and Genetics 45. Identification of Translocated Substrates of the Legionella pneumophila Dot/Icm System without the use of Eukaryotic Host Cells, Ralph R. Isberg and Matthias Machner 46. Function of Legionella Effectors, Howard A. Shuman, Christopher Pericone, Nadim Shohdy, Karim Suwwan de Felipe, and Margaret Clarke 47. The Legionella pneumophila Dot/Icm Type IV Secretion System, Carr D. Vincent, Kwang Cheol Jeong, Jessica Sexton, Emily Buford, and Joseph P. Vogel 48. Subcellular Localization of the Dot/Icm Type IV Secretion Proteins, Kwang Cheol Jeong, Carr D. Vincent, Emily Buford, and Joseph P. Vogel 49. Defining the Translocation Pathway of the Legionella pneumophila Type IV Secretion System, Carr D. Vincent, Jonathan R. Friedman, and Joseph P. Vogel 50. Loss of a Patatin-Like Phospholipase A Causes Reduced Infectivity of Legionella pneumophila in Amoeba and Macrophage Infection Models, Philipp Aurass, Sangeeta Banerji, and Antje Flieger 51. Identification of a Cytotoxic Legionella pneumophila lpxb Paralogue in a Multicopy Suppressor Screen using Acanthamoeba castellanii as a Selective Host, Urs Albers, Katrin Reus, and Hubert Hilbi 52. Type II Protein Secretion and Twin-Arginine Translocation Promote the Pathogenesis of Legionella pneumophila, Ombeline Rossier and Nicholas P. Cianciotto 53. The Type II Protein Secretion System of Legionella pneumophila Is Important for Growth in Iron-Rich Media and Survival in Tap Water at Low Temperatures, Maria A. Söderberg and Nicholas P. Cianciotto 54. Identification of Putative Substrates of the Legionella pneumophila Tat Secretion Pathway via Two-Dimensional Protein Gel Electrophoresis, E. De Buck, L. Maes, J. Robben, J.-P. Noben, J. Anné, and Elke Lammertyn 55. Identification of Target Proteins of the Lss Secretion System of Legionella pneumophila Corby, Klaus Heuner, Christiane Albert, Sebastian Jacobi, Emmy De Buck, and Elke Lammertyn 56. Legionella pneumophila Mip: New Function for an Old Protein? Sruti DebRoy and Nicholas P. Cianciotto 57. Phospholipases A of Legionella pneumophila: Virulence Factors by Diversity? Antje Flieger 58. Identification and Characterization of Legionella pneumophila Phospholipases A , Sangeeta Banerji, Margret Müeller, Stefan Stevanovic, and Antje Flieger 59. Characterization of GDSL-Hydrolases of the Lung Pathogen Legionella pneumophila, Sangeeta Banerji, Elena Rastew, Björn Hermes, and Antje Flieger 60. Genetic and Structural Examination of the Legiobactin Siderophore, Kimberly A. Allard, Domenic Castignetti, David Crumrine, Prakash Sanjeevaiah, and Nicholas P. Cianciotto 61. Eukaryotic-Like Proteins of Legionella pneumophila as Potential Virulence Factors, Fiona M. Sansom, Hayley J. Newton, and Elizabeth L. Hartland 62. Role of Legionella pneumophila-Specific Genes in Pathogenesis, Hayley J. Newton, Fiona M. Sansom, Elizabeth L. Hartland, and Vicki Bennett-Wood 63. The Hsp60 Chaperonin of Legionella pneumophila: an Intriguing Player in Infection of Host Cells, Audrey Chong, Angela Riveroll, David S. Allan, Elizabeth Garduño, and Raphael A. Garduño 64. Lipopolysaccharide Architecture of Legionella pneumophila Growth in Broth and Host Cells, Jürgen H. Helbig, Esteban Fernandez-Moreira, Enno Jacobs, Paul Christian Lück, and Martin Witt 65. Lag-1 Acetylation of Lipopolysaccharide, Natalie N. Whitfield and Michele S. Swanson 66. Immunochemical Analysis of Legionella pneumophila Outer Membrane Vesicles, Jürgen H. Helbig, Esteban Fernandez-Moreira, P. Christian Lück, Enno Jacobs, and Michele S. Swanson 67. Contribution of Legionella’s Surface to the Pregnant Pause Virulence Strategy,Esteban Fernandez-Moreira, Jürgen H. Helbig, and Michele S. Swanson 68. New Insights into Pathogenesis of Legionella pneumophila Infection: from Bedside Findings to Animal Models, Kazuhiro Tateda, Soichiro Kimura, Estu T. Fuse, and Keizo Yamaguchi 69. Induction of Apoptosis during Intracellular Replication of Legionella pneumophila in the Lungs of Mice, M. Santic, M. Molmeret, S. Jones, R. Asare, A. Abu-Zant, M. Doric, and Y. Abu Kwaik 70. The Role of the Phagosomal Transporter (Pht) Family of Proteins in Legionella pneumophila Pathogenesis, John-Demian Sauer and Michele S. Swanson 71. A Role for Phosphoinositide Metabolism in Phagocytosis and Intracellular Replication of Legionella pneumophila, Stefan S. Weber, Curdin Ragaz, Katrin Reus, and Hubert Hilbi 72. Interaction with the Ciliate Tetrahymena sp. May Predispose Legionella pneumophila to Infect Human Cells, Elizabeth Garduño, Gary Faulkner, Marco A. Ortiz-Jimenez, Sharon G. Berk, and Rafael A. Garduño 73. Genetics of Mouse Macrophage Resistance to Legionella pneumophila, Russell E. Vance, Tao Ren, Dario S. Zamboni, Craig R. Roy, William F. Dietrich 74. Role of Birc 1/Naip 5 in Macrophage Function and Susceptibility to Infection with Legionella pneumophila, Anne Fortier and Philippe Gros 75. Locus on Chromosome 13 in Mice Involved in Clearance of Legionella pneumophila from the Lungs, Seiji Kobayashi, Fumiaki Kura, Junko Amemura-Maekawa, Bin Chang, Naoki Yamamoto, and Haruo Watanabe 76. Inflammatory Immune Response to Cytosolic Flagellin Protects Mice from Legionella pneumophila Infection, Michele S. Swanson, Brenda G. Byrne, Natalie W. Whitfield, Etsu T. Fuse, Kazuhiro Tateda, and Ari B. Molofsky 77. A Peptidoglycan-Associated Lipoprotein of Legionella pneumophila Activates Toll-Like Receptor 2 in Murine Macrophages, Mi Jeong Kim, In Kyeong Lee, Jin Ah Yang, Hee Sun Sim, Jang Wook Sohn, and Min Ja Kim 78. Legionella Infection of Bone Marrow Dendritic Cells Induces Modulation by Catechins, James Rogers, Izabella Perkins, Alberto van Olphen, Nicholas Burdash, Thomas W. Klein, and Herman Friedman 79. Gene Expression and Virulence in Legionella: the Flagellar Regulon, Klaus Heuner, Sebastian Jacobi, Christiane Albert, Michael Steinert, Holger Brüggemann, and Carmen Buchrieser 80. Identification of Legionella pneumophila Genes under Transcriptional Control of LpnR Regulatory Proteins, E. Lammertyn, L. Maes, E. De Buck, I. Lebeau, and J. Anné 81. Modulation of rpoH Expression Using an Antisense Strategy, Fanny Ewann and Paul S. Hoffman 82. Novel Use of Heliobacter pylori Nitroreductase (rdxA4) as a Counterselectable Marker in Allelic Vector Exchange to Create Legionella pneumophila Philadelphia-1 Mutants, Paul S. Hoffman, Ann Karen C. Brassinga, Matthew A. Croxen, Charles J. Shoemaker, Michael G. Morash, and Jason J. LeBlanc 83. Analysis of Gene Expression in Legionella during Axenic Growth and Infection, Sergey Pampou, Irina Morozova, David Hilbert, Karim Suwwan de Felipe, Pavel Morozov, James J. Russo, Howard A. Shuman, and Sergey Kalachikov 84. Bringing the Genome of Legionella pneumophila to Life: the Transcriptional Program during Infection of Acanthamoeba castellanii, H. Brüggemann, A. Hagman, O. Sismeiro, M.-A. Dillies, K. Heuner, M. Steinert, C. Gouyette, J.-Y. Coppée, and C. Buchrieser 85. Genome Rearrangements and Horizontal Gene Transfer in Legionella pneumophila, Irina Morozova, Pavel Morozov, Sergey Pampou, Karim Suwwan de Felipe, Sergey Kalachikov, Howard A. Shuman, and James J. Russo 86. Genetic Diversity of Legionella pneumophila, C. Cazalet, S. Jarraud, Y. Ghavi-Helm, J. Allignet, F. Kunst, J. Etienne, P. Glaser, and C. Buchrieser 87. The Problem of Complexity, Rodney M. Ratcliff 88. Sequence-Based Discovery of Ecological Diversity within Legionella, Frederick M. Cohan, Alexander Koeppel, and Daniel Krizanc 89. Genome Sequencing and Genomics, Carmen Buchrieser, Paul Hoffman, James J. Russo, and Joseph P. Vogel IV. Environmental Biology, Detection, Prevention, and Control 90. Characterization of Sessile and Planktonic Legionella pneumophila in Model Biofilms, Barry S. Fields and Claressa Lucas 91. The Amoeba Dictyostelium discoideum Contributes to Legionella Infection, Michael Steinert, Carina Wagner, Marcela Fajardo, Olga Shevchuk, Can Ünal, Frank Galka, Klaus Heuner, Ludwig Eichinger, and Salvatore Bozzaro 92. Acanthamoeba castellanii Strongly Increases the Number of Legionella pneumophila in Model Tap Water Biofilms, Priscilla Declerck, J. Behets, E. Lammertyn, and Frans Ollevier 93. Biofilm Formation of Legionella pneumophila in Complex Medium under Static and Dynamic Flow Conditions, Jörg Mampel, Thomas Spirig, Stefan S. Weber, Janus A. J. Haagensen, Søren Molin, and Hubert Hilbi 94. Evaluation of Signaling between Legionella pneumophila and Multiple Prokaryotes, Stephanie D. Zeigler-Ballerstein and James M. Barbaree 95. Antimicrobial Activity of Some Lichen Extracts against Legionella pneumophila, Zuhal Zeybek, Nihal Doðruöz, Ayþin Çotuk, Ali Karagöz, and Ali Aslan 96. Isolation and Characterization of a Staphylococcus warneri Strain Producing an Anti-Legionella Peptide, Yann Héchard, Sébastien Ferraz, Emilie Bruneteau, Michael Steinert, and Jean-Marc Berjeaud 97. Occurrence and Diversity of Legionella pneumophila in Water Samples from the Brazilian Environment, Fábio R. S. Carvalho, Annette S. Foronda, and Vivian H. Pellizari 98. Diversity of Legionella spp. in Antarctic Lakes of Keller Peninsula, Fábio R. S. Carvalho, Fernando R. Nastasi, Rosa C. Gamba, Annette S. Foronda, and Vivian H. Pellizari 99. Effects of Sea Water Concentration and Temperature on the Survival of Legionella pneumophila Serogroup 1, Susan Bennett and Richard Bentham 100. Isolation of Legionella and Amoebae from Water Samples, Laura Franzin, Daniela Cabodi, and Nicoletta Bonfrate 101. Detection and Identification of Free-Living Protozoa in Drinking Water, Rinske Valster, Bart Wullings, Stefan Voost, Dick van der Kooij, Hauke Smidt, and Geo Bakker 102. Growth of Legionella in Nonsterilized, Naturally Contaminated Bathing Water in a System that Circulates the Water, Katsuhiko Ohata, Kanji Sugiyama, Mitsuaki Suzuki, Rieko Shimogawara, Shinji Izumiyama, Kenji Yagita, and Takuro Endo 103. Fluctuation in Legionella pneumophila Counts in Cooling Towers over a One-Year Period, S. Ragull, R. Montenegro, M. García-Núñez, I. Sanchez, A. Soler, N. Sopena, M. L. Pedro-Botet, M. Esteve, and M. Sabriá 104. Genotypic Variability and Persistence of Legionella pneumophila DNA Subtypes in 23 Cooling Towers from Two Different Areas, I. Sanchez, S. Ragull, M. García-Núñez, N. Sopena, M. L. Pedro-Botet, R. Montenegro, and M. Sabriá 105. Suitability of Peptide Nucleic Acid Probes for Detection of Legionella in Mains Drinking Water Supplies, Sandra A. Wilks and C. William Keevil 106. Legionella Detection from Water Samples by Reverse Transcriptase-PCR, Laura Franzin, Daniela Cabodi, and Nicoletta Bonfrate 107. Evaluation of the Dynal Biotech Legionella Immunomagnetic Separation Method versus Conventional Culture for the Isolation of Legionella pneumophila serogroup 1 from Water Samples, Sue M. Mietzner, Janet E. Stout, Jaclynn L. Shannon, Victor L. Yu, and David R. Wareing 108. A Novel and Rapid Legionella Detection System for Water Analysis, Steven Giglio, Paul T. Monis, and Christopher P. Saint 109. Use of Real-Time PCR for Detection and Quantification of Legionella Bacteria in Water on the Scale of a Watershed: the Vidourle Valley, Laurent Garrelly, Celine Minervini, L. Rolland, Séverin Pistre, and Jean-Christian Personné 110. Field Evaluation of the Binax Equate Test Kit for Enumeration of Legionella pneumophila Serogroup 1 in Cooling Water Samples, Anita Benovic and Richard Bentham 111. Method Development for Legionella Detection in Metalworking Fluids, Katalin Rossmoore, Leonard Rossmoore, and Christine Cuthbert 112. Risk Assessment for Legionella in Building Water Systems: Managing the Myths, Richard Bentham 113. Controlling Legionella in Hospital Water Systems: Facts versus Folklore, Janet E. Stout 114. Strategies for Infection Control of Nosocomial Legionnaires’ Disease: Four-Year Surveillance Experience in a Teaching Hospital in Italy, S. Boccia, P. Borella, V. Romano Spica, P. Laurenti, A. Cambieri, G. Branca, M. Tumbarello, R. Cauda, G. Fadda, and G. Ricciardi 115. Legionella Contamination of Domestic Hot Water in a Tertiary Level Hospital and Resulting Introduction of Control Measures, Mona Schousboe, Alan Bavis, and Ros Podmore 116. Review of Nosocomial Legionella Outbreaks, Tim Eckmanns, Christiane Reichhardt, Maria Martin, Frauke Nietschke-Tiemann, and Henning Rüden 117. Quantitative Microbial Risk Assessment Model for Legionella: Summary of Methods and Results, Thomas W. Armstrong and Charles N. Haas 118. Risk of Legionella in the Spa Industry: Inadequacy of Current Legislation Covering Thermal Waters Used for Medicinal Purposes, Vladimir Drasar, Radomir Polcar, and P. Christian Lück 119. Biological Treatment of Industrial Wastewater: a Possible Source of Legionella Infection, Görel Allestam, Birgitta de Jong, and Jonas Långmark 120. Inhibition of Legionella Growth in Circulating Bathing Water by Filter Refreshment Method Using a High Concentration of Chlorine, Kanji Sugiyama, Katsuhiko Ohata, Mitsuaki Suzuki, Rieko Shimogawara, Shinji Izumiyama, Kenji Yagita, and Takuro Endo 121. Disinfection of Hospital Water Systems and the Prevention of Legionellosis: What is the Evidence? Christiane Reichhardt, Maria Martin, Henning Rüden, and Tim Eckmanns 122. Six Months Experience of Silver-Hydrogen Peroxide Treatment for Legionella Control in Two Nursing Home Water Systems, M. L. Ricci, Italo Dell’Eva, Maria Scaturro, Piergiorgio Baruchelli, Germana De Ponte, Maria Losardo, Massimo Ottaviani, and Franco Guizzardi 123. Temperature Regimens versus Ionization TMVs, John Hayes 124. Design and Realization of Zero-Aerosol Cooling Towers, Denis Clodic, Assaad Zoughaib, Chantal Maatouk, Benoît Senejean, and Michèle Merchat 125. Legionella Population Control in Cooling Water Systems, Michèle Merchat, Gilles Chaperon, and Taher Mamodaly 126. Control of Legionella Proliferation Risk in Cooling Water Systems, Michèle Merchat and Anabel Deumier 127. Control of Legionella in Large Buildings through Community-Wide Introduction of Monochloramine, Matthew R. Moore, Brendan Flannery, Lisa B. Gelling, Michael Conroy, Duc Vugia, James Salerno, June Weintraub, Valerie Stevens, Barry Fields, Richard Besser 128. Efficacy of Monochloramine against Surface-Associated Legionella pneumophila in a Cooling Tower Model System, Irfan Türetgen and Aysin Çotuk 129. Monochloramine Treatment Induces Viable but Nonculturable (VBNC) State into Biofilm and Planktonic Legionella pneumophila Populations, Laëtitia Alleron, Jacques Frère, Nicole Merlet, Bernard Legube 130. Preventing Legionellosis with Hazard Analysis and Control Systems, William F. McCoy 131. Environmental Sampling Data to Determine Risk – a United Kingdom Perspective, Susanne Surman-Lee and Richard Bentham