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Conditions of hire
Members’ Guidance Sheet
Legionnaire’s Disease and Self-Catering
Legionnaires’ disease thrives in still tepid water, and can be fatal to vulnerable groups. Self-
caterers typically have properties empty for a time between lets, particularly in the off season,
and need to be aware of the risk areas and measures that must be taken
to minimise the risk.
This is a statutory requirement.
Prevention of Legionnaires' disease
The risk of catching Legionnaires' disease can be reduced with appropriate maintenance and
Essential Information for Providers of Residential Accommodation
gives a brief summary of recommendations from the
The full HSE Approved Code of Practice (L8)
What is Legionnaires' disease?
Legionnaires' is a bacterial disease that causes a lung infection or pneumonia. Infection occurs
by breathing in droplets of water which contain Legionella
bacteria. It cannot be passed from
Causes of Legionnaires' disease
Legionnaires' is caused by a bacterium known as Legionella pneumophila
. The disease and the
bacterium were discovered following an outbreak at an American Legion convention in
The bacteria are found widely throughout natural water systems such as rivers and ponds but
temperature is critical to its growth and it is in the warm or hot water of artificial water systems
How do you get Legionnaires' disease?
The source of the bacteria in an outbreak is usually a man-made water distribution system where
the bacteria have multiplied in great numbers. Warm storage tanks where the water stagnates
are ideal for legionella bacteria to multiply. The bacteria thrive in water temperatures between
25° and 45°C - about 35°C seems to be the optimum temperature. High temperatures above 60
This means that Legionnaires' disease can be caught from:
• Piped water, especially hot water, in large buildings where long runs of pipe work can be a
• Circulating water droplets in air-conditioning and cooling systems, cooling towers and
• Whirlpools, spas (jacuzzis), other warm-water baths and shower heads.
Infection occurs by breathing in water droplets (aerosol) that are contaminated by many
legionella bacteria. An outbreak can affect many people in the same hospital, hotel, office The Association of Scotland’s Self-Caterers
complex or other large building, around the same time. Occurrences are more common in late
Risk factors for developing Legionnaires' disease
Anyone can develop Legionnaires' disease. However, people are more likely to develop
Legionnaires' disease (and pneumonia caused by other bacteria) if they are already in poor
health. Conditions that increase the risk of Legionnaires' disease becoming a serious illness
• Chronic lung disease. This includes asthma and especially chronic obstructive pulmonary
• Other chronic (long-term) conditions such as chronic kidney disease (CKD), heart disease
• Cancer - especially lung cancer or leukaemia.
• Conditions or situations which affect or suppress your body's natural immune responses
and ability to fight infection, such as:
Human immunodeficiency virus (HIV) infection or acquired immune deficiency
Immunosuppressant medication. This includes chemotherapy given for cancer,
some medications given for rheumatological (joint) conditions or diseases such as
Crohn's disease and medications used if you have had an organ transplant.
Examples include: azathioprine, mycophenolate (CellCept®), ciclosporin
(Neoral®), tacrolimus, rituximab and interferon.
People are also more at risk of contracting Legionnaires' disease if they smoke and also if they
are aged over 50. Men are affected more than women.
Symptoms of Legionnaires' disease
Symptoms first appear between 2 and 10 days after exposure to the bacteria. Legionnaires'
initially produces a flu-like illness with tiredness, high fever (often 39.5°C or above), headache,
muscle aches and a dry cough. As the pneumonia develops there may be chest pain, shortness
of breath, abdominal pain, vomiting and diarrhoea, and hallucinations.
There are more than 500 cases a year in the UK – figures for 2006 show 551 reported cases of
Legionnaires’ disease in England and Wales, 160 of which were picked up while the affected
person was travelling abroad. In about 1 in 10 cases the infection proves fatal.
Treatments for Legionnaires' disease
Prompt treatment with antibiotics is effective but specific types of antibiotic must be used as the
bacteria can hide inside the cells of the respiratory tract, and the antibiotics must be able to
penetrate the cells. The earlier the illness is treated with antibiotics, the better the likely
outcome. The illness is fatal in some cases.
May 2012 Disclaimer – The information in the ‘Guidance Sheet’ is provided by the ASSC for use by Members in
support of their own independent business decisions. It does not constitute advice or instruction for which
the ASSC can be held liable in any way whatsoever. All Members and other readers remain responsible for
the consequences of any decisions taken whether in the light of information gained from this Guidance
The Association of Scotland’s Self-Caterers
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