Medical Hydrology and Balneology: Environmental Aspects

Medical Hydrology and Balneology: Environmental Aspects
peratures favour the growth of Legionella ( 36-41°C). Four Mab subgroups of
L.pneumophila sg 1, three other L.pneumophila serogroups (sg2,sg5, and sg6) and a
further 7 Legionella species were detected in the thermal water distribution network.
Both hotels have installed chlorine dioxide generators.Disinfection of thermal
waters is not permitted by law.
3. Peloids
Raw peat from five different deposits and spas were cultured. Two were positive
despite very low pH. L.sainthelensi sg1 and a Legionella sp.nov. were identified in
one, the second was positive for L.quateirensis in concentrations exceeding 102
cfu/g . Although infection by non-L.pneumophila species is rare, Legionella
sainthelensi has been reported to cause outbreaks in Canadian nursing homes. The
signifance of the novel species has yet to be determined.
Conclusions
Thermal waters used for medicinal purposes do not appear to demonstrate significantly
more risk than hotel hot waters. In all investigated cases virulent Legionella
colonized both distribution systems. Given the numbers of clients annually treated
there, the risk appears low and is dangerous only for patients with supressed immunity
and other serious underlying diseases. These risk groups should be assessed
by spa physicians and prevented from such potential exposure. Tour operators have
been also made aware of these risks.
Technical and organisational remedial measures were proposed. Contentious
parts of the Czech spa legislation that hamper prevention are presented (Spa Law
164/2001, Decree of Ministry of Health No.423/2001 On Spas and Sources).
Keywords: Legionella, Spa Waters, Peloids, Risk Assessment
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Balnea
2012, núm. 6, 241-242