Legionnaires' disease Although the risk of Legionnaires' disease being spread by large-scale water systems cannot be eliminated, it can be greatly reduced by writing and enforcing a highly detailed, systematic water safety plan appropriate for the specific facility involved (office building, hospital, hotel, spa, cruise ship, etc.) Some of the elements that such a plan may include are: An effective water safety plan also covers such matters as training, record-keeping, communication among staff, contingency plans, and management responsibilities. The format and content of the plan may be prescribed by public health laws or regulations. Effective antibiotics include most macrolides, tetracyclines, ketolides, and
Water supply and sanitation in Gibraltar was, perhaps not surprisingly, on the state of public health in the territory. The large numbers of water containers standing open across Gibraltar provided an ideal breeding habitat for mosquitoes. Ships carrying cargoes from Africa brought with them the tropical disease yellow fever, which is spread by female mosquitoes carrying the infection. From 1804, Gibraltar suffered five outbreaks of yellow fever; in the first and most devastating, the death toll amounted to 5,733 people out of a total of around 18,000, representing 32 per cent of the population. The second epidemic coincided with the arrival in 1814 of General Sir