What to do if legionella is detected

Updated 7 September 2026

Short answer

A positive sample is not the same as an outbreak. The action depends on the count and the type of system. Below 100 cfu/litre, review your controls. Between 100 and 1,000, resample and investigate. Above 1,000 in a domestic water system or above any detectable level in a cooling tower, take immediate action including disinfection and cessation of use where necessary.

A positive legionella sample is a signal, not an emergency by itself. Almost every water system produces an occasional positive at low count, usually because conditions have drifted at one outlet. The right response depends on what the count is, where it came from, and who is exposed.

For domestic hot and cold water systems (HSG274 Part 2)

The action thresholds in HSG274 Part 2 Table 2.3 are:

For cooling towers (HSG274 Part 1)

Cooling towers are treated more strictly because aerosols can travel hundreds of metres downwind. Any legionella detection at 1,000 cfu/litre or above requires immediate action: shut down the tower, disinfect, and investigate before restart. Lower detections trigger review of the treatment regime and repeat sampling.

For healthcare premises (HTM 04-01)

Healthcare premises operate to stricter action thresholds because of the vulnerability of patients. Any positive detection of Legionella pneumophila serogroup 1 in a clinical setting is treated as requiring immediate investigation, regardless of the count.

If someone has been ill

If a case of Legionnaires' disease has been linked epidemiologically to your premises, the health protection team (UKHSA in England, Public Health Wales, Public Health Scotland) will lead the investigation. You are required to cooperate, provide records, and allow sampling. HSE will also be notified under RIDDOR.

The wider lesson

A positive sample is usually a sign that the control scheme needs adjustment, not that the whole system needs to be stripped out. Review the assessment, look at whether monitoring and flushing are actually being done, and focus on the specific outlet or sub-system where the positive came from.

Legal basis

HSG274 Part 2 Table 2.3 on action levels for domestic water systems. HSG274 Part 1 Table 1.3 on cooling tower action levels. HTM 04-01 Part B for healthcare premises. RIDDOR 2013 Schedule 2 on reporting of Legionnaires' disease cases.

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Free legionella risk assessment template

A structured Word document following the five-step approach in ACOP L8. Covers risk identification, written scheme, monitoring, and records. If it isn't written down, you can't evidence it.

Follows ACoP L8 and HSG274 Part 2. Free. No spam.

Important This page is general guidance only. Legionella risk varies with the specific water system, its use, and the people exposed to it. You should consult a competent legionella risk assessor for advice on your premises. LegionellaCheck is an independent information service and is not affiliated with HSE, UKAS, the Legionella Control Association, or any water hygiene company. This site does not provide medical advice. If you suspect Legionnaires' disease, contact NHS 111 or your GP.