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Hospital-acquired legionellosis is a major problem. In Italy this issue is still underestimated because the reported figures are lower than the actual cases. This is probably due to a lack of diagnosis and monitoring. In Sicily, no cases of hospital-acquired legionellosis were reported in the last few years. In the year 2001, a reference laboratory was set up to help health authorities monitor and prevent hospital-acquired legionellosis. The authors report the data concerning a measure of environmental monitoring and water treatment carried out in a hospital where no legionellosis was ever detected before.