It is by now well-estalished that domestic hot water systems often harbour Legionella bacteria. Measurements into a number of Danish systems have revealed many other bacteria, among them the thermophilic species Thermus, which is predominantly found on heating coils, where local temperatures are higher. This bacterium not only hampers heat transfer due to fouling, but may also be pathogenic, due to release of endotoxins. Its presence may explain a wide spectrum of symptoms experienced by people after hot baths, such as rashes and itching. The paper summarizes these findings, and on this basis engineering and microbiological considerations are presented in an effort to find ways of future control strategies that go beyond Legionella prevention. Special attention is given to district heating connections, in which low supply and return temperatures are generally wanted in the primary circuit. (author) 16 refs.