A Complete Guide to Understanding Legionnaires’ Disease
Legionnaires’ disease is a form of lung disease that is similar to pneumonia. This severe infection is caused by the bacteria known as Legionella. This bacterium is contaminated through the inhalation of contaminated water or soil. Legionnaires’ disease is not communicable. People with lower immunity, older persons, and heavy smokers can get severe illness in their respiratory tract.
In this guide, we will provide all the details on Legionnaires’ Disease, from its causes to diagnosis, treatment, symptoms, related risk factors, mode of transmission, and preventive measures.
What is Legionnaires’ disease?
Legionnaires’ disease is a life-threatening disease that affects the lungs due to exposure to the bacterium Legionella pneumophila. Initially, the disease was identified in Philadelphia after an outbreak at an American Legion convention among attendees in 1976, and it became a recognized health issue all around the globe.
Important facts about Legionnaires’ disease
- Caused by – bacteria – Legionella bacteria
- Mode of contamination – inhalation of contaminated mists
- Not a contagious disease that is transmitted directly from a person
- Mostly caused by the human-made and poorly maintained water systems
- It can be life-threatening if not diagnosed or treated beforehand.
What is Legionella Pneumonia?
Legionella pneumonia is the broader line of Legionnaires’ disease. The Legionella bacteria get to the lungs by direct inhalation of the bacteria from the contaminated water vapors. These bacteria cause fluid buildup in the tiny air sacs known as alveoli in the lungs. This inflamed condition of the lungs is known as pneumonia.
Primary characteristics of Legionella Pneumonia:
- highly hazardous compared to other pneumonia types
- If left untreated, it can spread rapidly
- Difficulty in breathing and severe fever are the common symptoms
- In the worst-case scenario, it can also affect multiple organs
- must start targeted antibiotic treatments
Legionella pneumonia is often resistant to standard antibiotics, unlike typical community-acquired pneumonia. So, it is vital to make early detection and diagnosis afterward.
How does Legionnaires’ Disease Spread?
How does Legionnaires’ Disease Spread?
Legionella bacteria thrive in stagnant and warm water. Typically, the outbreaks occur in buildings with complex water systems, like,
- Resorts and hotels
- Office buildings
- Healthcare and hospital facilities
- Fountains
- Cruise ships
- Plumbing systems
- Cooling towers
When a person inhales contaminated water vapor that carries Legionella bacteria, they get infected. And this can occur from a contaminated air-conditioning system, showering, or using a hot tub.
Who Is at Risk?
Anyone can get affected with Legionnaires’ disease, but some people are more prone to get severe illness, they are –
- People with poor immunity
- Older people, aged above 50
- Heavy smokers and former smokers
- Chronic lung disease patients (e.g., COPD)
- People with kidney issues
- Those are highly diabetic
An aged and immunocompromised person is at higher risk of complications and a life-threatening scenario from the disease.
Symptoms of Legionnaires’ disease
Legionella bacteria usually take 2 to 10 days to develop and show symptoms in the affected body. Initially, the body shows flu-like symptoms, but gradually it grows to severe pneumonia.
Common symptoms of Legionnaires’ disease:
- High fever (above 104°F or 40°C)
- Chills
- Cough (may be dry or mucus)
- Shortness of breath
- Chest pain
- Muscle aches
- Headache
- Fatigue
- Mental fogging or changes
- Gastrointestinal issues (nausea, vomiting, or diarrhea)
This Logionella pneumophila bacteria sometimes may also cause a milder illness called Pontiac fever. It does not cause pneumonia like Legionnaires’ disease, and it resolves by itself.
Diagnosis
It is essential to diagnose early for better treatment. If the person is suspected of Legionnaires’ disease, especially with pneumonia-like symptoms, healthcare professionals may order:
- Blood tests to calculate the infection level and the functioning of the organ
- Urine antigen test (the most common and rapid test)
- Chest X-ray to identify pneumonia
- Respiratory sample or sputum culture for Legionella
Early testing can help identify the cause and get proper antibiotics for effective treatment.
Treatment Options
Antibiotics are the best treatments for Legionnaires’ disease. Some of the commonly prescribed antibiotics are:
- Azithromycin
- Levofloxacin
- Doxycycline
These antibiotics take about two weeks to treat the patient. Hospitalized patients may require intravenous antibiotics. Early interventions significantly improve recovery.
Can Legionnaires’ Disease be life-threatening?
Yes, 1 in 10 people who get Legionnaires’ disease will die, says the Centers for Disease Control and Prevention (CDC). But for the patient who gets an infection during a hospital stay, the fatality rate may be as high as 1 in 4.
How to prevent the risk of Legionnaires’ disease?
The prevention of Legionnaires’ disease mostly depends on the maintenance of water bodies. Every man-made water system must be kept clean with better water management programs to minimize the risk of Legionella growth.
Strategies to prevent Legionella growth:
- Maintain the water system regularly
Keep the temperature of water opposite to the temperature where Legionella grows (77°F–113°F or 25°C–45°C).
- Routine disinfection
It is better to clean and disinfect the hot tubs, cooling towers, and water tanks daily or use biocides where necessary.
- Water testing
Gradual testing for Legionella can help early detection of contamination and take preventive measures.
- Monitor for sediments and biofilm.
Biofilm supports the growth of Legionella, so it is essential to clean and inspect the water surfaces where the bacteria may thrive.
- Flush unused water lines.
Stagnant water can allow bacteria to thrive, so flush the water lines frequently.
- Risk assessments
Regular assessments of potential risk areas, mostly in hospital buildings, are essential to prevent outbreaks.
- Legionnaires’ disease outbreaks
The outbreak of Legionnaires’ disease still occurs globally. World Health Organization (WHO), CDC, and local health departments monitor and investigate reported cases.
In many counties, Legionnaires’ disease has been tracked and kept under control in outbreaks.
Frequently Asked Questions (FAQs)
Q: Is Legionnaires’ disease contagious?
A: No, it is not a contagious disease. The Infection happens through inhalation of contaminated water droplets.
Q: Can drinking water cause Legionnaires’ disease?
A: Not exactly. The transmission caused by inhalation of contaminated aerosols, not ingestion.
Q: How common is Legionnaires’ disease?
A: Due to early diagnosis and complex water systems, the cases are increasing globally. In the United States, approximately 10,000 cases are reported annually.
Q: Is there any vaccine for Legionnaires’ disease?
A: No, currently, no vaccine has been discovered to prevent Legionella infection.
Final Thoughts
Legionnaires’ disease is a life-threatening illness, but it can be prevented. With early diagnosis and treatment, one can easily fight the disease. With proper awareness and better maintenance of the water system, the risk of infection can be significantly avoided. People with a higher risk of infection must be aware of the symptoms and get rapid consultation if any respiratory illness is detected after exposure.
By making people aware of Legionnaires’ disease and its contamination, we can avoid outbreaks and protect public health around the world.
