About Legionnaires Disease (Legionella)

Overview

Legionnaires' disease, also known as Legionellosis, is a serious form of pneumonia caused by the Legionella bacteria. The symptoms of this disease include cough, muscle aches, fever, shortness of breath, and headache. The bacteria are typically spread through water droplets in the air, particularly in human-made water systems that are not properly maintained. Antibiotics are used to treat Legionnaires' disease, and most people who become ill require hospital care but can make a full recovery.

Causes and Risk Factors

Legionnaires disease, caused by the bacteria Legionella, can thrive in man-made water distribution systems and natural surface waters, including lakes, streams, and wet soil. Infection occurs through the inhalation of water droplets or direct consumption of contaminated water.

Non-modifiable risk factors are risk factors that cannot be changed. Non-modifiable risk factors of legionnaires disease (Legionella) include:

• Older age especially those who reside in a long-term care facility
• History of recent hospitalization
• Chronic cardiovascular or respiratory disease such as COPD or emphysema
• Immunocompromised individuals are more susceptible to infection

Modifiable risk factors are risk factors that can be changed or influenced. Modifiable risk factors of legionnaires disease include:

• Smoking is a modifiable risk factor that increases the likelihood of acquiring Legionnaires Disease.
• Exposure to water aerosols, such as through showers, hot tubs, or cooling towers, can also increase the risk of infection.

If you have concerns about your risk or symptoms, consult with your healthcare professional for personalized advice.

Symptoms

The most common early symptoms of Legionnaires disease include:

• Cough
• Shortness of breath
• Fever
• Muscle aches
• Headaches

As the disease progresses or becomes more severe, additional symptoms may occur, such as:

• Chest pain
• Diarrhea
• Nausea and vomiting
• Confusion

In some cases, Legionnaires disease can also cause infections in other parts of the body, like the heart or within body wounds. It's important to note that symptoms usually develop within 2 to 10 days after exposure to Legionella, but it can take longer. If you experience any pneumonia-like symptoms, it is recommended to seek medical attention promptly.

Diagnosis

The commonly performed examinations, tests, and procedures to diagnose Legionnaires disease include:

• Urinary Antigen Test: This test detects a specific molecule of the Legionella bacterium in urine.
• Culture of Lower Respiratory Secretions: Culturing patient specimens, such as sputum or bronchoalveolar lavage, on selective media is the gold standard for diagnosing Legionnaires Disease. This method can identify all species and serogroups of Legionella and provides the recovery of a patient isolate, which can be used to find an environmental match.

Additional examinations, tests, and procedures to determine the stage or severity of Legionnaires disease may include:

• CT scans: This imaging can provide clearer images of the lung involvement.
• Bronchoscopy: This procedure may be needed in less clear-cut cases to obtain specimens directly from the lungs.

It's important to note that these diagnostic tests should be interpreted by a healthcare professional in conjunction with clinical symptoms and other relevant factors.

Treatment Options

The goals of treatment for Legionnaires disease are to:

• Eliminate the infection: Antibiotics are the mainstay of treatment for Legionnaires disease. They work by targeting and killing the Legionella bacteria responsible for the infection. The specific antibiotics used may vary based on the severity of the illness and individual patient factors. It is important to complete the full course of antibiotics as prescribed by your healthcare professional.
• Relieve symptoms: Medications such as pain relievers and fever reducers may be recommended to help alleviate symptoms such as chest pains, headaches, and fever.
• Supportive care: In severe cases or for individuals with weakened immune systems, hospitalization may be necessary. Hospitalized patients may receive intravenous fluids to prevent dehydration and oxygen therapy or mechanical ventilation if their lungs are significantly affected.
• Prevention: In healthcare settings, preventive measures include routine maintenance of cooling towers and ensuring proper water management to minimize the risk of Legionella contamination.

It is important to note that these treatment recommendations are general guidelines. Individual treatment plans should be determined by a healthcare professional based on the severity of the illness and specific patient factors.

Medication dosing may be affected by many factors. Check with your health care professional about dosing for your individual situation. Other side effects can occur. Check with your health care professional or read the information provided with your medication for additional side effect information.