These outbreaks occurred in hotels, hospitals, nursing homes, cruise ships, prisons. The dominator was a bacterium that at times was caused by water and contaminated soil
Sporadic outbreaks of Legionnaires’ disease have occurred around the world. In the summer of 1976, thousands of American Legionnaires' gathered to celebrate the American bicentennial. A few weeks later thirty four people had died and hundreds were seriously ill. All of the people affected showed symptoms of severe pneumonia, some with a temperature as high as 107º Fahrenheit. After several months of research they identified the cause of the disease which was a bacteria that causes a lung infection; this is how the disease got its name.
Legionnaire’s disease is often caused by inhaling the bacteria now known as Legionella. This bacteria increases in large air conditioning systems, showers, whirlpool spas and occasionally in potting soil.
At present it is not known why some people become sick after becoming exposed to the bacteria and others do not. It has been discovered however, that some people are more vulnerable due to a weakened immune system, their age or are smokers.
Legionnaire’s disease develops approximately from two to fourteen days after exposure to the Legionella bacteria. The virus was traced to the hotel's water system and subsequent outbreaks have been linked to sources such as cooling towers, whirlpool spas, cruise ships, swimming pools, physical therapy equipment, decorative fountains, hospitals and nursing homes. People become infected when they inhale microscopic water droplets containing the Legionella bacteria.
Causes: Bacterial Legionella Pneaumophilia is the cause in most cases of Legionnaires' disease although there are other strains of Legionella that cause infection. The Legionella bacteria thrive in damp and warm environments. Outdoors this bacterium can live for months in lakes, rivers, hot springs and soil; however, the levels are so low they are no threat. The indoors is where the Legionella bacteria thrives as it breeds in water and air conditioning systems, whirlpool spas and the misters in a grocery store produce departments. Like most microorganisms, this bacterium anchors itself to the inside of pipes showerheads and faucets. One attached, the bacteria takes on the consistency of a sticky substance called a biofilm. As the water flows, it dislodges some of this biofilm, dispensing bacteria throughout the water system. Most outbreaks occur in large building primarily because of their complicated systems that allow the bacteria to grow easily. There is a slight chance of contacting Legionnaires' disease from home plumbing but very rare.
Symptoms:
- Headaches
- Muscle pain
- Chills
- Fever of 104º Fahrenheit or higher
- Cough with Mucus and sometimes blood
- Shortness of breath
- Chest pain
- Fatigue
- Loss of Appetite
- Gastrointestinal symptoms such as nausea, vomiting or diarrhea
- Confusion or other mental changes.
Diagnosis and Tests:
Special tests are required to distinguish Legionnaires’ disease from other types of pneumonia.
- Blood Tests
- Chest X-ray – this does not confirm Legionnaires' disease but will show the extent of the infection in the lungs.
- Test on a sample of the sputum or lung tissue
- CT scan of the brain or a spinal tap if neurological symptoms of confusion or concentrating are shown.
Complications:
- Respiratory failure
- Septic shock
- Acute Kidney failure
Treatment:
Legionnaire’s disease is usually treated with antibiotics; the earlier the treatment is started the less likely a chance of serious complications or even death will occur.
Prevention: requires meticulous disinfection and the cleaning of pools, spas and water systems.
For more information: www.iapa.ca, www.ccohs.ca, www.hc.scgcca/, www.toronto.ca/health/legionnaires
“Sylvia McGrath. Permission to republish Legionnaires’ disease must be granted by the author in writing.
