Legionella

Group 5
Benjamin Reyes

What is Legionella

Gram negative bacteria

A cause of legionnaires disease

A serious lung infection (pneumonia)

Naturally occurs on soil

1)

Water 68 to 122F

2)

In moist conditions between 20 45C

Background on Legionella

Philadelphia, Pennsylvania in July 1976

58th annual convention of American Legions Pennsylvania Department

Dramatically emerged from obscurity

Current-day building ventilation equipment

Cooling towers

Potable-water systems

10,000 to 15,000 cases

Background on Legionella

Pontiac fever

July 1968 (Pontiac, Michigan)

No person-to-person transmission has yet been documented.

Usually begins 2 to 10 days after an exposure to the bacteria.

Sources

Hot tubs and whirlpools on cruise ships

Cooling towers in air conditioning systems

Decorative fountains

Swimming pools

Physical therapy equipment

Water systems in hotels, hospitals and nursing homes

Legionella is not spread from one person to another.

Legionella is naturally found in water, especially warm water.

A person can get infected when they breathe in steam from a contaminated
hot tub.

Optimal growth temperature is 20-45C;

dormant below 20C

killed at temperatures above 60C.

Each year, 8,00018,000 people in the United States are hospitalized with
Legionnaires disease.

Soil. A few people have contracted Legionnaires' disease after working in the
garden or using contaminated potting soil.

People at higher risk:

people over 45 years of age

smokers and heavy drinkers

people suffering from kidney disease

People with chronic lung disease

anyone with an impaired immune system

People with AIDS and lung cancer

Recent surgery

Symptoms:

Legionnaires' disease usually develops two to 10 days after exposure to

legionella bacteria. It frequently begins with the following signs and
symptoms:

Headache

Muscle pain

Chills

Fever that may be 104 F (40 C) or higher

By the second or third day,

Cough, which may bring up mucus and sometimes blood

Shortness of breath

Chest pain

Gastrointestinal symptoms, such as nausea, vomiting and diarrhea

Confusion or other mental changes

Legionnaires disease

Legionnaires disease is a potentially fatal form of pneumonia.

Legionellosis is the collective name given to the pneumonia-like illness caused by legionella
bacteria. This includes the most serious legionnaires disease, as well as the similar but less
serious conditions of Pontiac fever and Lochgoilhead fever.

The disease has no particular clinical features that clearly distinguish it from other types of
pneumonia, and laboratory investigations must therefore be carried out in order to obtain a
diagnosis.

Legionnaires disease is usually treated successfully with antibiotics, but can sometimes be
fatal.

Legionnaires disease

LD is 2 to 5 times more common in men.

The death rate is 10-15%

40-50% of all cases are related to travel, usually

abroad, where air-conditioning systems and
stored water may be less well regulated.

Case numbers are highest between June and

September.

References:

http://www.hse.gov.uk/legionnaires/what-is.htm

http://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.html

http://www.patient.co.uk/doctor/legionella-and-legionnaires-disease

http://www.mayoclinic.org/diseases-conditions/legionnairesdisease/basics/symptoms/con-20028867

http://www.hse.gov.uk/legionnaires/what-is.htm

LEGIONELLA
DETECTION, REMEDIATION AND PREVENTION
PRESENTED BY: ROLAND CHRISTOPHER G. TUPPAL

Detection

Direct fluorescent antibody (DFA) test

This method uses fluorescence light microscopy to

detect the presence of the bacteria in water
samples.

Polymerase Chain Reaction (PCR)

Culture on Buffered Charcoal Yeast Extract

(BYCE) agar

is a selective growth medium used to culture or

grow certain bacteria

Diagnosis

Urine Antigen Test

Culture

Blood specimen

Remedy/Legionella Control

Temperature Control

Chlorine

Chlorine dioxide

Moist heat sterilization

European standard

Prevention

Source

Bacterial contamination

Water flow and air flow rates in the tower

Percentage of aerosolized water that escape the cooling tower

Water treatment program

Improved design of cooling towers

Pathway

Distance from the tower

Wind conditions

Moisture level in the air

Efficiency of filters in the ventilation sytsem

Exposure

Individuals who are 50 years of age or older

Smokers

People with chronic lung disease

Individuals with weakened immune systems