What is Legionnaires’ disease?

The name legion is usually associated with something sinister because its association with demons. This reputation makes the name all the more appropriate for this lethal form of pneumonia.

Causes and Risk Factors

Legionnaires’ disease is caused by an infection of the bacterium Legionella. The name was taken when an outbreak of pneumonia affected people who attention the American Legion convention in July 1976. The bacterium Legionella was unknown prior to that discovery. It is usually found in bodies of freshwater and are not harmful but only if it affects water systems built for human consumption.

This means that the bacterium may be found in plumbing systems, water tanks, heaters, cooling towers, hot tubs, fountains, showerheads, and sink faucets. When the bacterium grows and multiplies in a water system, it has to be inhaled by people through small droplets for it to infect.

Some people may have already been exposed to the bacterium, but they are not affected because they are healthy. Most of those affected usually have weaker immune systems especially those who are smokers (even after you quit), older than 50 years, have cancer and other diseases, or those that have a chronic lung disease.

Symptoms and Complications

It takes at least two days after the infection for the symptoms to show up. The first symptoms, including chills, fever, muscle pain and headache, might be mistaken for flu, but the fever can go as high as 104°F which is similar to that of pneumonia. Then in the next several days, the person will experience chest pain, nausea and vomiting, diarrhea, cough that is sometimes accompanied by mucus and/or blood, shortness of breath, and confusion. The symptoms can also be confused with Pontiac fever because it’s caused by the same bacterium but is milder and will usually go away even without treatment.

Legionnaires’ diseases, however, can be fatal when not treated. It affects the lungs, but it can affect other organs by wounding them. Untreated, it can lead to respiratory failure, acute kidney failure, and septic shock. It’s not a contagious disease, however, so if there is an outbreak, the common source of water is most likely the culprit and not the people who have Legionnaires’ disease.

Treatment of Legionnaires’ disease

Even after treatment, some people will experience long-term health effects of the condition or a persistence of problems if there is an outbreak. For proper treatment, the doctor must distinguish it from pneumonia by testing for the presence of Legionella antigens in the urine. Additionally, the severity is assessed through blood tests, chest X-ray, brain CT scan, and a sample of the lung tissue or sputum.

Most antibiotics such as macrolides and quinolones work well against Legionella, but the effects are better if the person is treated as soon as possible. Antibiotics may be administered directly into a vein and the person ahs to be admitted to the hospital in case he/she needs oxygen or a machine for breathing. The antibiotics are taken continuously 1 to 3 weeks, but recovery can take a long time.

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