|
| |
Legionnaire's Disease
Legionnaire's disease is an acute bacterial chest disease caused by the
bacterium named Legionella pneumophila. The bacterium can be found in water
delivery systems and can survive in the warm, moist, air conditioning systems of
large buildings including hospitals, hotels and other large establishments, etc.
The infection is transmitted through the respiratory system via contaminated
aerosols (very small water droplets). Person-to-person spread has not been
proved.Reservoir
The bacterium is water-associated and ubiquitous.It is often isolated from natural habitats (rivers, creeks, hot springs) and
from artificial equipment such as cooling towers associated with air
conditioning and industrial processes, and in warm water systems where the
temperature is maintained around 43˚C favouring proliferation of the bacteria.
Incubation period
2 - 10 daysSigns and Symptoms
- Tiredness and weakness
- Muscle aches and stiffness
- Fever (generally high fever)
- Cough: non-productive or coughing blood
- Shortness of breath
- Chest Pain
- Headache
- Loss of energy
- General ill feeling (malaise)
- Abdominal pain
- Diarrhoea
Diagnosis
Urinary antigen testing for Legionella antibodies carried out locally.Serum sent abroad for detection of Legionella antibodies.
Treatment
Antibiotic treatment (Erythromycin or Ciprofloxacin) prescribed by medical
doctor.Supportive treatment includes hospitalization for fluid and electrolyte
replacement and oxygen administration by mask or by mechanical ventilation, if
the respiratory system becomes severely compromised by the infection.
Prognosis
If the patient is treated promptly, the outcome is excellent but if the patient
has underlying illness that compromises his/her immune system or appropriate
therapy is delayed can result in prolonged hospitalization, complications and
sometimes even death.Control and Prevention
- Cooling towers of large air conditioning units should be drained when not in
use, cleaned with biocides (chlorinating agents) with scales and sediment
removed. Chlorination and heating (above 55˚C) of infected source is effective.
Important to investigate contacts and find the source of infection. TWO CASES
LINKED in time, place or person constitute an outbreak.
- The Department of Public Health has issued a Code of Practice for the
Hospitality Industry.
- The European Working Group for Legionella infections has set recommendations
for Legionnaire’s Disease. (EWGLI Guidelines:
http://www.ewgli.org/public_info/publicinfo_europeanguideline_download.asp)
| |
|
For MDs: 
