C O M M U N I C A B L E
D I S E A S E
LEGIONELLOSIS
T h e p r e v e n t i v e m e a s u r e s a r e ;
? C l e a n i n g a n d s t o r i n g o f w a t e r a n d
m a k i n g s u r e t h e w a t e r t e m p e r a –
t u r e s a r e a t r i g h t a m o u n t a r e p o s –
s i b l e w a y s t o p r e v e n t t h e d i s e a s e
t o o c c u r .
? T h e w a t e r s y s t e m s a r e t h e r e s e r –
v o i r s f o r t h e b a c t e r i a , t h e r e f o r e b y
c o n s i d e r i n g t h e w a t e r t e m p e r a t u r e
i s a p a r t i c u l a r i m p o r t a n t f a c t o r i n
c o n t r o l l i n g t h e r i s k s a n d s h o u l d b e
e i t h e r 2 0 ? C o r a b o v e 5 0 ? C .
? T a k e e x t r a p r e c a u t i o n s w h e n d e a l –
i n g w i t h c o m p o s t , p o t t i n g m i x a n d
a n y f o r m o f s o i l .
? A l w a y s w e a r a d u s k m a s k t h a t f i t s
t i g h t l y o v e r n o s e a n d m o u t h w h e n
a t e x p o s u r e .
? A v o i d w a t e r s t a g n a t i o n a s t h i s c a n
l e a d t o l e g i o n e l l a p r o l i f e r a t i o n .
Legionella and the
prevention of Legionellosis
Healthy Family for a Healthy Nation
For more information: visit www.WHO.com and Center for Disease Control and Prevention (CDC)
Preventing Legionella in
water systems
How is Legionellosis
disease transmitted?
L e gio n e llo s is is a re sp i ra to r y in f e ctio n
ca u se d b y le g io n e l lo si s p n e u m o p h ila b a c –
te ria ( CDC ). Th e Occu p a t io n a l S a f e t y a n d
He a lth A d min ist ra tio n (OS HA ) a lso d e f in e d
l e g io n e l lo s is a s a n in f e cti o n o f th e lu n g s
a n d i s a f o r m o f p n e u mo n ia . S tu d ie s ca r-
r ie d o u t sh o ws th a t mo re th a n 2 0 sp e cie s
o f le gio n e lla h a ve b e e n co n t rib u te d to h u –
ma n d ise a se s. L e gio n e l lo s is is th e te r m
r e f e rre d to th e in f e ctio n p ro d u ce d b y th e
a ge n t le g io n e l lo s is p n e u m o p h ila . L . p n e u –
m o p h ila is a gra m– n e ga t ive ro d th a t e x ist s
i n a n u mb e r o f d ist in –
g u i sh a b le se ro gro u p s .
In a d d itio n , to le –
g io n e llo si s d i se a se ,
th e sa me b a cte ria a lso
ca u se f lu– li ke d i s-
e a se ca l le d P o n tia c
f e ve r.
C a u s a t i ve Ag e n t s
Qu i t e a n u m b e r o f s p e c ie s o f l e g i o n el l a c au s e s
legionellosis but L . p ne u mo p h i l a i s t h e m a i n
agent that causes majority of cases.
Infection of the lungs (Google, 2018)
What is Legionellosis? W h a t a re t h e c l i n i c a l f e a t u re s o f L e –
g i o n e l l o s i s ?
? Cl i n i c a l f e a tu r e s o f le g i o n ell o s i s a r e n o n– s p e c i f –
i c f l u– l i k e s ym p t om s s u c h a s f e ve r , m ya l g i a , m a l a i se a n d h ea d a c h e o f t en wi t h d i a r r h o e a .
? A d d i t i o n a l s ym p t o m s m a y b e p r e s e n t su c h as
s h o r t n e ss o f b r e a t h an d n au s e a .
A p a t i e n t e xp e r i e n c i ng t h o s e s ym p t om s wi l l e ve n t u a l l y l e a d t o p n e um on i a .
W h e r e a re L e g i o ne l l a b a c t e r i a f o u n d ?
Th e s e s p e c i es o f b a c te r i a a r e m a i n l y f o u n d in wa t e r a n d s o m et i m es s o il e n vi r o nm e n t . Th e y a r e f o u n d i n n a t u r a l wa t e r s s u c h as l a k es , r i ve r s a n d m a n– m a d e wa t e r s ys t e m s t h a t d i s s em in a t e s wa t e r . Th e s e b a c t e r ia a r e p r e va l e n t i n h i g h te m p er a t u r e wa t e r s ys t e m s a s we l l a s wa r m s t a g n a n t wa t e r . S i m i l a r l y, t h e b ac t e r i u m a l s o s u r vi ve s i n se a wa t e r ( Or t i z, Ro q u e a n d Ha ze n , 1 9 8 7 ) a s we l l a s a r t i f ic i a l so u r c e s o f s a l t wa t e r ( He l l e r , 1 9 9 8 ) .
T h e i n c u b a t i o n P e r i o d
Th e i n c u b a t i o n p e r io d i s t he t i m e i n t e r va l b e t we e n e x-p o s u r e t o i n fe c t i o n a n d t h e a p p e a r a n c e o f t h e f i r s t s ym p t o m o f t h e di s e as e . Th e a ve r a g e i n c u b a ti o n p e r i -o d o f l e g i o ne l l os i s d is e a se i s 2–1 0 d a ys (W HO, 2 0 0 4 ) h o we ve r i n s o m e ci r c u ms t an c e s i t m a y e xt e n d t o e ve n l o n g e r t h a n 1 0 d a ys .
Th e r i s k o f g e t t i n g le g i o n el la i n f e c t i on i s p r im a r i l y r e -l a t e d t o t h r e e f ac t o r s ;
? Th e i n d i vi d u a l s u s ce p t i b il i ty t o e xp o s u r e
? Th e q u a n t i t y o f l e g i o n e l l a pr e s e n t a n d
? Th e l e n g t h o f e xp o s u r e
W hen a s us c e p t ib l e p e r so n i n h a l e s a c o n t am i n a t ed a e r o s o l co n s is t i n g o f d ro p le t o f t h e r i g h t s i ze ( 1-5 µ) , h e o r s h e c a n c a n d e ve l o p th e d i s e a se .
According to Center for Disease Control and
Prevention(CDC), Legionellosis is commonly
transmitted through airborne water droplets.
? Inhaling of aerosols (sprays or droplets
of water) from a contaminated source
for example a fountain, whirlpool spas,
air conditioning systems used in large
buildings and drinking and bathing
waters can spread the disease to hu-
mans.
However, there is no cases of person to per-
son transmission of legionellosis disease ac-
cording to WHO, 2004.
Treatment of Legionellosis
Diagnostic Tests
Tests for legionellosis disease should ideally
be performed for all patients with pneumonia
at risk, including those who seriously ill,
whether or not they have clinical features
suggesting legionellosis.
Treatment with fluoroquinolene pefloxacin
gives a person a high survival rate than treat-
ment with erythromycin.
Delay in the application of appropriate thera-
py for legionella pneumonia, many people
presenting with this disease are simply treat-
ed with macrolides, together with beta– lac-
tam antibiotics.
