Posted by: Chris Maloney | November 29, 2011

Legionaires’ Disease On the Rise in Maine?

Clean drinking water...not self-evident for ev...

Image via Wikipedia

Our ten cases are up to eighteen, so we must be getting more Legionaires disease in Maine.

A disturbing thought is that the cases might be linked to the hospitals or care facilities themselves.  The second is that people who contract Legionaires pneumonia often have suppressed immune systems due to other diseases, which make nursing homes and hospitals prime locations.  The third is that when water freezes it’s a lot harder for bacteria to grow in it.  We’ve had a lot of water and it has had a good chance to rethaw, so let’s all be careful where we’re drinking from.  On the other hand, according to Wikipedia, the bacteria can travel 6-7 km from its source.  So it’s possible that we really will never know.

The best thing to do, then, is to take good care of your immune system and get treated if you think you’re coming down with something.

Curr Opin Infect Dis. 2011 Aug;24(4):350-6.

Prevention of hospital-acquired legionellosis.


National Kaohsiung Normal University, Taiwan, ROC.



The incidence of hospital-acquired legionellosis appears to be increasing. Presence of Legionella in the hospital drinking water is the only risk factor known with certainty to be predictive of risk for contracting Legionnaires’ disease.


Given the high frequency of infection by nonpneumophila and nonserogroup 1 species, both Legionella respiratory culture on selective media and urine antigen testing should be available in the hospital clinical microbiology laboratory. If the drinking water is contaminated by nonpneumophila or nonserogroup 1 species, Legionella culture on selective media must be available for patients with hospital-acquired pneumonia. The impact of PCR application for environmental water specimen remains to be elucidated. Its advantage is that it is a rapid test and its weakness is its low specificity. Copper-silver ionization disinfection and point-of-use (POU) filters have proved effective. Chlorine dioxide and monochloramine are under evaluation and their ultimate role remains to be elucidated. Routine Legionella cultures in concert with disinfectant levels are the best indicators for ensuring long-term efficacy. Percentage distal site positivity for Legionella in drinking water is accurate in predicting risk. Quantitative criteria (CFU/ml) have proven inaccurate and should be abandoned.


Infection control professionals, not healthcare facility personnel or engineers, should play the leadership role in selecting and evaluating the specific disinfection modality. Proactive measures of routine environmental cultures for hospital water and disinfection modalities allow for effective prevention of this high-profile hospital-acquired infection.

PMID:  21666459
Diagn Microbiol Infect Dis. 2010 Nov;68(3):297-303.

Travel-associated Legionnaires disease: clinical features of 17 cases and a review of the literature.


Department of Infectious Diseases and Clinical Microbiology, Baskent University, Ankara, Turkey.


We retrospectively investigated patients with Legionnaires disease (LD) who had been admitted to the Baskent University Alanya Teaching and Research Hospital, Ankara, Turkey, from January 2002 to September 2009. Twenty definitive cases were followed as LD, 17 (85%) of which were travel associated. The mean age was 61.5 ± 9.5 years (range, 39-77 years). Diabetes mellitus was found in 7 (41.2%) of those patients. Gastrointestinal or neurologic abnormalities were found approximately in two-thirds and relative bradycardia in 9 (52.9%). LD was severe in 11 (64.7%) patients, which required intensive care unit follow-up. Although appropriate antibiotic therapy was initiated in all patients on admission day, 4 (23.5%) deaths occurred. In conclusion, clinicians should remain vigilant about the diagnosis of LD in patients with community-acquired pneumonia, especially in the presence of extrapulmonary involvement, risk factors for LD, and a history of recent travel. As in our cases, mortality is still high in sporadic cases despite early appropriate treatment.

Copyright © 2010 Elsevier Inc. All rights reserved.

PMID:  20955914

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