Dr. Casale: Legionnaires’ disease rare but serious

By Alfred Casale - To Your Health
Casale Casale -

Legionnaires’ disease, a rare but serious condition that might sound familiar to many, but few likely understand, has been making headlines.

Cases of Legionnaires’ disease, a severe type of pneumonia caused by exposure to Legionella bacteria, have been confirmed in Atlanta; Chesterfield County, Va.; and as close to Northeastern Pennsylvania as Elysburg.

Legionnaires’ disease is a lung infection, treatable with antibiotics. But it’s also severe enough that most people who become affected need hospital care, and while the majority make a full recovery, 1 in 10 die from the infection, according to the Centers for Disease Control.

Legionella is a naturally occurring bacteria that grows in fresh water, but when it spreads in water systems such as shower heads, centralized air-cooling systems, hot tubs, and large plumbing systems, it can become a health concern. Outbreaks are most common in places that have large or complex water systems, such as hotels, cruise ships and even hospitals.

The bacteria must be inhaled to cause Legionnaires’ disease — or Pontiac fever, which is another illness caused by Legionella—so people get sick mostly in scenarios where the water containing the bacteria has spread through the air in small droplets. Much less frequently, someone contracts Legionnaires’ disease by water that is aspirated, or breathed into the airway.

Only in rare circumstances does Legionnaires’ disease spread from person to person.

Much like other types of pneumonia, Legionnaires’ disease is associated with cough, shortness of breath, fever, muscle aches and headaches. It also may present symptoms of diarrhea, nausea and confusion.

Those most at risk are people age 50 and older, current or former smokers, and people with chronic lung disease like emphysema or chronic obstructive pulmonary disease (COPD), or a weakened immune system.

While the number of cases observed by the CDC in 2017 neared only 7,500, it’s important to note that many cases are likely misdiagnosed, so the number is almost certainly higher, and that reported cases have been on the rise since 2000.

While there are no vaccines to prevent Legionnaires’ disease, prevention is possible through the diligence of building owners and managers. Water inspection and management programs need to be developed and put in place to reduce the likelihood of Legionella growing in a water system.

Hot tubs are also likely breeding grounds, because warm temperatures not only promote Legionella growth but also make regulation of disinfecting chemicals, like chlorine, difficult. Hot tub chemicals should be monitored consistently to be certain disinfectants are present in the proper concentrations.

Once cases of Legionnaires’ disease are confirmed, investigations typically take place to find the source of the bacteria, as was the scenario during the recent outbreak in Atlanta, for which it was reported the bacteria was prevalent in a city hotel.

So, if you’ve been near a place where a Legionella presence has been reported, and you think you may have been exposed — or if you’re experiencing symptoms of cough, chills, fever or muscle aches — call your primary care provider to seek care immediately. Follow up with your local health department, who may decide to investigate, and mention any recent proximity to industrial water systems or hot tubs.

Casale
https://www.timesleader.com/wp-content/uploads/2019/08/web1_casale_edit-2.jpgCasale

By Alfred Casale

To Your Health

Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via [email protected] For a free heart risk assessment, visit geisinger.org/heartrisk.

Dr. Alfred Casale, a cardiothoracic surgeon, is associate chief medical officer for Geisinger and chair of the Geisinger Heart Institute. Readers may write to him via [email protected] For a free heart risk assessment, visit geisinger.org/heartrisk.