Download - 17 Legionella
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LegionellaGroup 5
Benjamin Reyes
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What is Legionella
Gram negative bacteria
A cause of legionnaires disease
A serious lung infection (pneumonia)
Naturally occurs on soil
1) Water 68 to 122F
2) In moist conditions between 20 45
C
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Background on Legionella
Philadelphia, Pennsylvania in July 1976
58th annual convention of American Legions Pennsylvania Department
Dramatically emerged from obscurity
Current-day building ventilation equipment
Cooling towers
Potable-water systems10,000 to 15,000 cases
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Background on Legionella
Pontiac fever
July 1968 (Pontiac, Michigan)
No person-to-person transmission has yet been documented.
Usually begins 2 to 10 days after an exposure to the bacteria.
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Sour
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Hot tubs and whirlpools on cruise ships
Cooling towers in air conditioning systems
Decorative fountains
Swimming pools
Physical therapy equipmentWater systems in hotels, hospitals and nursing homes
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Legionella is not spread from one person to another.
Legionella is naturally found in water, especially warm water.
A person can get infected when they breathe in steam from a contaminatedhot tub.
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Optimal growth temperature is 20-45C;
dormant below 20C
killed at temperatures above 60C.
Each year, 8,000 18,000 people in the United States are hospitalized with
Legionnaires disease.
Soil. A few people have contracted Legionnaires' disease after working in the
garden or using contaminated potting soil.
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People at higher risk:
people over 45 years of age
smokers and heavy drinkers
people suffering from kidney disease
People with chronic lung disease
anyone with an impaired immune system
People with AIDS and lung cancerRecent surgery
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Symptoms:
Legionnaires' disease usually develops two to 10 days after exposure tolegionella bacteria. It frequently begins with the following signs andsymptoms:
Headache
Muscle pain
Chills
Fever that may be 104 F (40 C) or higher
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By the second or third day,Cough, which may bring up mucus and sometimes blood
Shortness of breath
Chest painGastrointestinal symptoms, such as nausea, vomiting and diarrhea
Confusion or other mental changes
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Legionnaires disease
Legionnaires disease is a potentially fatal form of pneumonia.
Legionellosis is the collective name given to the pneumonia-like illness caused by legionellabacteria. This includes the most serious legionnaires disease, as well as the similar but lessserious conditions of Pontiac fever and Lochgoilhead fever.
The disease has no particular clinical features that clearly distinguish it from other types ofpneumonia, and laboratory investigations must therefore be carried out in order to obtain adiagnosis.
Legionnaires disease is usually treated successfully with antibiotics, but can sometimes befatal.
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Legionnaires disease
LD is 2 to 5 times more common in men.
The death rate is 10-15%
40-50% of all cases are related to travel, usuallyabroad, where air-conditioning systems and
stored water may be less well regulated.Case numbers are highest between June andSeptember.
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References:
http://www.hse.gov.uk/legionnaires/what-is.htm
http://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.html
http://www.patient.co.uk/doctor/legionella-and-legionnaires-disease
http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867
http://www.hse.gov.uk/legionnaires/what-is.htm
http://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.htmlhttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.htmlhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htm -
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LEGIONELLADETECTION, REMEDIATION AND PREVENTION
PRESENTED BY: ROLAND CHRISTOPHER G. TUPPAL
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Detection
Direct fluorescent antibody (DFA) test
This method uses fluorescence light microscopy todetect the presence of the bacteria in watersamples.
Polymerase Chain Reaction (PCR)
Culture on Buffered Charcoal Yeast Extract
(BYCE) agaris a selective growth medium used to culture orgrow certain bacteria
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Diagnosis
Urine Antigen Test
Culture
Blood specimen
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Remedy/Legionella Control
Temperature Control
Chlorine
Chlorine dioxide
Moist heat sterilization
European standard
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Prevention
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Source
Bacterial contamination
Water flow and air flow rates in the tower
Percentage of aerosolized water that escape the cooling tower
Water treatment program
Improved design of cooling towers
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Pathway
Distance from the tower
Wind conditions
Moisture level in the air
Efficiency of filters in the ventilation sytsem
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Exposure
Individuals who are 50 years of age or older
Smokers
People with chronic lung disease
Individuals with weakened immune systems