Legionnaires’ disease: Causes and Prevention

Legionnaires’ is a disease which is severe in form, often lethal and a type of pneumonia. It is caused by the bacteria Legionella Pneumophilia, found in both soil and water. The disease is caused by either drinking water containing the bacteria or when the contaminated water particles are inhaled into the lungs while choking during drinking, swallowing or ingestion.

How It Spreads

After legionella grows and multiplies in a very building water system, water containing bacteria then spread in droplets sufficiently little for individuals to take a breath. People will get Legionnaires’ illness after they inhale tiny droplets of water within the air that contain the microorganism. Fortunately, through services such as Legionella Regulations as laid down by NSW Health, you can avoid such mishaps.

Less ordinarily, individuals will get sick by drinking water containing bacteria. This happens when water accidentally goes into the lungs while drinking. People at exaggerated risk include those with swallowing difficulties.

Healthy individuals exposed to bacteria don’t get sick. People at increased risk of getting sick are:

• People 50 years or older
• Current or former smokers
• People with chronic lung disease (like chronic obstructive pulmonary disease or emphysema)
• People with weak immune systems or who take drugs that weaken the immune system (like after a transplant operation or chemotherapy)
• People with cancer
• People with underlying illnesses such as diabetes, kidney failure, or liver failure.

How to prevent Legionnaires’

There are not any vaccines which will stop Legionnaires’ illness. Instead, the key to preventing Legionnaires’ illness is to make certain that building owners and managers maintain building water systems so as to cut back the danger of bacteria growth and spread.

Since the microorganism survives in warm contaminated water, the temperature of water in the system should be below 20ºC (68ºF) or above 60ºC (140ºF). Since bacteria prefers water that’s contaminated with rust, algae, sludge, amoebae, slime, biofilm, lime scale, corrosion product or different organic matter and different microorganism, keeping it clean helps. There should be no stagnation of water as the bacteria thrive in water that’s stagnant for long.

Legionnaires’ prevention in water cooling systems

Water cooling systems have many aspects that are regulated by bacteria infection prevention pointers. These include authorisation, operating, maintaining, improvement and regular procedures.

There have to be regular inspections for microorganism growth, leaks, algae, blockages or stagnations and splashing. The design of the systems should be such so they will be cleansed frequently.

Exhaust should be discharged far from wherever it may be exposed to the general public.
Water in all the systems should be speedily moving and chemicals should be added, when needed, to limit the build-up of scaling, microbial growth, etc.

Legionnaires’ prevention in air conditioning systems

Air conditioning systems equally need to be economical in coming up with, commissioning, operating, maintaining and cleaning.

The air filters should not accumulate moisture and there should be provision for regular maintenance. Heat exchange coils should have corrosion-resistant components to prevent clogging and contamination.

The outbreaks of legionella are always expected, specifically in the warmer months, which facilitate the brooding and colonization of the Legionella bacteria. But the maintenance and health of the water systems is the surest way to reduce the brooding of these lethal bacteria. For more information, one can check out the NSW Health Legionella Guidelines, a website set up by HydroChem, Australia’s leading industrial and commercial wastewater treatment company.

Nature and Control of Legionnaires Disease

Legionella is a type of naturally present bacteria found in soil and water. It is harmless in small concentrations. But when it thrives and colonises, it becomes a severe health risk.

The colonisation of these bacteria occurs in temperatures between 35 to 46% degree C, in the presence of organic matter like algae. Legionnaire’s disease is a severe form of pneumonia caused by colonisation of the respiratory tract with Legionella bacteria.

The bacteria is contracted either through inhalation of water aerosols containing the bacteria or through aspiration (when water particles that are contaminated are inhaled into the lungs while choking due to swallowing, ingesting or drinking). Legionnaires prevention is based on such facts. It is good to use the services of cooling tower specialists like Legionella Regulations.

The most common symptoms of the disease begin to appear between two and 10 days after exposure to the bacteria. In rare cases, symptoms may not appear for 14 days.

A person infected initially displays flu-like symptoms like muscle pain, tiredness and headache leading to severe conditions like chills, fever, nausea, vomiting, dry cough, diarrhoea, difficulty in breathing and chest pain. This disease has a mortality rate of 30%.

Pontiac fever, the milder form of the disease, appears more like a typical case of flu where patients suffer from muscle aches and fever. Usually, it resolves on its own, within a few days.

Legionnaire’s disease is a highly infectious condition. The bacteria causing this disease is found throughout the world in air-conditioning units, plumbing systems, water fountains, hot tubs and mostly, cooling towers. The bacteria become airborne via a fine mist which is inhaled and cause the infection. Rarely, there are cases of patients aspirating infected water and becoming infected.

The bacteria grow most prolifically in warm water like in case of a hot tub. Because of warm temperatures, it is tough to keep chlorine levels strong enough to work against such potentially dangerous germs. Legionnaires prevention is done by monitoring cooling towers before any outbreak, and it can be done with the help of cooling tower specialists like Legionella Regulations.

Recently, a cause for worry has emerged where windshield wipers of cars have been found to be contaminated with this bacterium. It is guessed that the heat of the engine helps this bacterium to survive.

Outbreaks of this disease are common in cooling tower systems. They may also occur in hotels and resorts, hospitals, cruise ships etc. The following populations are at a heightened risk for the disease:

• Being over 50 years of age
• Former or current smokers
• Those with diseases like kidney failure, liver failure and diabetes.
• Persons suffering from cancer and those being treated with radiotherapy, immunotherapy or radiation.
• Persons with chronic lung disease like emphysema or obstructive pulmonary disease
• Persons with a weakened immune system
• Persons who have had an organ transplant

Conventional Treatment

Before the start of treatment, it is necessary to have a confirmed diagnosis. It is likely that the patient will be referred to an infectious disease specialist who will consult results from sputum samples, urine test and chest X-ray. In the initial appointment, ensure that the medical team is made aware if in the last two weeks, the patient has been hospitalised, been on a cruise, stayed in a hotel or used a hot tub.

The disease can be treated easily with antibiotics. It is usually done on an in-patient basis, where antibiotics can be administered intravenously and the patient can be monitored closely. The medical team will be watching for signs indicating a worsening of infection and for indicating that organ failure is likely to follow. Once stabilized, the patient is advised oral antibiotics.