What Is Legionnaires' Disease and What Are Its Causes?
Legionnaires' disease is also called legionellosis. It is an atypical form of pneumonia. It is caused by a bacteria called Legionella. Untreated cases of Legionnaires' disease can be dangerous and fatal. Treatment with antibiotics can cure Legionnaires’ disease. Some people continue to have problems after treatment.
Older adults are more susceptible to this disease. Smokers, alcoholic people, and those with poor immunity are affected more.
What Is the Incubation Period of Legionnaires’ Disease?
The time taken for a disease to show its symptoms is known as the incubation period. Legionnaires' disease starts showing its symptoms within two to fourteen days after exposure to the Legionella bacteria.
What Are the Symptoms of Legionnaires’ Disease?
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The symptoms begin with fever, chest pain, and fever.
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The spread of infection can happen to other organs such as the spleen, lymph nodes, liver, kidneys, and heart.
The specific symptoms of Legionnaires' disease include:
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Fever above 104 ℉.
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Chills.
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Fatigue.
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Cough. This may be accompanied by blood.
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Muscle ache.
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Shortness of breath.
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Loss of appetite.
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Chest pain.
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Nausea and vomiting.
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Diarrhea.
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Seizures.
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Confusion.
What Are the Risk Factors of Legionnaires’ Disease?
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Most healthy people do not get sick, even though they are exposed to Legionella. People who are at increased risk of getting sick are:
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People who are 50 years and older.
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Smokers. It can affect people who have quit smoking too.
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People with cancer are more susceptible.
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People with chronic lung diseases can also be affected. The diseases might include chronic obstructive pulmonary disease and emphysema.
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People who have poor immune systems.
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People with underlying health conditions such as diabetes, liver failure, and kidney failure.
How Does Legionnaires’ Disease Spread?
The bacteria Legionella grows and multiplies in the water system. The water containing Legionella then spreads through droplets. When people who are living near the unhygienic water supply tend to get exposed to more bacteria. In some cases, people can accidentally inhale Legionella. In this way, the bacteria directly goes into the lungs.
What Are the Complications of Legionnaires' Disease?
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Respiratory failure.
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Septic shock.
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Kidney failure.
What Are the Diagnostic Tests for Legionnaires’ Disease?
Culture:
Legionella can be isolated on supporting mediums such as buffered charcoal yeast extract agar when the urinary antigen test fails to detect Legionella's species. It can detect Legionella species and serogroups that the urinary antigen test does not.
Urinary Antigen Test:
The most common test for the diagnosis of Legionnaires’ disease is done in the laboratory using the urinary antigen test. If this test is performed in a patient who already has pneumonia, the test result is positive. The test can remain positive even after the antibiotic treatment.
Serologic and molecular techniques can help in finding out the bacteria.
NAATs Test:
Legionnaires' disease can be diagnosed with the help of nucleic acid amplification tests, also known as NAATs. These tests look for the presence of legionella DNA in a patient's tissue to make the diagnosis. NAATs are extremely sensitive and specific, and they can identify even small amounts of Legionella DNA in a relatively short amount of time. NAATs are versatile in that they can be run on a variety of materials, such as sputum, bronchoalveolar lavage fluid, or urine, and they can function either independently or in conjunction with other diagnostic procedures. However, additional research is required to fully understand the clinical utility of these tests for the diagnosis of Legionnaires' disease. Although recent studies agree that NAATs have several potential advantages over traditional culture-based methods, such as faster turnaround time and increased sensitivity, the researchers also note that further research is required.
What Are the Treatment Options of Legionnaires’ Disease?
Antibiotics like Macrolides and Tetracyclines, are used in the effective treatment of Legionella species. The current treatment of respiratory tract infections are Quinolones, such as Levofloxacin, Moxifloxacin, and Gemifloxacin. The most commonly used antibiotics are Levofloxacin, Doxycycline, and Azithromycin. These antibiotics are highly effective because they have the capacity of excellent penetration into the Legionella-infected cells. Macrolides such as Azithromycin are given for the treatment of patients in all age groups. Levofloxacin can be used in patients above 18 years of age. Doxycycline is prescribed for children above 12 years of age. Rifampicin is often used in combination with a Quinolone or Macrolide.
According to a study published in 2022, the suggested first-line treatment for Legionnaires' disease is either a fluoroquinolone (preferable azithromycin), such as levofloxacin or moxifloxacin, or a macrolide, such as moxifloxacin. The selection of an antibiotic may be influenced by the infection's severity, the patient's allergies or other health issues, and the local pattern of antibiotic resistance. Antibiotics may be administered in combinations in certain instances.
The average number of days recommended for treatment are five to ten. In the case of outbreaks with Legionnaires’ disease, antibiotics are given as prophylactic measures. In this way, huge populations getting affected can be prevented. High-risk individuals can be treated better without being exposed to serious infections.
How to Reduce the Risk of Legionella?
The risk of Legionella can be reduced at home itself. The possibility of Legionella species causing infection at home to the family members is relatively very low. Most of the household equipment cannot store much water. It is always good to maintain a proper clean source of water supply.
Follow these simple steps to prevent the bacteria from growing rapidly:
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Keeping the hot water thermostat regularly at a temperature of 60ºC can kill any Legionella bacteria. Be aware as the water at this high temperature may cause scalding. Scalding water refers to the burning of flesh and skin due to very high temperatures. It can result in blister formation in the skin. Sometimes the wound gets deeper and can be very painful. These wounds might take several weeks to heal completely.
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Keep all showerheads free from any accumulation of algae and any bacteria. Such microorganisms can be removed by descaling once every three months. The things required for descaling are lime juice, baking soda, white vinegar, and hot water. These ingredients can be used for domestic descaling. Domestic descaling solutions are also available. After the process of descaling is complete, flush the shower fully and soak it in a bleaching solution. This can help a person to sterilize the equipment and kill the bacteria.
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Clean the taps by brushing them with a nylon brush.
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If an individual is planning to go on a vacation for more than ten days a week, it is essential to run all showers and taps continuously for two minutes. This can flush out the bacteria.
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Check whether the lids on water tanks have tight-fitting. This can help to prevent contamination with microorganisms.
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Deposits such as rust or others should be replaced soon.
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If the hot water system is not heating properly, try to replace it as early as possible.
When to See a Doctor?
Diagnosing Legionnaires’ disease faster can increase the chances of getting recovery faster. It can help the recovery period become more effective. It can prevent serious complications. If the doctor thinks a person has been exposed to Legionella bacteria, they have to coordinate with him for a proper treatment plan.
What Is the Prognosis of Legionnaires’ Disease?
The patient's age, general health, and the extent of the illness at the time of diagnosis are just a few of the variables that can affect the prognosis for Legionnaires' disease. Recent studies have shown that cases of Legionella pneumonia with delayed antibiotic therapy have a worse prognosis. In addition, people who smoke also have a poor prognosis. Furthermore, in some people, especially those who are older or have underlying medical problems that impair their immune systems, the illness can be severe and even fatal. Septic shock, multi-organ failure, and acute respiratory distress syndrome (ARDS) are a few potential side effects of Legionnaires' disease. It is crucial to closely watch patients who have Legionnaires' disease and to act quickly if complications arise.
Conclusion:
In general, as a result of the rising number of reported cases of legionnaires' disease all over the globe. To help stop the illness from getting worse, people in the medical field and the general public need to be more careful and aware of their surroundings.
