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Legionnaire's disease

Legionellosis is an infection caused by species of the bacterium Legionella, most notably L. pneumophila. At least 46 species and 70 serogroups have been identified. L. pneumophila, a ubiquitous aquatic organism that thrives in warm environments (25 to 45 °C with an optimum around 35 °C) causes over 90 % of Legionnaires Disease. more...

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The disease has two distinct forms:

  • Legionnaires' disease is the name for the more severe form of infection which includes pneumonia
  • Pontiac fever is a milder respiratory illness without pneumonia caused by the same bacterium

Legionnaires' disease acquired its name in 1976 when an outbreak of pneumonia occurred among persons attending a convention of the American Legion in Philadelphia. Later, the bacterium causing the illness was named Legionella.

On January 18, 1977 scientists identified a previously unknown bacterium as the cause of the mysterious "Legionnaires' disease."

An estimated 8,000 to 18,000 people get Legionnaires' disease in the United States each year. Some people can be infected with the Legionella bacterium and have mild symptoms or no illness at all.

Outbreaks of Legionnaires' disease receive significant media attention. However, this disease usually occurs as a single, isolated case not associated with any recognized outbreak. When outbreaks do occur, they are usually recognized in the summer and early fall, but cases may occur year-round. About 5% to 30% of people who have Legionnaires' disease die.


Patients with Legionnaires' disease usually have fever, chills, and a cough, which may be dry or may produce sputum. Some patients also have muscle aches, headache, tiredness, loss of appetite, and, occasionally, diarrhea. Laboratory tests may show that these patients' kidneys are not functioning properly. Chest X-rays often show pneumonia. It is difficult to distinguish Legionnaires' disease from other types of pneumonia by symptoms alone; other tests are required for diagnosis.

Persons with Pontiac fever experience fever and muscle aches and do not have pneumonia. They generally recover in 2 to 5 days without treatment.

The time between the patient's exposure to the bacterium and the onset of illness for Legionnaires' disease is 2 to 10 days; for Pontiac fever, it is shorter, generally a few hours to 2 days.


Intestinal Infections: These may only occur as part of respiratory infections, where gastrointestinal symptoms have on occasion been described.

Extraintestinal Infections: L. pneumophila is specifically considered as a pathogen of the respiratory tract, where it is a cause of atypical pneumonia, also known as Legionnaires' disease. Other infections have also been reported, including haemodialysis fistulae, pericarditis and wound and skin infections. Bacteraemia is often associated with Legionnaires' disease.

One species Legionella Longbeachae is contracted via inhaling infected compost or soil.


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Experts Available to Discuss Legionnaire's Disease
From Business Wire, 7/20/05

TOPIC: At least nine patients came down with Legionnaire's disease after visiting a medical center in New Rochelle, NY, according to an article by The New York Times. Health officials say water samples from the cooling tower outside of the entrance to the hospital tested positive for legionella. Patients with Legionnaire's disease may experience flu-like symptoms. However, the disease can be fatal for people with compromised immune systems. Experts are recommending aggressive testing in hospitals to prevent outbreaks of the disease.

EXPERTS: ExpertSource can offer several highly qualified experts to comment on this story:

Dr. Joseph S. Cervia, medical director of Pall Corporation, is a leading expert on infectious disease in children and adults, including infections carried by water in hospitals. He is professor of Clinical Medicine and Pediatrics at the Albert Einstein College of Medicine in the Bronx, NY. Cervia is board-certified by American Academy of HIV Medicine, American Board of Pediatrics, American Board of Internal Medicine, Specialty Boards of Adult and Pediatric Infectious Diseases. As Medical Director and Senior Vice President for Pall Medical, Cervia has global responsibility for products, services and relationships in the medical arena. He can speak about how microbes, like those that cause Legionnaires' disease and other life-threatening infections, live in most hospital water systems as biofilm. He can explain in clear and simple language how biofilm gets into hospitals via ice cubes, drinking water, aerosols from showers and faucets, reprocessing of medical devices, and other routine uses of water. Cervia is also an expert in antibiotic resistance in patients and growing resistance of biofilm microbes to traditional disinfection methods. He can explain point-of-use filtration technology and its effectiveness in preventing transmission of waterborne microbes that can cause infection. He can also speak about experience in preventing transmission of Legionnaires' disease in Europe -- several nations currently mandate point-of-use 0.2 micron filters for hospitals.

Stephen Falder is the inventor of an entirely new class of biocide, which is effective against a broad spectrum of microorganisms including MRSA, E. coli, Legionella, Listeria. His company Byotrol produces a range of products that are used to combat the spread of bacteria in the health care, food processing and industrial sectors. A chemist and biologist by background, Falder has extensive expertise in the area of managing the spread of microorganisms in critical environments. Byotrol's products offer a number of benefits over conventional bactericides because they can deal effectively with drug resistant strains, continue to be effective for up to 7 days after application and are virtually harmless to humans and animals and are formulated from substances that have a very low environmental impact. Byotrol's products utilize chemicals that are already approved for use in biocides, and because of this, the company believes it can significantly shorten the time to market required for approvals.

Peter Dandalides M.D. is the President and CEO of Byotrol Health, LLC and is Director of Healthcare for Byotrol plc. Dandalides practiced as a physician in the area of clinical, consultative infectious diseases for nine years, during which time he started and managed his own private practice, taught internal medicine and infectious diseases, and led the Infection Control Department and Hospital Epidemiology program at Spartanburg Regional Medical Center, Spartanburg, South Carolina. He has held senior management positions in hospital administration, graduate medical education, healthcare insurance and the healthcare services industry, culminating in his appointment as President and Chief Operating Officer of SHPS Healthcare Services, a division of SHPS, Inc. He holds degrees in microbiology and medicine from Ohio State University. He completed post-graduate training in internal medicine at the University of Pittsburgh and infectious diseases/hospital epidemiology at the University of North Carolina. Dandalides is responsible for developing the Company's business in the healthcare sector. He has advised Byotrol LLC since 2001 and joined the company on a full-time basis in 2004.

Dr. Jack McCarthy has led numerous investigations for a wide variety of exposures to toxic pollutants and their associated health effects. His work has focused on the analysis of pollutants originating from both indoor and outdoor sources. He is the co-author of the Indoor Air Quality Handbook (2000). Dr. McCarthy received a B.S. in Biology from Boston College, and an M.S. in health sciences and an SC.D in environmental sciences and physiology, both from Harvard University. His recent articles in Time, Business Week, USA Weekly, and segments on several TV stations around the country have focused on the growing concern over the health and insurance implications of mold contamination. The public is looking for answers and guidance as to how they can put this "newly recognized" hazard into perspective. Newton, MA-based Environmental Health & Engineering (EH&E), a national leader in mold assessment and remediation management, is working on more than $150 million of mold projects around the country. EH&E has made its health and engineering staff available to provide credible, responsible, and expert background information on mold contamination related issues for print, on-camera, or on-air coverage.

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