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Ailmemts & Remedies

Legionnaires’ disease

Definition:
Legionnaires’ disease is a severe form of pneumonia. It is a potentially fatal infectious disease caused by Gram negative, aerobic bacteria belonging to the genus Legionella.  Over 90% of legionellosis cases are caused by Legionella pneumophila, a ubiquitous aquatic organism that thrives in temperatures between 25 and 45 °C (77 and 113 °F), with an optimum around 35 °C (95 °F).

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People usually get it by breathing in mist from water that contains the bacteria. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don’t spread from person to person.

Older adults, smokers and people with weakened immune systems are particularly susceptible to Legionnaires’ disease.

Legionella bacterium also causes Pontiac fever, a milder illness resembling the flu. Separately or together, the two illnesses are sometimes called legionellosis. Pontiac fever usually clears on its own. But untreated Legionnaires’ disease can be fatal. Although prompt treatment with antibiotics usually cures Legionnaires’ disease, some people continue to experience problems after treatment.

The disease and the bacterium were discovered following an outbreak at an American Legion convention in Philadelphia in 1976, hence the name.

Symptoms:
Legionnaires’ disease usually develops two to 14 days after exposure to legionella bacteria. It frequently begins with the following signs and symptoms:

*Headache
*Muscle pain
*Chills
*Fever that may be 104 F (40 C) or higher

By the second or third day, you’ll develop other signs and symptoms that may include:

*Cough, which may bring up mucus and sometimes blood
*Shortness of breath
*Chest pain
*Fatigue
*Loss of appetite
*Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
*Confusion or other mental changes

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

A mild form of Legionnaires’ disease — known as Pontiac fever — may produce symptoms including fever, chills, headache and muscle aches. Pontiac fever doesn’t infect   lungs, and symptoms usually clear within two to five days.

Causes:
Legionnaires’ is caused by a bacteria known as Legionella pneumophila.

The bacteria is found widely throughout natural water systems such as rivers and ponds but temperature is critical to its growth and it is in the warm or hot water of artificial water systems such as heating plants or whirlpools that it can really thrive, forming a biofilm or layer of living bacteria over artificial structures.

Other sources include the water systems of large buildings, cooling towers of air conditioning systems, fountains and ponds, and communal showers.

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It used to be thought that people caught Legionella when they breathed in an aerosol or fine mist of contaminated water. But while this may be true in some cases it is now thought that Legionella more commonly occurs when contaminated water in the mouth (drinking water for example) is able to get past the body’s normal defences and passes down into the lungs.

This is known as aspiration and it explains why smokers and those with chronic lung disease are especially vulnerable to Legionella. Normally fluid in the mouth is pushed down the gullet and into the stomach where any particles such as bacteria can be broken down.

The gag reflex prevents water entering into the breathing tubes, and the action of tiny hair-like projections or cilia on the mucosal membranes surface brushes back any particles that have passed towards the lungs.

But in smokers and those with lung disease or weakened immunity these mechanisms may not work properly and bacteria can pass more easily into the lungs to establish a pneumonia.

Occurrences are more common in late summer and early autumn. Men are affected more than women, particularly middle-aged men.

Complications:
Legionnaires’ disease can lead to a number of life-threatening complications, including:

*Respiratory failure. This occurs when the lungs are no longer able to provide the body with enough oxygen or can’t remove enough carbon dioxide from the blood.

*Septic shock. This occurs when a severe, sudden drop in blood pressure reduces blood flow to vital organs, especially the kidneys and brain. The heart tries to compensate by increasing the volume of blood pumped, but the extra workload eventually weakens the heart and reduces blood flow even further.

*Acute kidney failure. This is the sudden loss of your kidneys’ ability to perform their main function — filtering waste material from your blood.

When your kidneys fail, dangerous levels of fluid and waste accumulate in your body.When not treated effectively and promptly, Legionnaires’ disease may be fatal, especially if your immune system is weakened by disease or medications.

Diagnosis:
Legionnaires’ disease is similar to other types of pneumonia. To help identify the presence of legionella bacteria quickly,  doctor may use a test that checks your urine for legionella antigens — foreign substances that trigger an immune system response.  One or more of the following test may also be required:

*Blood tests

*A chest X-ray, which doesn’t confirm Legionnaires’ disease but can show the extent of infection in your lungs

*Tests on a sample of your sputum or lung tissue

*A CT scan of your brain or a spinal tap (lumbar puncture) if you have neurological symptoms such as confusion or trouble concentrating

Treatment:
Current treatments of choice are the respiratory tract quinolones (levofloxacin, moxifloxacin, gemifloxacin) or newer macrolides (azithromycin, clarithromycin, roxithromycin). The antibiotics used most frequently have been levofloxacin and azithromycin. Macrolides are used in all age groups while tetracyclines are prescribed for children above the age of 12 and quinolones above the age of 18. Rifampicin can be used in combination with a quinolone or macrolide. Tetracyclines and erythromycin led to improved outcomes compared to other antibiotics in the original American Legion outbreak. These antibiotics are effective because they have excellent intracellular penetration and Legionella infects cells.

The mortality at the original American Legion convention in 1976 was high (34 deaths in 180 infected individuals) because the antibiotics used (including penicillins, cephalosporins, and aminoglycosides) had poor intracellular penetration. Mortality has plunged to less than 5% if therapy is started quickly. Delay in giving the appropriate antibiotic leads to higher mortality.

Prognosis:
According to the journal Infection Control and Hospital Epidemiology, hospital-acquired Legionella pneumonia has a fatality rate of 28%, and the principal source of infection in such cases is the drinking-water distribution system

Prevention:
A recent research study provided evidence that Legionella pneumophila, the causative agent of Legionnaires’ disease, can travel airborne at least 6 km from its source. It was previously believed that transmission of the bacterium was restricted to much shorter distances. A team of French scientists reviewed the details of an epidemic of Legionnaires’ disease that took place in Pas-de-Calais in northern France in 2003–2004. There were 86 confirmed cases during the outbreak, of whom 18 died. The source of infection was identified as a cooling tower in a petrochemical plant, and an analysis of those affected in the outbreak revealed that some infected people lived as far as 6–7 km from the plant.

A study of Legionnaires’ disease cases in May 2005 in Sarpsborg, Norway concluded that: “The high velocity, large drift, and high humidity in the air scrubber may have contributed to the wide spread of Legionella species, probably for >10 km. “…

In 2010 a study by the UK Health Protection Agency reported that 20% of cases may be caused by infected windscreen washer systems filled with pure water. The finding came after researchers spotted that professional drivers are five times more likely to contract the disease. No cases of infected systems were found whenever a suitable washer fluid was used.

Temperature affects the survival of Legionella as follows:

*70 to 80 °C (158 to 176 °F): Disinfection range
*At 66 °C (151 °F): Legionellae die within 2 minutes
*At 60 °C (140 °F): They die within 32 minutes
*At 55 °C (131 °F): They die within 5 to 6 hours
*Above 50 °C (122 °F): They can survive but do not multiply
*35 to 46 °C (95 to 115 °F): Ideal growth range
*20 to 50 °C (68 to 122 °F): Growth range
*Below 20 °C (68 °F): They can survive but are dormant

Removing slime, which can carry legionellae when airborn, may be an effective control process

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose

Resources:
http://en.wikipedia.org/wiki/Legionellosis
http://www.mayoclinic.com/health/legionnaires-disease/DS00853/DSECTION
http://www.nlm.nih.gov/medlineplus/legionnairesdisease.html
http://www.bbc.co.uk/health/physical_health/conditions/legionnaires1.shtml

http://www.primehealthchannel.com/legionnaires-disease-symptoms-causes-tests-prevention-and-treatment.html

http://www.cruiselawnews.com/articles/legionnaires-disease/

http://rpgrecords.com/wp-content/uploads/2011/04/legionnaires-disease.jpg

Categories
Ailmemts & Remedies

Legionnaire’s disease

Other Names : Legionella pneumonia; Pontiac fever

Definition:
Legionellosis is an infectious disease caused by Gram negative, aerobic bacteria belonging to the genus Legionella. Over 90% of legionellosis cases are caused by

Legionella pneumophila, a ubiquitous aquatic organism that thrives in temperatures between 25 and 45 °C (77 and 113 °F), with an optimum around 35 °C.

The bacteria that cause Legionnaire’s disease have been found in water delivery systems. They can survive in the warm, moist, air conditioning systems of large

buildings, including hospitals.

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Legionella pneumophila (SEM)  

Lung tissue during legionellosis.

Most cases are caused by Legionella pneumophila. The rest of the cases are caused by other Legionella species.

Spread of the bacteria from person to person has not been proven.

Most infections occur in middle-aged or older people, although they have been reported in children. Typically, the disease is less severe in children.

Legionellosis takes two distinct forms:-
*Legionnaires’ disease, also known as “Legion Fever,” is the more severe form of the infection and produces pneumonia.
*Pontiac fever is caused by the same bacterium but produces a milder respiratory illness without pneumonia that resembles acute influenza

Legionnaires’ disease acquired its name in July 1976 when an outbreak of pneumonia occurred among people attending a convention of the American Legion in

Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown bacterium, subsequently named Legionella. Some people can be infected

with the Legionella bacterium and have only mild symptoms or no illness at all.

Outbreaks of Legionnaires’ disease receive significant media attention. However, this disease usually occurs as single, isolated cases not associated with any

recognized outbreak. When outbreaks do occur, they are usually in the summer and early autumn, though cases may occur at any time of year. The fatality rate of

Legionnaires’ disease has ranged from 5% to 30% during various outbreaks. “The death rate for patients who develop Legionnaire’s disease while in the hospital is

close to 50%, especially when antibiotics are started late,” according to the NIH and U.S. National Library of Medicine service’s MedlinePlus. Most infections occur

in those who are middle-age or older.

Signs and symptoms:-
Symptoms tend to get worse during the first 4 – 6 days. They typically improve in another 4 – 5 days.

Symptoms may include:……….

•Chest pain
•Coughing up blood
•Fever
•Gastrointestinal symptoms, such as diarrhea, nausea, vomiting, and abdominal pain
•General discomfort, uneasiness, or ill feeling (malaisemalaise)
•Headache
•Joint pain
•Lack of coordination (ataxiaataxia)
•Loss of energy
•Muscle aches and stiffness
•Nonproductive cough
•Shaking chills
•Shortness of breath

Laboratory tests may show that patients’ renal functions, liver functions and electrolytes are deranged, including hyponatremia. Chest X-rays often show pneumonia

with bi-basal consolidation. It is difficult to distinguish Legionnaires’ disease from other types of pneumonia by symptoms or radiologic findings alone; other tests

are required for diagnosis.

Persons with Pontiac fever experience fever and muscle aches without 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.

Cause:-
L. pneumophila is specifically considered as a pathogen of the respiratory tract. Other infections have also been reported, including haemodialysis fistulae,

pericarditis, and wound and skin infections. Bacteraemia is often associated with Legionnaires’ disease. Intestinal infections may only occur as part of respiratory

infections, and where gastrointestinal symptoms have on occasion been described.

No animal infections have been specifically recorded.

Infections of protozoa such as Hartmannella vermiformis and related protozoa have been shown to be able to support the growth of L. pneumophila in tap water. Also

Acanthamoeba, Naegleria and Tetrahymena can be infected by L. pneumophila. pathway may be how these organisms survive in the environment.

Risk Factor:
•Lung failure
•Death

Transmission:-
Legionellosis infection normally occurs after inhaling an aerosol (suspension of fine particles in air) containing Legionella bacteria. Such particles could

originate from any infected water source. When mechanical action breaks the surface of the water, small water droplets are formed, which evaporate very quickly. If

these droplets contain bacteria, the bacteria cells remain suspended in the air, invisible to the naked eye but small enough to be inhaled into the lungs. This often

occurs in poorly ventilated areas such as prisons where a condensating air conditioner can spread it throughout the entire room, infecting anyone not immune to the

strain of bacteria. Potential sources of such contaminated water include cooling towers used in industrial cooling water systems as well as in large central air

conditioning systems, evaporative coolers, hot water systems, showers, windshield washers, whirlpool spas, architectural fountains, room-air humidifiers, ice making

machines, misting equipment, and similar disseminators that draw upon a public water supply. The disease may also be spread in a hot tub if the filtering system is

defective. Freshwater ponds, creeks, and ornamental fountains are potential sources of Legionella. The disease is particularly associated with hotels, cruise ships

and hospitals with old, poorly maintained pipework and cooling systems. A study published by the European Journal of Epidemiology points to automotive windshield

washing systems as a source, recommending the addition of an antibacterial agent to the system’s reservoir.In several cases Compost sparks Legionnaire’s fear as

well.

Breeding ground:
The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning

systems of large buildings. Indoor ornamental fountains have been confirmed as a cause of Legionnaires’ disease outbreaks. In all documented cases submerged lighting

as a heat source was attributed to the outbreak. Controlling the growth of Legionella in ornamental fountains is touched on in many of the listed guidelines.

However, specific guidelines for ornamental fountains have also been published.

You may click to learn about Legionella bacteria and  How to control it

Diagnosis:
People of any age may suffer from Legionnaires’ disease, but the illness most often affects middle-age and older persons, particularly those who smoke cigarettes or

have chronic lung disease. Immunocompromised patients are also at elevated risk. Pontiac fever most commonly occurs in persons who are otherwise healthy.

The most useful diagnostic tests detect the bacteria in sputum, find Legionella antigens in urine samples, or the comparison of Legionella antibody levels to in two

blood samples taken 3 to 6 weeks apart. A urine antigen test which is simple, quick, and very reliable will only detect Legionella pneumophila serogroup 1. In

addition the urine antigen test will not identify the specific subtypes so it cannot be used to match the patient with the environmental source of infection.

Exams and Tests:-
The health care provider will perform a physical exam, and may hear abnormal sounds called crackles when listening to the chest with a stethoscope.

Tests that may be done include:

•Arterial blood gasesArterial blood gases
•Chest x-rayChest x-ray
•Complete blood count (CBCCBC), including white blood cell countwhite blood cell count
•Erythrocyte sedimentation rateErythrocyte sedimentation rate
•Liver function testsLiver function tests
•Sputum cultureSputum culture for the Legionella bacteria
•Sputum indirect fluorescent antibody test for the Legionella bacteria
•Urine tests to check for Legionella pneumophila bacteria

Treatment:
Current treatments of choice are the respiratory tract quinolones (levofloxacin, moxifloxacin, gemifloxacin) or newer macrolides (azithromycin, clarithromycin,

roxithromycin). The antibiotics used most frequently have been levofloxacin and azithromycin. Macrolides are used in all age groups while tetracyclines are

prescribed for children above the age of 12 and quinolones above the age of 18. Rifampicin can be used in combination with a quinolone or macrolide. Tetracyclines

and erythromycin led to improved outcomes compared to other antibiotics in the original American Legion outbreak. These antibiotics are effective because they have

excellent intracellular penetration and Legionella infects cells.

The mortality at the original American Legion convention in 1976 was high (34 deaths in 180 infected individuals) because the antibiotics used (including

penicillins, cephalosporins, and aminoglycosides) had poor intracellular penetration. Mortality has plunged to less than 5% if therapy is started quickly. Delay in

giving the appropriate antibiotic leads to higher mortality.

Antibiotics are used to fight the infection. Treatment is started as soon as Legionnaire’s disease is suspected, without waiting for confirmation by lab test.

Other treatments may include:

•Fluid and electrolyteelectrolyte replacement
•Oxygen (given through a mask or breathing machine)

Prognosis:
According to the journal Infection Control and Hospital Epidemiology, hospital-acquired Legionella pneumonia has a fatality rate of 28%, and the principal source of

infection in such cases is the drinking-water distribution system.

Legionnaire’s disease can be life-threatening. The death rate is higher in patients with other diseases. The death rate for patients who develop Legionnaire’s

disease while in the hospital is close to 50%, especially when antibiotics are started late.

Legionnaire’s disease can be life-threatening. The death rate is higher in patients with other diseases. The death rate for patients who develop Legionnaire’s

disease while in the hospital is close to 50%, especially when antibiotics are started late.


Prevention:

Treating water delivery systems can prevent the spread of disease.

Various studies have shown that some 40% to 60% of cooling towers tested contained Legionella.

A recent research study provided evidence that Legionella pneumophila, the causative agent of Legionnaires’ disease, can travel airborne at least 6 km from its

source. It was previously believed that transmission of the bacterium was restricted to much shorter distances. A team of French scientists reviewed the details of

an epidemic of Legionnaires’ disease that took place in Pas-de-Calais in northern France in 2003–2004. There were 86 confirmed cases during the outbreak, of whom 18

died. The source of infection was identified as a cooling tower in a petrochemical plant, and an analysis of those affected in the outbreak revealed that some

infected people lived as far as 6–7 km from the plant.

A study of Legionnaires’ disease cases in May 2005 in Sarpsborg, Norway concluded that: “The high velocity, large drift, and high humidity in the air scrubber may

have contributed to the wide spread of Legionella species, probably for >10 km. …”

In 2010 a study by the UK Health Protection Agency reported that 20% of cases may be caused by infected windscreen wiper water. The finding came after researchers

spotted that professional drivers are five times more likely to be infected.

Temperature affects the survival of Legionella as follows:-
*70 to 80 °C (158 to 176 °F): Disinfection range
*At 66 °C (151 °F): Legionellae die within 2 minutes
*At 60 °C (140 °F): Legionellae die within 32 minutes
*At 55 °C (131 °F): Legionellae die within 5 to 6 hours
*Above 50 °C (122 °F): They can survive but do not multiply
*35 to 46 °C (95 to 115 °F): Ideal growth range
*20 to 50 °C (68 to 122 °F): Legionellae growth range
*Below 20 °C (68 °F): Legionellae can survive but are dormant

Removing slime may be an effective control process.

Outbreaks:-
Philadelphia, United States, 1976
The first recognized outbreak occurred on July 27, 1976 at the Bellevue Stratford Hotel in Philadelphia, Pennsylvania, where members of the American Legion, a United

States military veterans association, had gathered for the American Bicentennial. Within two days of the event’s start, veterans began falling ill with a

then-unidentified pneumonia. They were tachypneic and complained of chest pain. As many as 221 people were given medical treatment, and 34 deaths occurred. At the

time, the U.S. was debating the risk of a possible swine flu epidemic, and this incident prompted the passage of a national swine flu vaccination program. That cause

was ruled out, and research continued for months, with various theories discussed in scientific and mass media that ranged from toxic chemicals to terrorism

(domestic or foreign) aimed at the veterans.

The U.S. Centers for Disease Control and Prevention mounted an unprecedented investigation and, by September, the focus had shifted from outside causes, such as a

disease carrier, to the hotel environment itself. In January 1977, the Legionellosis bacterium was finally identified and isolated, and found to be breeding in the

cooling tower of the hotel’s air conditioning system, which then spread it through the entire building. This finding prompted new regulations worldwide for climate

control systems.

United Kingdom, 1985
In April 1985, 175 patients were admitted to the District or Kingsmead Stafford Hospitals with chest infection or pneumonia. 28 died. The medical diagnosis showed

that this was Legionnaires’ disease and the immediate epidemiological investigation traced the source of the infection to the air-conditioning cooling tower on the

roof of the Stafford District Hospital. A Government Inquiry was set up to investigate how the infection occurred and why it became Britain’s largest epidemic of

Legionnaires’ disease. The infection was linked to one small zone in the hospital: the outpatients department. The initial investigation searched for engineering

reasons to explain why this particular zone was the risk area. More detailed and wider epidemiological surveys subsequently showed that staff working in the whole

area supplied with fresh air taken adjacent to the tower, had antibodies to the disease. The outpatients department was unique in having a very large transient

population of susceptible individuals either receiving treatment or accompanying friends.

Netherlands, 1999
In March 1999, an outbreak in the Netherlands occurred during a flower exhibition in Bovenkarspel. 200 people became ill and at least 32 people died. There is a

possibility that more people died from it, but these people were buried before the Legionella infection was recognized. The source of the bacteria were probably a

whirlpool and a humidifier in the exhibition area.

Melbourne, Australia, 2000
In April 2000, an outbreak of Legionella pnemophila serogroup 1 occurred in Melbourne, Australia. The outbreak resulted in 125 confirmed cases of Legionnaire’s

disease, with 95 (76%) hospitalised. It is reported that 4 died from the outbreak. The investigation traced the source of the infection to the cooling tower at the

newly opened aquarium. Since this outbreak, legionella infection statistics are required to be reported by the state government as a notifiable disease.[35]

Stringent Regulations were introduced by the State to control legionella in 2001.

Spain, 2001
The world’s largest outbreak of Legionnaires’ disease happened in July 2001 (patients began appearing at the hospital on July 7), in Murcia, Spain. More than 800

suspected cases were recorded by the time the last case was treated on July 22; 636–696 of these cases were estimated and 449 confirmed (so, at least 16,000 people

were exposed to the bacterium) and 6 died (a case-fatality rate of approximately 1%).

A case-control study matching 85 patients living outside the city of Murcia with two controls each was undertaken to identify the outbreak source; the

epidemiological investigation implicated the cooling towers at the Morales Meseguer Hospital. An environmental isolate from these towers with an identical molecular

pattern as the clinical isolates was subsequently identified and supported that epidemiologic conclusion.

United Kingdom, 2002
Main article: 2002 Barrow-in-Furness Legionnaires’ disease outbreak
In 2002, Barrow-in-Furness in the U.K. suffered an outbreak of Legionnaires’ disease. Six women and one man died as a result of the illness; another 172 people also

contracted the disease. The cause was found to be a contaminated cooling tower at the town’s Forum 28 arts centre. Barrow Borough Council later became the first

public body in the UK to be charged with corporate manslaughter but were cleared. They were, however, along with architect Gillian Beckingham, fined for breaches of

Health and Safety regulations in a trial that ended in 2006.

Norway, 2005
In Fredrikstad, Norway, 56 people became ill and ten died from Legionnaires’ disease caused by bacteria growing in an air scrubber of a nearby factory.

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
http://www.nlm.nih.gov/medlineplus/ency/article/000616.htm
http://en.wikipedia.org/wiki/Legionellosis

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Categories
Ailmemts & Remedies

Legionnaires’ Disease

Definition:
Legionnaires’ disease, also known as Legionellosis, is a rare form of pneumonia.It takes its name from the first known outbreak which occurred in a hotel that was hosting a convention of the Pennsylvania Department of the American Legion in 1976...

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Causes:

It is a type of pneumonia caused by bacteria. You usually get it by breathing in mist from water that contains the bacteria.The Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings. They do not seem to grow in car or window air-conditioners. The mist may come from hot tubs, showers or air-conditioning units for large buildings. The bacteria don’t spread from person to person.The disease is fatal in approximately 5% to 15% of cases.

CLICK & SEE..> :Legionella bacteria under the microscope

Symptoms:
Symptoms of Legionnaires’ disease include fever, chills, a cough and sometimes muscle aches and headaches. Other types of pneumonia have similar symptoms. You will probably need a chest x-ray to diagnose the pneumonia. Lab tests can detect the specific bacteria that cause Legionnaires’ disease.

The bacteria are more likely to make you sick if you:

* Are older than 65
* Smoke
* Have a lung disease
* Have a weak immune system

Legionnaires’ disease is serious and can be life-threatening. However, most people recover with antibiotic treatment. Legionnaires’ has an incubation period of between two and 10 days.
Initial symptoms of are similar to those of flu – headache, musclepain, and a general feeling of being unwell.These symptoms are followed by high fever and shaking chills. Nausea, vomiting, and diarrhoea may occur.On the second or third day, dry coughing begins and chest pain might occur. There may also be difficulty breathing.Mental changes, such as confusion, disorientation, hallucination and loss of memory, can occur to an extent that seems out of proportion to the seriousness of fever. Some patients may develop pneumonia. This could affect both lungs and lead to hospitalisation if severe.

Diagnosis:
Legionnaires’ disease is underreported and underdiagnosed, primarily because special tests are needed to distinguish Legionnaires’ disease from other types of pneumonia. To help identify the presence of legionella bacteria quickly, your doctor may use a test that checks your urine for legionella antigens — foreign substances that trigger an immune system response. You may also have one or more of the following:

* Blood tests
* A chest X-ray, which doesn’t confirm Legionnaires’ disease but does show the extent of infection in the lungs
* Tests on a sample of your sputum or lung tissue
* A CT scan of your brain or a spinal tap (lumbar puncture) if you have neurological symptoms such as confusion or trouble concentrating

Risk Factorts:

Legionnaires’ disease usually strikes middle-aged people. Those at risk include smokers and those with an existing health problem.Many others may contract the bug and yet show no signs of infection. It is likely that many cases of Legionnaires’ disease go undiagnosed.People suffering from cancer or chronic kidney diseases are among those less able to fight infections.Chronic diseases, such as diabetes and alcoholism, also seem to increase vulnerability to Legionnaires’ disease.Cigarette smokers are more likely to contract Legionnaires disease, perhaps because smokers are generally more likely than non-smokers to develop respiratory tract infections.

Treatment:

Legionnaires’ is most often treated with the antibiotic drugs erthryomycin and rifampin. Recovery often takes several weeks.

Prevention:

The likelihood of Legionella infection can be best reduced by good engineering practices in the operation and maintenance of air and water handling systems.Cooling towers and evaporative condensers should be inspected and thoroughly cleaned at least once a year.Corroded parts, such as drift eliminators, should be replaced. Algae and accumulated scale should be removed.Cooling water should be treated constantly. Ideally, an automatic water treatment system should be used that continuously controls the quality of the circulating water.Fresh air intakes should not be built close to cooling towers since contaminated water particles may enter the ventilation system.This page contains basic information. If you are concerned about your health, you should consult a doctor .

Disclaimer: This information is not meant to be a substitute for professional medical advise or help. It is always best to consult with a Physician about serious health concerns. This information is in no way intended to diagnose or prescribe remedies.This is purely for educational purpose.

Resources:
BBC NEWS:8 Feb, 2003
http://www.nlm.nih.gov/medlineplus/legionnairesdisease.html
http://www.mayoclinic.com/print/legionnaires-disease/DS00853/METHOD=print&DSECTION=all

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