About the Disease
Legionnaires’ disease is a severe, often lethal, form of pneumonia. It’s caused by the bacterium Legionella pneumophila found in both potable and nonpotable water systems. Each year, an estimated 10,000 to 18,000 people are infected with the Legionella bacteria in the United States.
It is not uncommon for patients with Legionnaires’ disease to be admitted to the intensive care unit. Some will suffer long-term impaired health-related quality of life. A study of outbreak survivors showed persistence of fatigue (75%), neurologic symptoms (66%) and neuromuscular symptoms (63%) in months after an outbreak. See Share Your Story for a first-hand account of the severity of this disease.
Articles on Legionnaires’ Disease
Prevention of Hospital-Acquired Legionellosis
by Lin YE, Stout JE and Yu VL. Curr Opin Infect Dis. 2011. 24(4):350-6.More hospitals are facing the dilemma of Legionella outbreaks as they discover the drinking water is the source. This article provides an update of the use of PCR detection for water, the use of CFU/mL vs distal site positivity as an indicator of risk, risk assessment, neurologic complications in patients, and new laboratory tests for patient management.
Controlling Legionella in Hospital Drinking Water: An Evidence-Based Review of Disinfection Methods
by Lin YE, Stout JE and Yu VL. Infect Control Hosp Epidemiol. 2011 32(2):166-173.“State-of-the-Art” disinfection methods applied to drinking water are reviewed. Many commonly-used approaches are not only non-evidence based and ineffective but are expensive and logistically tedious to implement. Efficacy must be defined by disappearance of Legionella from the drinking water. Disinfection concentrations and % distal site positivity must be measured regularly for the lifespan of the system. Infection control professionals must take the lead in selecting the disinfection modality and the commercial vendor. Evidence-based medicine with documented record of success should be the criteria for selection; anecdotal testimonials are often unreliable. Healthcare facility managers should be consulted in an advisory role.