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It's Enough to Make You Stay Home

Legionnaire's disease is out there

By Mary Kugler, BSN, RN,C
About.com Guide to Rare/Orphan Diseases

Cleveland, Ohio, United States
Donald Tafoya had the flu. The Ford Motor Company employee decided to call in sick the next day to his job at the Cleveland (Ohio) casting plant. However, his fever, chills, and cough seemed to be getting worse, so on March 3, 2001, he went to the hospital. He was diagnosed with pneumonia in both lungs, and given a breathing tube, oxygen, and antibiotics. Initially he seemed to do much better, but on March 10, he suddenly died.

At first, doctors said the 61-year-old Tafoya had died of a cardiac arrest. However, when two of his coworkers shortly afterwards also fell ill with pneumonia, the doctors became suspicious. One of them made the correct diagnosis: infection with Legionella pneumophila, also known as legionellosis or Legionnaire's disease. The Ford plant was shut down for 5 days and the bacteria eliminated, but unfortunately another one of the ill workers died.

Melbourne, Australia
In Melbourne, two people also died of legionellosis in February and March. Three others were infected but recovered. The infection was traced to a building in the downtown area. Melbourne has had several legionellosis outbreaks over the years, the worst being in the Fall of 2000, when 100 people became ill and two died after visiting the Melbourne Aquarium.

How it got its name
Veterans at an American Legion conference in a U.S. hotel in 1976 suddenly started becoming ill. They all had serious cases of pneumonia which weren't responding well to antibiotics. About 200 men became ill, and a number of them began to die. Doctors weren't sure what this pneumonia was, and it didn't seem to be spread like other pneumonias through person-to-person contact. News media across the United States carried the story of the mystery illness which seemed to be a "new" disease. The source of the infecting bacteria was finally traced to the hotel's air conditioning system. In the end, 34 men died, and the strange pneumonia was called "Legionnaire's Disease." When the bacterium causing the infection was identified, it was named Legionella pneumophila ("pneumophila" means "lung-loving").

Where it comes from
Legionella bacteria thrive in lukewarm water found in air conditioning systems, cooling towers, whirlpool spas, and shower rooms. When these systems aren't cleaned regularly, the Legionella bacteria grow. People breathe in water mist that has the bacteria in it, and develop pneumonia. Home spas and air conditioners aren't known to harbor Legionella.

Who is at risk
Unfortunately, anyone can contract legionellosis. However, there are people who are at higher risk because they are more susceptible to infection. People who are middle-aged or elderly, and those who already have respiratory problems or are smokers are at risk, as are people with cancer, kidney failure, diabetes, or AIDS.

Can it be prevented?
If building owners follow health department guidelines for cleaning and maintaining cooling towers and air conditioning systems, Legionella is kept at bay. Also, better design of these systems will help prevent the bacteria from taking hold.

Information for this article was taken from:
Bachelard, Michael. Killer disease traced to legal site. The Australian, 19 March 2001.
Centers for Disease Control and Prevention. Legionellosis: Legionnaire's Disease and Pontiac Fever. Available online.
Multicultural Health Communications Service. The Facts About Legionnaire's Disease. Available online in many languages.
Spector, Kaye. Test confirms family's fears. The Plain Dealer, March 16, 2001.

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