8/10/2019 17 Legionella

1/29

LegionellaGroup 5

Benjamin Reyes

8/10/2019 17 Legionella

2/29

What is Legionella

Gram negative bacteria

A cause of legionnaires disease

A serious lung infection (pneumonia)

Naturally occurs on soil

1) Water 68 to 122F

2) In moist conditions between 20 45

C

8/10/2019 17 Legionella

3/29

8/10/2019 17 Legionella

4/29

8/10/2019 17 Legionella

5/29

8/10/2019 17 Legionella

6/29

8/10/2019 17 Legionella

7/29

8/10/2019 17 Legionella

8/29

Background on Legionella

Philadelphia, Pennsylvania in July 1976

58th annual convention of American Legions Pennsylvania Department

Dramatically emerged from obscurity

Current-day building ventilation equipment

Cooling towers

Potable-water systems10,000 to 15,000 cases

8/10/2019 17 Legionella

9/29

Background on Legionella

Pontiac fever

July 1968 (Pontiac, Michigan)

No person-to-person transmission has yet been documented.

Usually begins 2 to 10 days after an exposure to the bacteria.

8/10/2019 17 Legionella

10/29

Sour

8/10/2019 17 Legionella

11/29

Hot tubs and whirlpools on cruise ships

Cooling towers in air conditioning systems

Decorative fountains

Swimming pools

Physical therapy equipmentWater systems in hotels, hospitals and nursing homes

8/10/2019 17 Legionella

12/29

Legionella is not spread from one person to another.

Legionella is naturally found in water, especially warm water.

A person can get infected when they breathe in steam from a contaminatedhot tub.

8/10/2019 17 Legionella

13/29

Optimal growth temperature is 20-45C;

dormant below 20C

killed at temperatures above 60C.

Each year, 8,000 18,000 people in the United States are hospitalized with

Legionnaires disease.

Soil. A few people have contracted Legionnaires' disease after working in the

garden or using contaminated potting soil.

8/10/2019 17 Legionella

14/29

People at higher risk:

people over 45 years of age

smokers and heavy drinkers

people suffering from kidney disease

People with chronic lung disease

anyone with an impaired immune system

People with AIDS and lung cancerRecent surgery

8/10/2019 17 Legionella

15/29

Symptoms:

Legionnaires' disease usually develops two to 10 days after exposure tolegionella bacteria. It frequently begins with the following signs andsymptoms:

Headache

Muscle pain

Chills

Fever that may be 104 F (40 C) or higher

8/10/2019 17 Legionella

16/29

By the second or third day,Cough, which may bring up mucus and sometimes blood

Shortness of breath

Chest painGastrointestinal symptoms, such as nausea, vomiting and diarrhea

Confusion or other mental changes

8/10/2019 17 Legionella

17/29

Legionnaires disease

Legionnaires disease is a potentially fatal form of pneumonia.

Legionellosis is the collective name given to the pneumonia-like illness caused by legionellabacteria. This includes the most serious legionnaires disease, as well as the similar but lessserious conditions of Pontiac fever and Lochgoilhead fever.

The disease has no particular clinical features that clearly distinguish it from other types ofpneumonia, and laboratory investigations must therefore be carried out in order to obtain adiagnosis.

Legionnaires disease is usually treated successfully with antibiotics, but can sometimes befatal.

8/10/2019 17 Legionella

18/29

Legionnaires disease

LD is 2 to 5 times more common in men.

The death rate is 10-15%

40-50% of all cases are related to travel, usuallyabroad, where air-conditioning systems and

stored water may be less well regulated.Case numbers are highest between June andSeptember.

8/10/2019 17 Legionella

19/29

References:

http://www.hse.gov.uk/legionnaires/what-is.htm

http://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.html

http://www.patient.co.uk/doctor/legionella-and-legionnaires-disease

http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867

http://www.hse.gov.uk/legionnaires/what-is.htm

http://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.htmlhttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.mayoclinic.org/diseases-conditions/legionnaires-disease/basics/symptoms/con-20028867http://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.patient.co.uk/doctor/legionella-and-legionnaires-diseasehttp://www.cdc.gov/healthywater/swimming/rwi/illnesses/legionella.htmlhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htmhttp://www.hse.gov.uk/legionnaires/what-is.htm

8/10/2019 17 Legionella

20/29

LEGIONELLADETECTION, REMEDIATION AND PREVENTION

PRESENTED BY: ROLAND CHRISTOPHER G. TUPPAL

8/10/2019 17 Legionella

21/29

8/10/2019 17 Legionella

22/29

Detection

Direct fluorescent antibody (DFA) test

This method uses fluorescence light microscopy todetect the presence of the bacteria in watersamples.

Polymerase Chain Reaction (PCR)

Culture on Buffered Charcoal Yeast Extract

(BYCE) agaris a selective growth medium used to culture orgrow certain bacteria

8/10/2019 17 Legionella

23/29

Diagnosis

Urine Antigen Test

Culture

Blood specimen

8/10/2019 17 Legionella

24/29

Remedy/Legionella Control

Temperature Control

Chlorine

Chlorine dioxide

Moist heat sterilization

European standard

8/10/2019 17 Legionella

25/29

8/10/2019 17 Legionella

26/29

Prevention

8/10/2019 17 Legionella

27/29

Source

Bacterial contamination

Water flow and air flow rates in the tower

Percentage of aerosolized water that escape the cooling tower

Water treatment program

Improved design of cooling towers

8/10/2019 17 Legionella

28/29

Pathway

Distance from the tower

Wind conditions

Moisture level in the air

Efficiency of filters in the ventilation sytsem

8/10/2019 17 Legionella

29/29

Exposure

Individuals who are 50 years of age or older

Smokers

People with chronic lung disease

Individuals with weakened immune systems