Legionnaires Disease Outbreaks

At this time of the year, respiratory diseases are a concern and occupy a prominent place in the news. While COVID-19 and flu are recurring topics of media discussion, other illnesses are also emerging as noteworthy. Recently, there have been outbreaks of Legionnaires Disease in various corners of the world. Due to how Legionnaires Disease can spread and the potential impact on the individual, traveling professionals and policymakers would be well advised to stay abreast of developments relating to this outbreak.

What is Legionnaires Disease?

Legionnaires disease is a respiratory illness caused by an infection of the bacteria Legionella. It manifests as a severe form of pneumonia. The infection leads to inflammation of the lungs and the resulting difficulties. Typically, Legionnaires Disease infection takes place when the Legionella bacteria is inhaled or swallowed, with the source often being dirt or standing fresh water. 

Legionnaires Disease has a close relationship with water, particularly closed water supplies. Found naturally in many “wild” water sources, Legionnaires typically become an issue for humans when they take up residence in an enclosed man-made water system, such as:

• Showerheads, faucets, and other fixtures
• Hot water tanks and water heaters
• Complex and/or sizeable plumbing or irrigation systems
• Hot tubs and saunas
• Fountains and other decorative water features

Infections are often caused when someone inhales or imbibes water or water particles containing Legionella. When it does spread to humans, Legionnaires Diseases typically display symptoms between two and ten days after infection. The 1 to 3 days  of a Legionnaires infection often start with the following symptoms:

• Headache
• Muscle aches
• Fever that may be 104 F (40 C) or higher

By the second or third day, individuals with Legionnaires typically progress to an expanded set of symptoms, including the following:

• Cough, which might bring up mucus and sometimes blood
• Shortness of breath
• Chest pain
• Gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
• Confusion or other mental changes

Beyond exposure, a few risk factors may make an individual susceptible to Legionnaires’ Disease. These include tobacco use, chronic lung or respiratory issues, advanced age, and a weakened immune system. Contact a medical professional immediately if you’ve been exposed to Legionnaires’ Disease or are displaying its characteristic symptoms. 

Current Legionnaires Outbreaks

While Legionnaires Disease isn’t prevalent in the developed world, recently, there have been a series of infections and outbreaks. Chiefly found in the northeastern US and the Upper Midwest, these instances of Legionnaires Disease are all linked to multi-unit housing buildings or resorts/hotels. The water system in a large Brooklyn public housing complex, the hot tub at a New Hampshire resort, and a public water system in Minnesota have all led to cases or outbreaks of Legionnaires. Legionella is an opportunistic bacteria that will take up residence wherever conditions are right, without care for class or status.

While there is no reason for excess concern regarding Legionnaires Disease, some basic precautions for travelers may be in order if they intend to visit areas that have experienced an outbreak. Some possible precautions include the following: 

• Avoid accommodation that features poorly maintained plumbing, poorly cleaned bathrooms and toilets, or otherwise degraded water infrastructure.
• Avoid use of hot tubs and similar devices, as these are common incubators for Legionella.
• When possible avoid public or shared showers like those in a gym or public pool.
• Seek immediate medical advice if exposed to Legionnaires or exposure is suspected.

Legionnaires disease is no cause for panic, but rather awareness, careful planning, and consistent engagement with expert advice and professional resources. By exercising these routine cautions, we can all limit the possibility of infection.