Legionnaire's Disease

What is Legionnaire's disease?

Legionnaire's disease (LD) is a condition where germs called Legionella cause damage to your lungs. The Legionella germs can be found in many different water sources. You can get LD year round, but most people are infected in the summer and fall. Sometimes LD can occur in outbreaks, where two or more people are infected. Outbreaks happen when people who have been in the same place get LD at almost the same time. Early treatment of LD can decrease or prevent any damage to other organs in your body. With treatment, the LD germs will be killed, and you may recover without any further problems.

What causes LD?

LD is caused by breathing in steam or water droplets infected with Legionella germs. You may also get LD by choking on infected liquids and foods. Examples of foods are pureed (blended) or tube feedings mixed with infected water. LD cannot be passed on from one person to another. The germs usually grow in places with warm water which includes any of the following:

• Air-conditioning systems and cooling towers of large buildings.
  
  
• Hot water tanks.
  
  
• Humidifiers and mechanical ventilators (breathing machines).
  
  
• Lakes, ponds, rivers, streams, and thermal pools.
  
  
• Large plumbing systems and bathroom shower heads.
  
  
• Water fountains, ice machines, and vegetable misters.
  
  
• Whirlpool spas and hot tubs.

What increases my risk of getting LD?

All people who breathe in Legionella germs may not get sick. Any of the following may increase your risk of getting LD:

• Age: People 65 years old and older have an increased risk of getting LD.
  
  
• Long-term care facilities: Staying in a healthcare facility or rehabilitation center for long periods of time may increase your risk.
  
  
• Smoking and alcohol abuse: Smoking and drinking many alcoholic drinks for a long period of time increases your risk of getting LD. Both smoking and alcohol abuse decrease your body's ability to protect against inhaled germs.
  
  
• Travel: Traveling to other countries and visiting different places may increase your risk of getting LD.
  
  
• Weak immune system: Your body's immune system helps your body fight infection. Medical problems such as cancer, diabetes, heart disease, and lung or kidney problems may weaken your immune system. Certain medicines such as steroids, or antirejection medicines may also weaken your immune system. Antirejection medicines are taken after an organ transplant to protect the new organ.

What are the signs and symptoms of LD?

LD symptoms usually appear 2 to 10 days after being exposed to the germs. You may have any of the following:

• Chills, shaking, or fever.
  
  
• Decreased appetite and no energy.
  
  
• Dry cough and trouble breathing.
  
  
• Headaches and body pain.
  
  
• Passing dark or bloody urine.
  
  
• Problems thinking and remembering things.
  
  
• Throwing up, having loose watery stools, or pain in your stomach.

How is LD diagnosed?

Your caregiver will ask what symptoms you have and how bad they are. He may ask which places or countries you have visited in the last two weeks. He may also ask if you visit spas or use hot tubs often. Tell him if anyone in your home or workplace has had a recent lung infection. Tell him if you have had pipes or plumbing repaired at home or work recently. You may need one or more of the following:

• Blood tests: You may need blood taken to give caregivers information about how your body is working. The blood may be taken from your hand, arm, or IV.
  
  
• Bronchoscopy: This is a procedure to look inside your airway and learn the cause of your airway or lung condition. A bronchoscope (thin tube with a light) is inserted into your mouth and moved down your throat to your airway. You may be given medicine to numb your throat and help you relax during the procedure. Tissue and fluid may be collected from your airway or lungs to be tested.
  
  
• Chest x-ray: This is a picture of your lungs. Caregivers may use the x-ray to look for signs of pneumonia (lung infection) that can occur with LD.
  
  
• Sputum sample: Sputum (mucus from your lungs) is collected in a cup when you cough. The sample is sent to a lab to be tested for the germ that is causing your illness. It can also help your caregiver choose the best medicine to treat the infection.
  
  
• Urine sample: For this test you need to urinate into a small container. You will be given instructions on how to clean your genital area before you urinate. Do not touch the inside of the cup. Follow instructions on where to place the cup of urine when you are done.

How is LD treated?

Caregivers will give you medicines called antibiotics to kill the germs causing LD. The antibiotics may be given IV for the first 7 to 10 days. An IV is a tube placed in your vein for giving medicine or liquids. This tube is capped or connected to tubing and liquid. You may also need to take antibiotics by mouth for a period of time after.

How can I prevent LD?

You may be able to kill the germs causing LD by cleaning the places they may grow often. You may need to use a special cleaning fluid to kill the germs that cause LD. Ask your caregiver for more information on which cleaning fluids to use. You may also do the following:

• Have your air-conditioning system, hot tubs, or water tanks cleaned regularly.
  
  
• If you have a humidifier, follow the instructions on how to keep it clean.
  
  
• If you use a nebulizer, use sterile (clean) water for it. Follow the instructions on how to use and keep your nebulizer clean. A nebulizer is a special device which gives breathing medicines in a mist form.
  
  
• Tell your caregiver if someone you work or live with may have LD.

When should I call my caregiver?

Call your caregiver if:

• You have chills, shaking, or fever.
  
  
• You have very dry skin, dry mouth and tongue, or feel very thirsty.
  
  
• You have questions or concerns about your condition, treatment, or care.

When should I seek immediate help?

Seek care immediately or call 911 if:

• You cannot stop throwing up and cannot keep your medicines down.
  
  
• You cough up blood.
  
  
• You feel dizzy, or have problems thinking and remembering things clearly.
  
  
• You have trouble breathing.
  
  
• You suddenly have chest pain.
  
  
• Your symptoms become worse, even after taking medicine.

Where can I find more information?

Contact the following for more information:

• Centers for Disease Control and Prevention
  1600 Clifton Road
  Atlanta , GA 30333
  Phone: 1- 404 - 6393311
  Phone: 1- 800 - 3113435
  Web Address: http://www.cdc.gov
  

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment.

Learn more about Legionnaire's Disease