Routine prevention activities
Cool water system registrtation and regulation
Education about potting mix (warning labels), hand washing etc
Use of sterile water in HC facilities for nebulisers
Special circumstances: clusters/outbreaks.
Exposures: Look for air conditioning towers within 500 m radius using cooling tower register,
environmental sampels, looking to match isolates against clinical specimens
Active case finding through GP alerts, ED alerts
Lab def AND clinical
Lab def = isolation of legionella (sputum) OR detection of legionella urinary antigen OR seroconversion/4x increase in legionella Ab
Clinical: fever OR cough OR pneumonia
Case Mx: urgent response for clusters, non-urgent for L. longbeachae
Case Investigation: L. pneumophilia: exposure history (CWS, spa pools, hot water systems, residence in a long-term facility, other sources of aerosols). L longbeachae: potting mix use, glove use, hand washing
Reservoir: soil and acquatic habitats
t/mission: inhalation of aerosols. Aerosol-producing devices implicated: air conditioning cooling towers, whirlpool spas, showers, fountains, car washes, nebulisers, humidifier, water misters. Also potting mix implicated.
RFs for clinical disease: smokers, underlying chronic disease, transplant recipients, HIV/AIDs, cancer, age > 50 yo
Incubation period: 2 to 10 days
Active case finding where there is suspicion of common source. Involve EHO
Contact Mx: NA unless share same environmental exposure
Legionella pneumophila and Legionella longbeachae. L pneumophila serogroup 1 causes the majority of OBs.