Legionellosis (Routine prevention activities (Cool water system…
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.