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Legionnaire’s disease

Long-Term Care Nursing Advisor, October 21, 2005

Canadian health officials recently declared Legionnaire's disease the source of an outbreak that killed nearly to 20 people in a Toronto nursing home.

Caused by a type of bacteria called Legionalla, Legionnaire's disease is a type of pneumonia that can cause death in 5%-30% of infected victims. Legionella is found naturally in the environment, usually in standing water. People usually become infected with Legionnaire's disease when they breathe in vapor contaminated with the bacteria.

Symptoms typically appear two to 14 days after exposure and include high fever, cough, chills, joint pain, and shortness of breath.

There are a number of tests clinicians can use to determine the presence of the disease. Chest auscultation may reveal rales or rhonchi, and pericarditis and endocarditis may be present. Urine tests for the bacteria may be positive, and sputum-direct fluorescent antibody staining may reveal legionella. Arterial blood gas analysis may show a low concentration of oxygen, and complete blood count tests frequently indicate increased white blood cell counts.

Legionnaire's disease is most commonly treated with antibiotics, especially those in the macrolides and quinolones classes.

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