By Samhar Almomani, Publishing Associate: Researcher and Writer at Save the Water™ | September 23, 2023
Legionnaires’ disease may be an unfamiliar disease to many people. Currently, it only infects around 10,000 people per year in the United States. However, the number of infections being reported has been on the rise since 2000. A recent study estimates that the actual number of infections is 1.8-2.7 times higher than is actually reported. It’s important that we start paying attention to this disease. One reason is that one in ten people who get sick from Legionnaires’ disease end up dying from it.
Recently, a major Legionnaires’ disease outbreak was reported. It resulted in the death of 16 people in Poland, with over 150 people hospitalized. This fatal outbreak shows how the disease can spread through municipal water networks and cause infections over a large area.
What is Legionnaires’ Disease?
Legionnaires’ disease is a type of pneumonia, or lung infection. It often results in serious health outcomes. The infection is caused by Legionella bacteria. It’s transmitted either through breathing in small water droplets or through swallowing water contaminated with the bacteria. There’s no person-to-person transmission, which makes containment easier.
Legionnaires’ disease was first observed in the summer of 1976 in the city of Philadelphia. It occurred during the Pennsylvania State American Legion, an organization of World War II veterans. It was first described as a mysterious epidemic that caused fatal respiratory illness. An investigation ensued. The result was a theory that the cause of the outbreak was from the Bellevue-Stratford Hotel’s air conditioning cooling units. Over 200 people showed severe cold symptoms, and the outbreak took the lives of 29 attendees. The disease was named after the Legion members, the Legionnaires’.
Before the outbreak in Philadelphia, there was a 1968 outbreak in Pontiac, Michigan among workers of the city’s health department. Researchers thought it was “Pontiac fever.” It wasn’t until the Philadelphia outbreak that researchers realized that Legionella is what caused Pontiac fever. The main difference is that Legionnaires’ disease involves pneumonia, while Pontiac fever does not.
Symptoms of Legionnaires’ Disease
It’s difficult to diagnose Legionnaires’ disease, as it often shows as common cold symptoms. The disease usually begins with a headache, muscle aches, and/or a fever that is 104F or higher. On the second or third day of the infection, more serious symptoms begin to show:
- Cough, which may appear with mucus or blood in serious incidents
- Shortness of breath or difficulty breathing
- Chest pains
- Gastrointestinal symptoms including nausea, vomiting, or diarrhea
- Fogginess, confusion, or other mental changes
Some demographics may suffer more from a Legionnaires’ disease infection:
- People who are over 50 years old
- Those who suffer from a chronic lung disease
- Those with a weakened immune system
- Current or previous smokers
- People with other chronic health conditions, such as cancer or diabetes
Recent Outbreaks
There have been a number of Legionnaires’ disease outbreaks in the past few weeks. The rising number of infections could signify an increase of outbreaks in the future and a rising number of fatalities. In some cases, the outbreak was small. For example, the August outbreak at Las Vegas hotels included two guests at Caesars Palace and one guest at The Orleans Hotel & Casino.
A smaller outbreak occurred in Lancaster, Pennsylvania. This outbreak was found at the county prison. One inmate tested positive for Legionnaires’ disease and prompted the prison to begin sanitation procedures. It was only one positive case. However, it could have easily spread to a number of other inmates due to the shared water source.
In other areas, bigger outbreaks occurred. For example, there were nine confirmed cases of Legionnaires’ disease in Passaic County and Bergen County in New Jersey. The New Jersey Department of Health receives about 250-375 reports of Legionnaires’ disease infections each year. This means dozens of contaminated water sources.
Preventing Future Outbreaks
Rising temperatures have been cited as a reason why there may be more Legionnaires’ disease outbreaks in the future. Researchers speculate that the recent outbreak in Poland could be tied to rising temperatures in the region. Consequently, it could hint towards a rising number of infections in Europe in the near future.
Water management programs that take Legionnaires’ disease into consideration are the key to preventing future outbreaks. The Centers for Disease Control and Prevention (CDC) sets out seven key elements and four principles for effective water management to control Legionnaires’ disease.
These elements and principles revolve around creating a water management program team. These teams would be dedicated to ensuring that Legionnaires’ disease does not contaminate water sources. They would have several main duties:
- Ensuring water temperatures are not in the range that promotes Legionella growth
- Putting a stop to water stagnation
- Making sure that water systems have proper sanitation
- Having devices that “prevent sediment, scale, corrosion, and biofilm” which provide the conditions for Legionella to grow
