Legionnaire's disease: The pneumonia from the shower

The name of the disease comes from a meeting of former US American soldiers in Philadelphia in 1976. There, several participants fell ill with atypical pneumonia, which was not successfully treated with penicillin. About half a year later, in 1977, the pathogen was diagnosed with this mysterious disease: it is the bacterium Legionella pneumophila.

Rod-shaped bacteria trigger the disease

This serious pneumonia caused by the infection with Legionella pneumophila can have fatal consequences. Legionella are everywhere in fresh water, but not in the sea. They are rod-shaped bacteria with small flagella, with which they move. To live and multiply in water they need a temperature between 25 and 50 degrees Celsius, at higher temperatures they die.

The Legionella occurring in the water do not make you sick directly. But if legionella contaminated water is used, for example, in showers or in whirlpools, the bacteria can be inhaled through the fine mist of the water droplets. Then it can come to the disease.

The source of the Legionnaire's disease outbreak is in old and poorly maintained pipeline systems and sanitary facilities, but also in all spray and air conditioning systems.

Symptoms of Legionnaire's disease

About two to ten days after infection, the disease breaks out with the following signs:

  • malaise
  • body aches
  • a headache
  • cough

Within a few hours, the condition may have changed drastically: now there is a high fever, chills and chest pain. Occasionally, patients also complain of abdominal pain with nausea and vomiting.

The usual pathogens are missing

The clinical picture corresponds to that of conspicuously severe pneumonia, without the usual pathogens of pneumonia being found.

For example, in patients with limited immune defenses, often in the elderly, patients with diabetes, cancer or HIV, the disease can quickly kill if not detected and treated in time.

Diagnosis and therapy

The detection of Legionella is necessary to confirm the diagnosis. For example, antigens can be detected in urine using a fluorescence method.

Patients with a confirmed Legionella disease are treated with an antibiotic for at least 10 to 12 days, and immunocompromised patients for 3 weeks. In severe cases, patients are treated in the hospital.

Special home care precautions need not be taken because the disease is not transmitted from person to person and therefore there is no risk of infection.

Report to the health department

Confirmed cases of Legionnaires' disease must be reported to the Health Department. The suspected disease itself is not notifiable. The respective health department then forwards the data among other things to the Robert Koch Institute (RKI) in Berlin, where it is collected and evaluated. The RKI calculates with up to 30, 000 pneumonias by Legionella in Germany annually.

Preventive measures: remediation of old pipelines

You can not be vaccinated against Legionella. In order to prevent Legionella outbreaks, sanitary facilities, air conditioning and spray systems must be kept free of the germs. There are a number of instructions and instructions that are issued by the Baden-Baden Commission of the Federal Environmental Agency.

In new or planned drinking water heating and piping systems, for example, water temperatures below 55 degrees Celsius must never prevail at any point in the distribution system. There is no difference between hospitals, hotels or other public buildings. However, special conditions apply to intensive care units.

The hygienic requirements for the prevention of Legionella infestation also apply to dental practices and beauty salons as well as for the private sector when humidifiers or inhalers are used. These devices must be regularly and thoroughly cleaned and dried. For the holidays, it is recommended to keep the shower warm for a few minutes while leaving the bath, so that the fine mist can not be inhaled.

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