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Current Environmental Health Reports Jun 2018The global importance of Legionnaires' disease (LD) and Pontiac fever (PF) has grown in recent years. While sporadic cases of LD and PF do not always provide contextual... (Review)
Review
PURPOSE OF REVIEW
The global importance of Legionnaires' disease (LD) and Pontiac fever (PF) has grown in recent years. While sporadic cases of LD and PF do not always provide contextual information for evaluating causes and drivers of Legionella risks, analysis of outbreaks provides an opportunity to assess these factors.
RECENT FINDINGS
A review was performed and provides a summary of LD and PF outbreaks between 2006 and 2017. Of the 136 outbreaks, 115 were LD outbreaks, 4 were PF outbreaks, and 17 were mixed outbreaks of LD and PF. Cooling towers were implicated or suspected in the a large portion of LD or PF outbreaks (30% total outbreaks, 50% confirmed outbreak-associated cases, and 60% outbreak-associated deaths) over this period of time, while building water systems and pools/spas were also important contributors. Potable water/building water system outbreaks seldom identify specific building water system or fixture deficiencies. The outbreak data summarized here provides information for prioritizing and targeting risk analysis and mitigation strategies.
Topics: Disease Outbreaks; Humans; Legionnaires' Disease; Water Microbiology; Water Supply
PubMed: 29744757
DOI: 10.1007/s40572-018-0201-4 -
Legionella feeleii: pneumonia or Pontiac fever? Bacterial virulence traits and host immune response.Medical Microbiology and Immunology Feb 2019Gram-negative bacterium Legionella is able to proliferate intracellularly in mammalian host cells and amoeba, which became known in 1976 since they caused a large... (Review)
Review
Gram-negative bacterium Legionella is able to proliferate intracellularly in mammalian host cells and amoeba, which became known in 1976 since they caused a large outbreak of pneumonia. It had been reported that different strains of Legionella pneumophila, Legionella micdadei, Legionella longbeachae, and Legionella feeleii caused human respiratory diseases, which were known as Pontiac fever or Legionnaires' disease. However, the differences of the virulence traits among the strains of the single species and the pathogenesis of the two diseases that were due to the bacterial virulence factors had not been well elucidated. L. feeleii is an important pathogenic organism in Legionellae, which attracted attention due to cause an outbreak of Pontiac fever in 1981 in Canada. In published researches, it has been found that L. feeleii serogroup 2 (ATCC 35849, LfLD) possess mono-polar flagellum, and L. feeleii serogroup 1 (ATCC 35072, WRLf) could secrete some exopolysaccharide (EPS) materials to the surrounding. Although the virulence of the L. feeleii strain was evidenced that could be promoted, the EPS might be dispensable for the bacteria that caused Pontiac fever. Based on the current knowledge, we focused on bacterial infection in human and murine host cells, intracellular growth, cytopathogenicity, stimulatory capacity of cytokines secretion, and pathogenic effects of the EPS of L. feeleii in this review.
Topics: Animals; Cell Line; Cytokines; Humans; Legionella; Legionnaires' Disease; Mice; Polysaccharides, Bacterial; Virulence; Virulence Factors
PubMed: 30386929
DOI: 10.1007/s00430-018-0571-0 -
Lancet (London, England) Jan 2016Since first identified in early 1977, bacteria of the genus Legionella are recognised as a common cause of community-acquired pneumonia and a rare cause of... (Review)
Review
Since first identified in early 1977, bacteria of the genus Legionella are recognised as a common cause of community-acquired pneumonia and a rare cause of hospital-acquired pneumonia. Legionella bacteria multisystem manifestations mainly affect susceptible patients as a result of age, underlying debilitating conditions, or immunosuppression. Water is the major natural reservoir for Legionella, and the pathogen is found in many different natural and artificial aquatic environments such as cooling towers or water systems in buildings, including hospitals. The term given to the severe pneumonia and systemic infection caused by Legionella bacteria is Legionnaires' disease. Over time, the prevalence of legionellosis or Legionnaires' disease has risen, which might indicate a greater awareness and reporting of the disease. Advances in microbiology have led to a better understanding of the ecological niches and pathogenesis of the condition. Legionnaires' disease is not always suspected because of its non-specific symptoms, and the diagnostic tests routinely available do not offer the desired sensitivity. However, effective antibiotics are available. Disease notification systems provide the basis for initiating investigations and limiting the scale and recurrence of outbreaks. This report reviews our current understanding of this disease.
Topics: Anti-Bacterial Agents; Bacteriological Techniques; Culture Techniques; Disease Outbreaks; Disease Reservoirs; Humans; Incidence; Infectious Disease Incubation Period; Legionella; Legionnaires' Disease; Risk Factors; Water Supply
PubMed: 26231463
DOI: 10.1016/S0140-6736(15)60078-2 -
The Medical Clinics of North America May 1980
Review
Topics: Adult; Air Conditioning; Anti-Bacterial Agents; Disease Outbreaks; Female; Humans; Legionnaires' Disease; Male; Middle Aged; Seasons; United States
PubMed: 6993807
DOI: 10.1016/s0025-7125(16)31600-5 -
Lancet (London, England) Dec 1980
Topics: Amoeba; Humans; Humidity; Legionella; Legionnaires' Disease
PubMed: 6108406
DOI: 10.1016/s0140-6736(80)92494-0 -
Lancet (London, England) Nov 1980
Topics: Adolescent; Adult; Aged; Air Conditioning; Alveolitis, Extrinsic Allergic; Amoeba; Child; Disease Outbreaks; Entamoeba; Fever; Humans; Humidity; Legionella; Legionnaires' Disease; Male; Michigan; Middle Aged; Occupational Diseases; Protozoan Infections
PubMed: 6107603
DOI: 10.1016/s0140-6736(80)92120-0 -
Clinical Infectious Diseases : An... Jan 2007
Topics: Antigens, Bacterial; Disease Outbreaks; Humans; Legionnaires' Disease
PubMed: 17173222
DOI: 10.1086/510394 -
Clinical Microbiology Reviews Jul 2002There is still a low level of clinical awareness regarding Legionnaires' disease 25 years after it was first detected. The causative agents, legionellae, are freshwater... (Review)
Review
There is still a low level of clinical awareness regarding Legionnaires' disease 25 years after it was first detected. The causative agents, legionellae, are freshwater bacteria with a fascinating ecology. These bacteria are intracellular pathogens of freshwater protozoa and utilize a similar mechanism to infect human phagocytic cells. There have been major advances in delineating the pathogenesis of legionellae through the identification of genes which allow the organism to bypass the endocytic pathways of both protozoan and human cells. Other bacteria that may share this novel infectious process are Coxiella burnetti and Brucella spp. More than 40 species and numerous serogroups of legionellae have been identified. Most diagnostic tests are directed at the species that causes most of the reported human cases of legionellosis, L. pneumophila serogroup 1. For this reason, information on the incidence of human respiratory disease attributable to other species and serogroups of legionellae is lacking. Improvements in diagnostic tests such as the urine antigen assay have inadvertently caused a decrease in the use of culture to detect infection, resulting in incomplete surveillance for legionellosis. Large, focal outbreaks of Legionnaires' disease continue to occur worldwide, and there is a critical need for surveillance for travel-related legionellosis in the United States. There is optimism that newly developed guidelines and water treatment practices can greatly reduce the incidence of this preventable illness.
Topics: Animals; Humans; Legionella; Legionnaires' Disease; Research; Virulence
PubMed: 12097254
DOI: 10.1128/CMR.15.3.506-526.2002 -
Revue Medicale Suisse Oct 2017Legionellosis refers to the two clinical syndromes caused by Legionella : Pontiac fever, a benign febrile illness and Legionnaires'disease (or pneumonia). Clinically and...
Legionellosis refers to the two clinical syndromes caused by Legionella : Pontiac fever, a benign febrile illness and Legionnaires'disease (or pneumonia). Clinically and radiologically, Legionnaires'disease presents itself as a « typical » pneumonia caused by Streptococcus pneumonia. Diagnosis is usually made by using urinary antigen testing. Culture and PCR are also helpful. Legionella is resistant to betalactam antibiotics, and is treated by quinolones or macrolides.
Topics: Anti-Bacterial Agents; Humans; Legionellosis; Legionnaires' Disease
PubMed: 29022658
DOI: No ID Found -
Respiratory Investigation Mar 2024
Topics: Humans; Legionella; Legionnaires' Disease; Legionella pneumophila
PubMed: 38301531
DOI: 10.1016/j.resinv.2024.01.008