Legionnaire Disease and Pontiac Fever (cont.)
What is the treatment for legionellosis?
There are three major classes of antibiotics that are effective in treating legionellosis. These include the fluoroquinolones such as ciprofloxacin (Cipro), levofloxacin (Levaquin), and moxifloxacin (Avelox), the macrolides such as erythromycin,
azithromyocin (Zithromax), and clarithromycin (Biaxin), and the tetracyclines including doxycycline (Vibramycin). The choice of antibiotic is often dependent on the patient's clinical state, tolerance to the medication, and degree of certainty as to the diagnosis.
In severe cases of Legionnaires' disease that seem more resistant to a single antibiotic, a second drug called rifampin may be added.
Pontiac fever requires no specific treatment.
How is legionellosis spread?
Outbreaks of legionellosis have occurred after people have
inhaled aerosols that come from a water source (for example, air-conditioning cooling towers, whirlpool spas, or showers) contaminated
with Legionella bacteria. People may be exposed to these aerosols in
homes, workplaces, hospitals, or public places. Infection cannot be
acquired from another person with legionellosis, and there is no
evidence of people becoming infected from auto air conditioners or
household window air-conditioning units.
Where is the Legionella bacterium found?
Legionella organisms can be found in many types of water
systems. However, the bacteria reproduce to high numbers in warm,
stagnant water (95-115 F), such as that which is found in
certain plumbing systems and hot-water tanks, cooling towers, and
evaporative condensers of large air-conditioning systems, and
whirlpool spas. Cases of legionellosis have been identified
throughout the United States and in several other countries. The
disease likely occurs worldwide.
The bacterium thrives in the mist sprayed from air-conditioning
ducts. Thus, it can infest an entire building or airplane. Factors that are now known to enhance the growth of
Legionella
bacteria in man-made water environments include the following:
- water temperatures of 25-42 C;
- stagnation of the water;
- scale and sediment in the water; and
- certain free-living amoebae organisms in water capable of
supporting intracellular growth of legionellae.
Next: How can legionellosis be prevented? »
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