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Top 10 Things Every Clinician Needs to Know About Legionellosis
1. |
What does the diagnosis of Legionellosis include? |
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Two clinical syndromes: Legionnaires' disease and Pontiac fever. | ||||||||||||||||||||||||||||
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2. |
Who should be tested for Legionnaires' disease? |
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View IDSA guidelines (exit site) | ||||||||||||||||||||||||||||
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3. |
How do I test for Legionnaires' disease?
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4. |
Why is it important to obtain a respiratory specimen for culture of possible Legionella infection? |
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Isolation of Legionella from respiratory secretions, lung tissue, pleural fluid, or a normally sterile site is still an important method for diagnosis, despite the convenience and specificity of urinary antigen testing. Investigations of outbreaks of Legionnaires' disease rely on both clinical and environmental isolates. Clinical and environmental isolates can be compared using monoclonal antibody and molecular techniques. Because Legionella are commonly found in the environment, clinical isolates are necessary to interpret the findings of an environmental investigation. |
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5. |
What is the preferred treatment for Legionnaires' disease? |
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6. |
Why do I need to ask patients about travel in the 14 days before onset of disease? |
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Although outbreaks of travel-associated legionellosis are infrequently identified, more than 20% of all cases are thought to be associated with recent travel. Outbreaks of Legionnaires' disease among travelers are difficult to detect because of the low attack rate, long incubation period, and the dispersal of persons from the source of the outbreak. Timely reporting of travel-associated cases could allow early identification and control of known sources of infection.
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7. |
How common is Legionnaires' disease? |
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Each year an estimated 8,000-18,000 hospitalized cases occur in the U.S. However, accurate data reflecting the true incidence of disease are not available because of underutilization of diagnostic testing and under-reporting. It is a common cause of severe pneumonia requiring hospitalization. The majority of reported cases are sporadic. Travel-associated outbreaks, outbreaks in community settings, and nosocomial and occupational outbreaks are common. |
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8. |
Where do Legionella come from? |
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Legionella can be found in natural, freshwater environments, but they are present in insufficient numbers to cause disease. Potable (drinking) water systems, whirlpool spas, and cooling towers provide the 3 conditions needed for Legionella transmission-heat, stasis, and aerosolization; therefore, these are common sources of outbreaks. |
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9. |
What are epidemiologic risk factors for legionellosis? |
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10. |
How should you report Legionellosis? |
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Legionellosis is a nationally notifiable disease. Report cases of Legionellosis to your local or state health department.
Call, fax, or mail this information to your local or state health department within 7 days of diagnosis. Prompt reporting could allow early identification and control of known sources of infection. |
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