Legionellosis

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Legionellosis is a potentially fatal infectious disease caused by Gram negative, aerobic bacteria belonging to the genus Legionella.[1][2] Over 90% of legionellosis cases are caused by Legionella pneumophila, a ubiquitous aquatic organism that thrives in temperatures between 25 and 45 °C (77 and 113 °F), with an optimum around 35 °C (95 °F).[3]

Legionellosis takes two distinct forms:

  • Legionnaires' disease, also known as "Legion Fever",[4] is the more severe form of the infection and produces pneumonia.[5]
  • Pontiac fever is caused by the same bacterium but produces a milder respiratory illness without pneumonia that resembles acute influenza.[5]

Legionnaires' disease acquired its name in July 1976 when an outbreak of pneumonia occurred among people attending a convention of the American Legion in Philadelphia. On January 18, 1977 the causative agent was identified as a previously unknown bacterium, subsequently named Legionella. Some people can be infected with the Legionella bacterium and have only mild symptoms or no illness at all.

Outbreaks of Legionnaires' disease receive significant media attention. However, this disease usually occurs as single, isolated cases not associated with any recognized outbreak. When outbreaks do occur, they are usually in the summer and early autumn, though cases may occur at any time of year. The fatality rate of Legionnaires' disease has ranged from 5% to 30% during various outbreaks. "The death rate for patients who develop Legionnaire's disease while in the hospital is close to 50%, especially when antibiotics are started late", according to the NIH and U.S. National Library of Medicine service's MedlinePlus. Most infections occur in those who are middle-age or older.[6]

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