LEGIONNAIRE'S DISEASE

General Information

DEFINITION--A form of lung infection (bronchopneumonia) named after an epidemic that affected 182 people attending an American Legion convention in 1976.

BODY PARTS INVOLVED--Bronchial tubes; lungs.

SEX OR AGE MOST AFFECTED--Both sexes, but more common in men over age 40.

SIGNS & SYMPTOMS

• General ill feeling.
• Headache.
• Chills and fever up to 105F (40.6C).
• Muscle aches.
• Cough without sputum that progresses to one with gray or blood-streaked sputum.
• Nausea, vomiting, diarrhea.
• Disorientation.

CAUSES--Infection from bacteria (Legionella pneumophilia) that is not contagious between persons. The germ is transmitted through the air, and the incubation period after exposure is 2 to 10 days. In the 1976 epidemic, the germ was transmitted through the cooling and evaporating elements of a large, central air-conditioning system. The bacteria are also found in excavation sites and newly plowed soil.

RISK INCREASES WITH

• Chronic, debilitating illness including diabetes mellitus, chronic kidney failure or emphysema.
• Smoking. This increases the risk 3 to 4 times.
• Excess alcohol consumption.
• Use of immunosuppressive drugs, including cortisone and anticancer drugs.

> Don't drink more than 1 or 2 alcoholic drinks--if any--a day.

What To Expect

DIAGNOSTIC MEASURES--

• Your own observation of symptoms.
• Medical history and physical exam by a doctor.
• Laboratory blood studies and culture of sputum, bronchoscopy (see Surgery section).

APPROPRIATE HEALTH CARE

• Doctor's treatment.
• Hospitalization for intensive care and oxygen (severe cases).
• Self-care for mild cases or during convalescence after hospitalization.

POSSIBLE COMPLICATIONS

• Shock or delirium.
• Congestive heart failure.
• Kidney failure.
• Heart-rhythm disturbances.

PROBABLE OUTCOME--Usually curable with prompt diagnosis and treatment. If untreated, 15% of cases are fatal.

How To Treat

GENERAL MEASURES----The following apply to mild cases or to care after hospitalization:

• Use a cool-mist ultrasonic humidifier to increase air moisture and thin lung secretions so they can be coughed up more easily. Clean humidifier daily.
• Use warm compresses or a heating pad on the chest to relieve chest pain.
• Practice deep-breathing exercises as often as your strength allows.
• Avoid loud talking, laughing or singing. They may trigger excessive coughing.
• Keep warm. If you become chilled, the infection can become more severe.

MEDICATION--

• Your doctor may prescribe antibiotics. Be sure to finish all prescribed medication.
• If the cough is painful and doesn't produce sputum, you may use non-prescription medicine to suppress it. If the cough produces sputum, don't suppress it.
• You may take aspirin or acetaminophen to reduce fever.

ACTIVITY--Rest in bed until completely well. Allow 2 to 4 weeks for recovery.

DIET--No special diet. Maintain adequate fluid by drinking 6-8 glasses daily.

Call Your Doctor If

• You have symptoms of Legionnaire's disease.
• The following occurs during or after treatment: Temperature spike to 102F (38.9C). Severe chest pain, despite treatment. Increased shortness of breath. Dark or bluish nails, lips or skin. Blood in the sputum.
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.