Materiały źródłowe

• #1 Legionnaires’ Disease | Orange County California – Health Care Agency

  https://www.ochealthinfo.com/legionella

  Legionnaires’ disease is characterized by illness with pneumonia diagnosed radiographically or clinically. Clinical symptoms may vary but include acute onset of lower respiratory illness with fever or cough. […] Legionellosis is reportable in Orange County within seven calendar days of identification. To report a case, health care providers/facilities should contact Communicable Disease Control Division at (714) 834-8180 or fax reports to (714) 560-4050. […] Recommended testing for Legionnaires disease includes PCR or culture of lower respiratory specimens and urine antigen. Lower respiratory specimens should ideally be obtained prior to start of antibiotics or as soon as possible after treatment has started. The urine antigen test can detect Legionella infections in some cases for days to weeks after treatment. Urine antigen testing detects Legionella pneumophila serogroup 1, the most common cause of Legionnaires disease.

• #1

  https://www.who.int/news-room/fact-sheets/detail/legionellosis

  Legionnaires disease has an incubation period of 2 to 10 days (but up to 16 days has been recorded in some outbreaks). […] Treatments exist, but there is currently no vaccine available for Legionnaires’ disease. […] Untreated Legionnaires disease usually worsens during the first week. […] Patients with Legionnaires disease always require antibiotic treatment following diagnosis. […] The death rate as a result of Legionnaires disease depends on the severity of the disease, the appropriateness of initial anti-microbial treatment, the setting where Legionella was acquired, and host factors (for example, the disease is usually more serious in patients with immuno-suppression). […] The public health threat posed by legionellosis can be addressed by implementing water safety plans by authorities responsible for building safety or water system safety.

• #1 Legionellosis (Legionnaires’ Disease and Pontiac Fever) | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/legionellosis.htm

  Legionnaires’ disease is not normally spread from person to person. […] Treatment depends on whether or not the person has Pontiac fever or Legionnaires’ disease. Pontiac fever requires supportive care only and will go away on its own. Legionnaires’ disease is treated with antibiotics. […] Most people who get sick need care in a hospital but make a full recovery. However, about 1 out of 10 people who get Legionnaires disease die from the infection. […] Legionnaires’ disease can be prevented by minimizing growth in building water systems. This is accomplished with development and implementation of a comprehensive water management program complaint with American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) Standard 188. Centers for Medicare Medicaid Services requires hospitals, and long-term care facilities to implement a water management program meeting this industry standard.

• #1 Legionnaires’ Disease | Legionella Pneumonia | MedlinePlus

  https://medlineplus.gov/legionnairesdisease.html

  Legionnaires’ disease is a serious type of pneumonia caused by Legionella bacteria. […] These systems can include hot tubs, fountains, and the plumbing systems of large buildings, such as hotels or nursing homes. […] You are more likely to develop an infection if you: […] Live in a long-term care facility. […] If you have Legionnaires’ disease, you will likely need care in a hospital. The treatment is with antibiotics. Most people will recover, especially if they were healthy when they got the disease. Getting treatment early can increase the chances of getting better. […] You can lower your risk of getting Legionnaires’ disease if you: […] Ask about how well your buildings’ water systems are maintained.

• #1 Legionnaire’s Disease Nursing Management – RNpedia

  https://www.rnpedia.com/nursing-notes/medical-surgical-nursing-notes/legionnaires-disease-nursing-management/

  Legionnaires Disease is an acute bronchopneumonia produced by gram-negative bacillus, Legionella pneumophila. […] The following people are at risk: Middle-age and elderly people, immunocompromised patients or those with lymphoma or other disorders associated with delayed hypersensitivity, patients with chronic underlying diseases, such as diabetes, chronic renal failure, or chronic obstructive pulmonary disease, those with alcoholism, cigarette smokers, and those on a ventilator for extended periods. […] It has an incubation period around 2 to 10 days. […] Nursing Management: Closely monitor the patients respiratory status, continually monitor the patients vital signs, replace fluid and electrolytes, provide mechanical ventilation and other respiratory therapy, and give antibiotic therapy as indicated.

• #1 Legionnaire’s Disease Nursing Management and Interventions – Nurseslabs

  https://nurseslabs.com/legionnaires-disease/

  Legionnaires Disease is an acute bronchopneumonia produced by gram-negative bacillus, Legionella pneumophila. […] Nursing Management includes closely monitoring the patient’s respiratory status, continually monitoring the patient’s vital signs, replacing fluid and electrolytes, providing mechanical ventilation and other respiratory therapy, and giving antibiotic therapy as indicated.

• #1 Legionnaire’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/legionnaires-disease-nursing-diagnosis/

  Legionnaires disease is a severe form of pneumonia caused by Legionella bacteria. This nursing diagnosis focuses on the care and management of patients with Legionnaires disease, a potentially life-threatening condition that requires prompt and effective nursing interventions. […] Effective nursing interventions are crucial in managing Legionnaires disease and promoting patient recovery. The following interventions should be implemented: […] The nursing assessment is crucial in identifying and managing Legionnaires disease. The following steps outline the assessment process: […] The following are common nursing care planning goals and expected outcomes for patients with Legionnaires disease: […] The nursing assessment is crucial in identifying and managing Legionnaires disease. […] The following nursing care plans address common problems associated with Legionnaires disease:

• #1 Azthena logo with the word Azthena

  https://www.news-medical.net/health/Diagnosis-and-treatment-of-Legionnaires-disease.aspx

  Physical examination of a Legionnaires disease patient shows high rise of temperature, rapid and shallow breathing, relative slowing of heart rate etc. […] Patients with risk factors like other long term illnesses like kidney or lung disease or diabetes are usually conditions that necessitate hospital admission. This is particularly so in case of elderly patients. […] Oxygen is given via nasal tubes or via a mask to help breathing. Intravenous fluids are given as infusion via a needle in a vein in the arm to prevent dehydration. […] Heart rate, blood pressure and other vitals are closely monitored and regulated if necessary. In case of respiratory failure patients may need ventilator support for breathing.

• #1 Legionnaire’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/legionnaires-disease-nursing-diagnosis/

  The patient will report decreased fatigue and increased energy levels within 3 days. […] The patient will demonstrate improved tolerance for activities of daily living within 5 days. […] The patient will maintain oxygen saturation 92% during activities within 48 hours. […] The patient will maintain oxygen saturation 92% on prescribed oxygen therapy. […] The patient will demonstrate arterial blood gas values within normal limits within 48 hours. […] The patient will report decreased shortness of breath and improved breathing comfort within 72 hours. […] Patient and family will verbalize understanding of Legionnaires disease, its treatment, and prevention within 48 hours. […] The patient will demonstrate adherence to prescribed treatment plan throughout the hospital stay. […] Patient and family will identify at least three strategies for preventing future Legionnaires disease infections before discharge.

• #1 Legionnaires’ Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17750-legionnaires-disease

  Legionnaires disease is treated with antibiotics. You may get antibiotics through your veins (IV) or in a pill that you swallow. If you’re having trouble breathing, your provider may give you treatments to help you get enough oxygen. You’ll probably have to stay in the hospital while you’re treated. […] You may also receive extra oxygen through a tube in your nose or a mask. In serious cases, you may need to have a machine breathe for you until you can do it on your own again (mechanical ventilation). […] Building managers can reduce the risk of Legionnaires disease by maintaining and properly disinfecting water and ventilation systems. […] You can reduce your risk at home by making sure shower heads, faucets, hot tubs and humidifiers are properly cleaned. […] Legionnaires disease can make you very sick, and you’ll probably need to be treated in the hospital. Fortunately, it can be treated with antibiotics.

• #1 Legionnaires Disease Treatment & Management: Approach Considerations, Prehospital and Emergency Department Care, Inpatient Care

  https://emedicine.medscape.com/article/220163-treatment

  A delay in treatment significantly increases the risk for mortality in Legionnaires disease (LD). Therefore, include empiric anti-Legionella therapy in the regimen for severe community-acquired pneumonia and in specific cases of nosocomial pneumonia. […] Although Legionella pneumonia can present as a mild illness, most patients require hospitalization with parenteral antibiotics. Most healthy hosts exhibit clinical response to treatment within 3-5 days. […] Oxygen therapy is the mainstay of prehospital therapy in Legionnaires disease (LD). Intravenous (IV) access and fluid therapy may be indicated for dehydration or septic shock. Restraints may be required for patients with altered mental status. Seizure precautions may be indicated. […] Patient management includes the following: Control the airway as indicated clinically; support ventilation and oxygenation. Rehydrate the patient as indicated, especially in shock or diarrheal disease. Antipyretics may be used as indicated. Cardiac monitoring may be required if chest pain, hypotension, bradycardia, or other indicators are present. Obtain laboratory specimens (respiratory culture and urine antigen testing), chest radiographs, computed tomography (CT) scans, and cerebrospinal fluid (CSF), as indicated. Begin empiric antibiotic therapy.

• #1 Legionnaire’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/legionnaires-disease-nursing-diagnosis/

  The patient will maintain adequate oxygenation (oxygen saturation 92% on room air). […] The patient will demonstrate improved respiratory function and decreased work of breathing. […] The patient will remain afebrile for 24 hours. […] The patient will report reduced chest pain and discomfort. […] The patient will report decreased shortness of breath and work of breathing within 48 hours. […] The patient will demonstrate effective use of deep breathing and coughing techniques. […] The patient will maintain body temperature within normal range (97.8F-99F or 36.5C-37.2C) within 24 hours. […] The patient will demonstrate adequate hydration status (urine output 30 mL/hr, moist mucous membranes) within 24 hours. […] The patient will report increased comfort and decreased muscle aches within 12 hours.

• #1 Legionnaires’ Disease: Update on Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9124264/

  Most published studies evaluating antibiotic treatment for Legionnaires disease are observational and consequently susceptible to bias and confounding. […] Delayed antibiotic treatment in Legionella pneumonia is a factor associated with a worse prognosis. […] It is recommended that antibiotics directed against Legionella spp. be included promptly in the empirical therapy of severe cases of CAP and in cases of immunocompromised patients. Inadequate or delayed antibiotic treatments in Legionella pneumonia have been associated with worse prognosis. […] The current guidelines for CAP recommend either a fluoroquinolone (levofloxacin or moxifloxacin) or a macrolide (preferably azithromycin) as first-line therapy for Legionnaires disease. […] The optimal duration of antibiotic therapy for Legionnaires disease has not been established, and it may vary according to the antimicrobial agent used, disease severity, and response to therapy.

• #1 Legionnaires’ Disease Signs & Symptoms | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/legionnaires-disease

  Legionnaires disease requires medical treatment, normally including hospitalization. If left untreated, it can be fatal. […] If you or a loved one develops the symptoms of Legionnaires disease, seek medical care immediately. […] Legionnaires disease doesn’t just go away. It requires sustained medical attention, typically in a hospital. It is treated with antibiotics, often administered intravenously. Patients having trouble breathing may also receive oxygen until their lung capacity improves. […] With proper treatment, most persons suffering from Legionnaires disease eventually recover. Expect to continue with antibiotics for some time, even after release from the hospital. […] If not addressed, Legionnaires disease can have severe complications, up to and including death. These include respiratory failure, kidney injury, neurological problems, cardiac inflammation, and a form of muscle-tissue breakdown called rhabdomyolysis. […] The primary means of preventing Legionnaires disease is to stop the buildup of Legionella bacteria in home and commercial water-use systems. Regular maintenance is typically required.

• #1 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  Legionnaires disease (LD) is a common but under-diagnosed cause of community-acquired pneumonia (CAP), although rapid detection of urine antigen testing (UAT) and advances in molecular testing have improved the diagnosis. LD entails intensive care unit (ICU) admission in almost one-third of cases, and the mortality rate ranges from 4% to 40%. […] A high proportion of patients with LD requires intensive care unit (ICU) admission for artificial organ support therapy, with a rate that ranges from 20% to 40% according to the study. […] The aim of this review is to outline the latest advances in the diagnosis and therapy of severe LD. […] Therapy is currently based on macrolides, quinolones, or a combination of the two, with prolonged treatment in severe cases. […] Given that the incidence of LD is rising, studies on specific biomarkers of severity may be of great interest.

• #1 Legionnaires Disease Treatment & Management: Approach Considerations, Prehospital and Emergency Department Care, Inpatient Care

  https://emedicine.medscape.com/article/220163-treatment

  Patients with mild to moderate pneumonia are admitted to the hospital for parenteral antibiotics and supportive measures. Patients deemed to have a severe pneumonia may require admission to the intensive care unit (ICU) for closer monitoring. Quickly initiate empiric antibiotic treatment and obtain a diagnostic workup. […] In milder cases, patients can be treated in an outpatient setting with oral antibiotics that are targeted against Legionella and are bactericidal, have long half-lives, and achieve high lung tissue concentrations. […] For patients with moderate or severe infection that requires hospitalization, or those who cannot tolerate oral medications, the intravenous (IV) route of administration is preferred. […] Consultation with a pulmonologist or infectious disease specialist is strongly recommended in cases of Legionnaires disease (LD).

• #1 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  The host immune response (hyperinflammation and/or immunoparalysis) may also be associated with increased severity. […] Prognostic factors related to mortality or poor outcome are: age, female sex, kidney failure, prolonged corticosteroid therapy, CRP levels exceeding 500 mg/L, high severity-of-illness (APACHE II score 15 at admission or SAPS II above 46), severe hypoxemia requiring ventilatory support or high-flow nasal oxygen, renal disease, rhabdomyolysis, presence of malignancy, immunosuppression, nosocomial source of infection, and a delay of 24 h in administration of appropriate treatment. […] The potential role of combination therapy also remains controversial. […] The usefulness of procalcitonin in LD is not well-established, because its levels do not rise to the same degree as in the case of other pneumonia pathogens.

• #1 Legionella Infection Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/965492-treatment

  For Legionnaires disease (LD), a high level of suspicion and prompt initiation of adequate antimicrobial therapy are critical to improve clinical outcomes. […] Support therapy in patients with shock and respiratory failure is administered as needed. […] Specific therapy includes antibiotics capable of achieving high intracellular concentrations (eg, macrolides, quinolones, ketolides, tetracyclines, rifampin). […] Azithromycin is the drug of choice for children with suspected or confirmed Legionella disease. […] The recommended duration of therapy is 5-10 days if azithromycin is used. […] Consultations may include the following: Infectious disease specialist, Critical care specialist, Pulmonologist. […] Patients with Legionnaires disease do not require contact or respiratory isolation (person-to-person transmission has never been demonstrated). […] Standard precautions are recommended.

• #1 Legionnaires’ Disease: Update on Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9124264/

  Legionellosis is becoming increasingly important as a public health problem throughout the world; although it is an underreported disease, studies have consistently documented a high incidence. […] Testing for Legionella spp. is recommended at hospital admission for severe community-acquired pneumonia, and antibiotics directed against Legionella spp. should be included early as empirical therapy. Inadequate or delayed antibiotic treatment in Legionella pneumonia has been associated with a worse prognosis. […] Either a fluoroquinolone (levofloxacin or moxifloxacin) or a macrolide (azithromycin preferred) is the recommended first-line therapy for Legionnaires disease; however, little information is available regarding adverse events or complications, or about the duration of antibiotic therapy and its association with clinical outcomes.

• #1 Treatment – Legionella.org

  https://legionella.org/about-the-disease/what-is-legionnaires-disease/treatment/

  Legionnaires’ disease is a severe, often lethal, form of pneumonia. […] It is not uncommon for patients with Legionnaires’ disease to be admitted to the intensive care unit. […] Many antibiotics are highly effective against Legionella bacteria. […] The two most potent classes of antibiotic are the macrolides (azithromycin), and the quinolones (ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin, trovofloxacin). […] Other agents that have been shown to be effective include tetracycline, doxycycline, minocycline, and trimethoprim/sulfamethoxazole. […] Erythromycin, the former antibiotic of choice, has been replaced by more potent and less toxic antibiotics.

• #1 Legionella Infection Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/965492-treatment

  Most patients with Legionnaires disease (LD) require initial hospitalization for intravenous antibiotics. […] Closely monitor patients for signs of shock and/or respiratory or multiorgan failure and the need for ICU care. […] Patients who begin to steadily improve can be switched to oral antibiotics. […] Continue to monitor patients in the hospital for at least 1 day after switching to oral antimicrobial therapy because relapse is possible. […] Patients with Pontiac fever do not require hospitalization. […] Outpatient treatment with oral antibiotics may be considered for selected patients with mild disease if they can be closely monitored for signs of deterioration. […] Continue outpatient treatment after the patient is discharged from the hospital until antibiotic therapy is completed and symptoms resolve.

• #1 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  The role of corticosteroids as an adjuvant therapy in CAP is a hot topic nowadays. […] In general, infections secondary to intracellular pathogens are slower to respond to antibiotics. […] A strategy of test and treat, with early diagnosis and right-first-time therapy, is the cornerstone for optimal management.

• #1 Legionnaires’ Disease: Symptoms, Causes, and Treatment

  https://patient.info/chest-lungs/legionnaires-disease-leaflet

  The outlook for Legionnaires’ disease is best if the illness is diagnosed as early as possible, and you are treated with antibiotics immediately. […] After recovery from Legionnaires’ disease, you may get symptoms such as tiredness, poor concentration, cough or mild shortness of breath. These may take several months to settle.

• #1 Legionnaires’ Disease | Vermont Department of Health

  https://www.healthvermont.gov/disease-control/other-reportable-diseases/legionnaires-disease

  Talk to your health care provider if you believe you might have been exposed to Legionella and have symptoms. Be sure to mention if you have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks. The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread. Building owners and managers can develop a water management program to reduce their buildings risk for growing and spreading the bacteria.

• #1 Legionnaires’ disease | Better Health Channel

  https://www.betterhealth.vic.gov.au/health/conditionsandtreatments/legionnaires-disease

  Legionnaires disease can be treated with antibiotics and early treatment can reduce severity. […] Most people with Legionnaires disease will be admitted to hospital. […] The infection can be treated with appropriate antibiotics. […] The risk of Legionnaires disease can be reduced by ensuring the growth of Legionella bacteria in systems such as spas, hot water systems and cooling towers is controlled. […] People can also take care to avoid exposure to the bacteria from other sources, such as potting mix and water sources in the home. […] Spa pools require careful maintenance, disinfection and frequent cleaning because they provide ideal conditions for the growth of Legionella, which can be carried into the lungs by aerosols (tiny air particles) created by the spa pool jets. […] The correct use of spa pool water chemicals, good management of the disinfection, filtration and recirculation systems and regular cleaning of spa pool surfaces can keep spa pool water in a clean, safe and healthy condition.

• #1 Legionellosis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/legionellosis.shtml

  Legionellosis is a serious lung infection caused by the bacteria Legionella. This infection is also known as Legionnaires Disease. […] Routine home maintenance can prevent growth of the bacteria. […] Water Heaters: Most manufacturers recommend that water heaters be flushed every year. This helps reduce the risk of bacteria growth. […] Showers: Remove the shower head and manually clean it. This can be done by soaking it in a mixture of 1 tablespoon household bleach to 1 gallon of water for about two hours. […] Humidifiers: Humidifiers should be cleaned and disinfected regularly. Always unplug the humidifier first. Clean the inside using a mixture such as 1 tablespoon household bleach to 1 gallon of water, and dry. […] CPAP Machines and Nebulizers: Use distilled water only and clean regularly. Follow the manufacturers instructions for cleaning.

• #1 Legionellosis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/legionellosis

  Legionellosis is a serious lung infection caused by the bacteria Legionella. This infection is also known as Legionnaires Disease. […] Routine home maintenance can prevent growth of the bacteria. […] Water Heaters: Most manufacturers recommend that water heaters be flushed every year. This helps reduce the risk of bacteria growth. […] Showers: Remove the shower head and manually clean it. This can be done by soaking it in a mixture of 1 tablespoon household bleach to 1 gallon of water for about two hours. […] Humidifiers: Humidifiers should be cleaned and disinfected regularly. Always unplug the humidifier first. Clean the inside using a mixture such as 1 tablespoon household bleach to 1 gallon of water, and dry. Follow the manufacturers instructions for cleaning. […] CPAP Machines and Nebulizers: Use distilled water only and clean regularly. Follow the manufacturers instructions for cleaning.

• #1 Task Force/Recommendations For Long-Term Care Facilities | Texas DSHS

  https://www.dshs.texas.gov/legionellosis-legionnaires-disease/legionellosis-legionnaires-disease-task-force-recommendations/task-force-recommendations-long

  Nursing homes, other LTCFs, and other medical assisted living facilities pose a unique set of challenges from both the infection control and public health perspectives. […] Each LTCF should have a legionellosis control plan. This operational plan should address surveillance and reporting strategies, and when environmental (water distribution system) testing and remediation are necessary. […] If a resident of the LTCF is diagnosed with Legionnaires’ disease, either while residing in the facility or within 9 days of transfer to an acute care hospital for pneumonia, the case should be investigated in a manner similar to the way cases are investigated in the hospital setting. […] Confirmed cases of Legionnaires’ disease or Pontiac fever should be reported to the local health department (800-705-8868) as „definitely nosocomial,” or „possibly nosocomial,” or „not nosocomial” cases within one week of confirmed diagnosis.

• #1 LEGIONNAIRES’ DISEASE IN NURSING HOMES AND LONG-TERM CARE FACILITIES: AN EMERGING CATASTROPHE • The Journal of Nursing Home Research

  https://www.jnursinghomeresearch.com/442-legionnaires-disease-in-nursing-homes-and-long-term-care-facilities-an-emerging-catastrophe.html

  We recommend culturing a minimum of 10 sites in addition to all hot water tanks. We add one additional site for every 100 nursing home residents. The sites chosen should be in locations where the most disabled residents are housed. Thus, we recommend that nursing homes and long-term care facilities should perform routine cultures for Legionella in the water distribution of their nursing homes at least once a year. If the distal site positivity exceeds 30%, preventive measures are indicated. […] Based on the mode of transmission, environmental cultures for Legionella in the drinking water is a necessary first step in prevention. […] If Legionella is found in the water supply, and the distal site positivity rate exceeds 30% or patients have contracted Legionnaires disease, disinfection of the drinking water warrants primary consideration.

• #1 Legionnaires’ Disease and Legionella in Healthcare Facilities and Nursing Homes – Legionella Control Systems

  https://legionellacontrolsystems.com/legionnaires-disease-and-legionella-in-healthcare-facilities-and-nursing-homes/

  Hospitals and other healthcare facilities are at a higher risk when it comes to Legionnaires disease cases and outbreaks. It is estimated by the CDC that Legionnaires disease kills 25% of those who get it from a healthcare facility, higher than the average across all facilities. This includes facilities such as: […] In addition, these types of facilities also tend to be at higher risk for Legionnaires disease and Legionella: […] While Legionnaires disease and Legionella pose a risk to all facilities, healthcare facilities typically serve the populations at highest risk for Legionnaires disease. This is because their residents, visitors, and patients include a large population of older people and those who have certain risk factors, such as being a current or former smoker, having a chronic disease, or having a weakened immune system.

• #1 Task Force/Recommendations For Long-Term Care Facilities | Texas DSHS

  https://www.dshs.texas.gov/legionellosis-legionnaires-disease/legionellosis-legionnaires-disease-task-force-recommendations/task-force-recommendations-long

  Environmental testing should be conducted whenever there are one or more definite nosocomial cases or two or more possible nosocomial cases. […] Prevention strategies for Legionella pneumonia should be developed and implemented by all LTCFs in Texas as part of their legionellosis control plan. […] The following preventive measures should be initiated immediately whenever one definite or two possible nosocomial Legionella cases occurring within a 6 month period are identified: […] Remediation efforts should be initiated immediately to reduce levels of Legionella colonization in the facility’s water system.

• #1 Legionnaires’ disease in communities & healthcare facilities

  https://www.health.ny.gov/publications/6595/

  An investigation is required if the reported case is a patient or resident who spent time in a regulated healthcare facility, such as a hospital or nursing home. This investigation includes an environmental assessment of the facility and potential sampling for Legionella in the potable (drinking) water system. The purpose of the investigation is to try to learn the source of the exposure so it can be addressed to prevent further illness. […] Health care facilities may be required to provide alternate sources of water to their patients or residents and staff, sanitize their water systems, modify their systems, or a combination of these measures.

• #1 LEGIONNAIRES’ DISEASE IN NURSING HOMES AND LONG-TERM CARE FACILITIES: AN EMERGING CATASTROPHE • The Journal of Nursing Home Research

  https://www.jnursinghomeresearch.com/442-legionnaires-disease-in-nursing-homes-and-long-term-care-facilities-an-emerging-catastrophe.html

  We are introducing a new innovative approach using intermittent disinfection with intensive environmental monitoring of Legionella colonization. […] A major benefit of infection control participation is the avoidance of poor decision-making during the chaos of an outbreak. Inexperienced consultants and healthcare facilities managers often make costly and useless recommendations to management. Prevention can be low-cost and effective.

• #1 Nursing Facility Infection Control Requirement – Legionnaires Disease | CMS Compliance Group

  https://cmscompliancegroup.com/blog/sc-legionnaires-disease/

  The Centers for Medicare & Medicaid Services (CMS) issued a S&C letter for all Medicare certified healthcare facilities regarding its expectation that facilities have water management policies and procedures in place to reduce the risk of growth/spread of Legionella and other opportunistic pathogens in building water systems. CMS notes that Legionella outbreaks have been linked to poorly maintained water systems in buildings with large/complex systems, including nursing homes and hospitals. […] Since nursing facilities often service the at-risk population, as part of their Infection Prevention and Control Program, they must develop and adhere to P&Ps that inhibit microbial growth in their building water systems to reduce the risk of growth and spread of Legionella. To be compliant, providers must conduct a facility risk assessment to identify potential locations where waterborne pathogens could grow and spread in the water system. Facilities must also implement a water management program that considers the ASHRAE industry standard and CDC toolkit. The program must contain control measures. Testing protocols and acceptable ranges for the control measures must be specific, results documented, and corrective actions taken when necessary.

• #1 Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires Disease (LD) | CMS

  https://www.cms.gov/medicare/provider-enrollment-and-certification/surveycertificationgeninfo/policy-and-memos-to-states-and-regions-items/survey-and-cert-letter-17-30-

  Legionella Infections: The bacterium Legionella can cause a serious type of pneumonia called LD in persons at risk. […] Outbreaks have been linked to poorly maintained water systems in buildings with large or complex water systems including hospitals and long-term care facilities. […] Facilities must develop and adhere to policies and procedures that inhibit microbial growth in building water systems that reduce the risk of growth and spread of legionella and other opportunistic pathogens in water.

• #1 Mitigate Legionella in Health Care Facilities | Chardon Labs

  https://www.chardonlabs.com/resources/how-to-mitigate-legionella-outbreaks-in-health-care-facilities/

  Your WMP should also outline a response plan in case a Legionella outbreak occurs in your facility. Creating and following a comprehensive WMP is a multi-step process requiring ongoing documentation, reporting and monitoring. […] Facilities that house older individuals and people with weakened immune systems are advised to have a WMP. […] To protect the health and safety of both employees and patients, health care facilities should comply with water system standards to mitigate Legionella. […] The Joint Commission released a standard (EC.02.05.02) that went into effect in January 2022. EC.02.05.02 mandates that medical facilities have a WMP to reduce the risk of Legionella and other waterborne pathogens.

• #1 Legionnaires’ Disease and Legionella in Healthcare Facilities and Nursing Homes – Legionella Control Systems

  https://legionellacontrolsystems.com/legionnaires-disease-and-legionella-in-healthcare-facilities-and-nursing-homes/

  Both the Centers for Medicare Medicaid Services and the Centers for Disease Control and Prevention deem it essential that hospitals, nursing homes and other relevant healthcare facilities have a water management program. The program should be effective in limiting Legionella from growing and spreading in their facility, and include Legionella testing as warranted. […] An additional benefit of a comprehensive water management program is that it can have additional benefits in the control of other water-related healthcare-associated infections and pathogens including gram-negative bacteria such as Pseudomonas, Burkholderia, Stenotrophomonas, as well as nontuberculous mycobacteria. […] According to the CDC, 9 out of 10 US healthcare-associated outbreaks could be prevented with effective water management. […] If you manage a healthcare facility or nursing home, contact Legionella Control Systems right now about reducing your risk by creating or enhancing your Water Management Program. […] Contact Legionella Control Systems for CDC Legionella risk assessment and Legionella testing.

• #1 About Legionnaires’ Disease – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/basics.html

  Legionnaires disease is a serious type of pneumonia (lung infection) caused by Legionella bacteria. […] If you have symptoms of pneumonia, it is important to see a health care provider right away. Legionnaires disease is treated with antibiotics. […] The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread in building water systems and devices through good maintenance strategies. These strategies include monitoring water temperatures and disinfectant levels and preventing stagnant water conditions.

• #1 Legionnaires’ disease case at BID Needham under investigation

  https://www.wcvb.com/article/legionnaires-disease-case-needham-bid/64188736

  Massachusetts health officials are investigating one case of health care-associated Legionnaires’ disease involving a patient at a Boston-area hospital. The Massachusetts Department of Public Health confirmed the case involved someone who contracted the disease while they were a patient at Beth Israel Deaconess Hospital in Needham. Hospital officials also confirmed they were working with the state in connection with the case. […] DPH said it was dictating infection control measures to the hospital. „Legionella is a rare cause of infection in patients. Most people who are exposed to legionella do not develop infection from it. We are investigating this case and continue to take all necessary steps to protect our patients, visitors and staff,” said Dr. Sharon Wright, Chief Infection Prevention Officer for Beth Israel Lahey Health.

• #1 Legionnaires’ Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17750-legionnaires-disease

  After you go home from the hospital, you may still need to take medications to make sure the infection goes away completely. […] Talk to your healthcare provider if you have concerns about ongoing symptoms. […] If you have symptoms of Legionnaires disease, contact your healthcare provider right away. If there’s an outbreak of Legionnaires disease in a building where you’ve worked or stayed, ask your provider what precautions you should take. […] Legionnaires disease is treatable but can be life-threatening. If you think you have Legionnaires disease or have stayed in an area with an outbreak, contact your healthcare provider right away.

• #1 Legionnaires’ Disease: Causes, Signs and Treatment | Banner

  https://www.bannerhealth.com/services/infectious-disease/treatment/legionnaires-disease

  Legionnaires disease is a type of pneumonia you get from Legionella bacteria. People usually get the bacteria by breathing in droplets of water or soil that contain the bacteria. […] Legionnaires disease is treated with antibiotics. The earlier you start treatment, the better the chances of a full recovery. In some cases, people with the infection may need to stay in the hospital to receive antibiotics through an IV. Treatment may also include oxygen therapy to help your lungs get the oxygen they need. […] Early diagnosis and treatment with antibiotics can help avoid these complications. If you think you have Legionnaires disease, seek medical care immediately. Your health care provider or a Banner Health specialist can help prevent and manage complications effectively. […] Preventing Legionnaires disease is mainly about making sure that water systems are clean and well-maintained. […] Legionnaires disease is a serious infection but with proper care its treatable. If you think you’ve been exposed or are showing symptoms, don’t wait. Get medical help right away. Banner Health is here to provide expert care and resources to help you stay healthy and recover quickly.

• #2 Legionnaire’s Disease Nursing Management and Interventions – Nurseslabs

  https://nurseslabs.com/legionnaires-disease/

  Legionnaires Disease is an acute bronchopneumonia produced by gram-negative bacillus, Legionella pneumophila. […] Nursing Management includes closely monitoring the patient’s respiratory status, continually monitoring the patient’s vital signs, replacing fluid and electrolytes, providing mechanical ventilation and other respiratory therapy, and giving antibiotic therapy as indicated.

• #2 Legionnaires’ Disease | Vermont Department of Health

  https://www.healthvermont.gov/disease-control/other-reportable-diseases/legionnaires-disease

  Legionella bacteria can cause a serious type of pneumonia (lung infection) called Legionnaires disease. Legionnaires disease is not contagious and almost never spreads from person to person. Most healthy people do not get Legionnaires disease after being exposed to Legionella. People can get sick with Legionnaires’ disease when they breathe in small droplets or mist of water containing Legionella bacteria into their lungs. Outbreaks are often linked to large or complex water systems, like those found in hospitals, hotels and cruise ships. The most common sources of infection are from showers, air conditioning cooling towers, decorative fountains and hot tubs. […] Symptoms usually begin two to 14 days after being exposed to the bacteria, but it can take longer. The disease can be treated with antibiotics. Most people who get sick need care in a hospital but make a full recovery. However, about one in 10 people who get it will die from the infection.

• #2 What’s New

  https://www.cdph.ca.gov/Programs/CID/DCDC/Pages/Legionellosis(Legionella).aspx

  Most healthy people exposed to Legionella do not develop Legionnaires disease. But some people are at higher risk of getting Legionnaires disease, including: Adults over the age of 50, Current and former smokers, People with certain health conditions, such as: Chronic lung disease (including COPD and emphysema), Cancer, Diabetes, Kidney or liver failure, Treatment with medication that weakens the immune system (including chemotherapy and medicine taken after organ transplant). […] People at risk for Legionnaires disease can help prevent infection by reducing their exposure to recreational or decorative water sources where Legionella could be a concern. These include: Hot tubs, Misters and decorative water fountains, Showers outside the home, such as at gyms, spas, or recreation centers. […] Because it can be difficult to avoid breathing in mist or water droplets that could contain Legionella, the key to preventing Legionnaires disease is to reduce the growth and spread of Legionella in the first place.

• #2 Legionnaires Disease Treatment & Management: Approach Considerations, Prehospital and Emergency Department Care, Inpatient Care

  https://emedicine.medscape.com/article/220163-treatment

  A delay in treatment significantly increases the risk for mortality in Legionnaires disease (LD). Therefore, include empiric anti-Legionella therapy in the regimen for severe community-acquired pneumonia and in specific cases of nosocomial pneumonia. […] Although Legionella pneumonia can present as a mild illness, most patients require hospitalization with parenteral antibiotics. Most healthy hosts exhibit clinical response to treatment within 3-5 days. […] Oxygen therapy is the mainstay of prehospital therapy in Legionnaires disease (LD). Intravenous (IV) access and fluid therapy may be indicated for dehydration or septic shock. Restraints may be required for patients with altered mental status. Seizure precautions may be indicated. […] Patient management includes the following: Control the airway as indicated clinically; support ventilation and oxygenation. Rehydrate the patient as indicated, especially in shock or diarrheal disease. Antipyretics may be used as indicated. Cardiac monitoring may be required if chest pain, hypotension, bradycardia, or other indicators are present. Obtain laboratory specimens (respiratory culture and urine antigen testing), chest radiographs, computed tomography (CT) scans, and cerebrospinal fluid (CSF), as indicated. Begin empiric antibiotic therapy.

• #2 Legionnaires’ Disease Signs & Symptoms | Baptist Health

  https://www.baptisthealth.com/care-services/conditions-treatments/legionnaires-disease

  Legionnaires disease requires medical treatment, normally including hospitalization. If left untreated, it can be fatal. […] If you or a loved one develops the symptoms of Legionnaires disease, seek medical care immediately. […] Legionnaires disease doesn’t just go away. It requires sustained medical attention, typically in a hospital. It is treated with antibiotics, often administered intravenously. Patients having trouble breathing may also receive oxygen until their lung capacity improves. […] With proper treatment, most persons suffering from Legionnaires disease eventually recover. Expect to continue with antibiotics for some time, even after release from the hospital. […] If not addressed, Legionnaires disease can have severe complications, up to and including death. These include respiratory failure, kidney injury, neurological problems, cardiac inflammation, and a form of muscle-tissue breakdown called rhabdomyolysis. […] The primary means of preventing Legionnaires disease is to stop the buildup of Legionella bacteria in home and commercial water-use systems. Regular maintenance is typically required.

• #2 Legionellosis (Legionnaires’ disease) | health.vic.gov.au

  https://www.health.vic.gov.au/infectious-diseases/legionellosis-legionnaires-disease

  Legionellosis is an urgent notifiable condition that must be notified immediately to the Department of Health by medical practitioners and pathology services. […] Legionellosis presents as a febrile illness or pneumonia, which may be severe. […] Smokers and immunocompromised people are at increased risk of contracting legionellosis. […] Legionellosis has 2 recognised presentations – Legionnaires disease and Pontiac fever. […] Legionnaires disease – This is the pneumonic form of the illness. There is often a severe flu-like prodrome, with anorexia, nonproductive cough, malaise, myalgia and fever. […] Patients may present with any form of pneumonia. As a group, they are more likely than other community-acquired pneumonias to fulfill criteria for severe disease. […] Other features commonly include hyponatraemia, fever greater than 40 degrees celsius, renal impairment, diarrhoea and confusion. […] The incubation period for Legionnaires disease is 2-10 days, most commonly 5-6 days. […] Early antibiotic treatment improves survival. […] Australian treatment guidelines for severe pneumonia include empirical cover for legionellosis.

• #2 Legionnaire’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/legionnaires-disease-nursing-diagnosis/

  The patient will maintain adequate oxygenation (oxygen saturation 92% on room air). […] The patient will demonstrate improved respiratory function and decreased work of breathing. […] The patient will remain afebrile for 24 hours. […] The patient will report reduced chest pain and discomfort. […] The patient will report decreased shortness of breath and work of breathing within 48 hours. […] The patient will demonstrate effective use of deep breathing and coughing techniques. […] The patient will maintain body temperature within normal range (97.8F-99F or 36.5C-37.2C) within 24 hours. […] The patient will demonstrate adequate hydration status (urine output 30 mL/hr, moist mucous membranes) within 24 hours. […] The patient will report increased comfort and decreased muscle aches within 12 hours.

• #2 Treatment – Legionella.org

  https://legionella.org/about-the-disease/what-is-legionnaires-disease/treatment/

  Legionnaires’ disease is a severe, often lethal, form of pneumonia. […] It is not uncommon for patients with Legionnaires’ disease to be admitted to the intensive care unit. […] Many antibiotics are highly effective against Legionella bacteria. […] The two most potent classes of antibiotic are the macrolides (azithromycin), and the quinolones (ciprofloxacin, levofloxacin, moxifloxacin, gemifloxacin, trovofloxacin). […] Other agents that have been shown to be effective include tetracycline, doxycycline, minocycline, and trimethoprim/sulfamethoxazole. […] Erythromycin, the former antibiotic of choice, has been replaced by more potent and less toxic antibiotics.

• #2 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  The host immune response (hyperinflammation and/or immunoparalysis) may also be associated with increased severity. […] Prognostic factors related to mortality or poor outcome are: age, female sex, kidney failure, prolonged corticosteroid therapy, CRP levels exceeding 500 mg/L, high severity-of-illness (APACHE II score 15 at admission or SAPS II above 46), severe hypoxemia requiring ventilatory support or high-flow nasal oxygen, renal disease, rhabdomyolysis, presence of malignancy, immunosuppression, nosocomial source of infection, and a delay of 24 h in administration of appropriate treatment. […] The potential role of combination therapy also remains controversial. […] The usefulness of procalcitonin in LD is not well-established, because its levels do not rise to the same degree as in the case of other pneumonia pathogens.

• #2 Legionnaires Disease Treatment & Management: Approach Considerations, Prehospital and Emergency Department Care, Inpatient Care

  https://emedicine.medscape.com/article/220163-treatment

  Patients with mild to moderate pneumonia are admitted to the hospital for parenteral antibiotics and supportive measures. Patients deemed to have a severe pneumonia may require admission to the intensive care unit (ICU) for closer monitoring. Quickly initiate empiric antibiotic treatment and obtain a diagnostic workup. […] In milder cases, patients can be treated in an outpatient setting with oral antibiotics that are targeted against Legionella and are bactericidal, have long half-lives, and achieve high lung tissue concentrations. […] For patients with moderate or severe infection that requires hospitalization, or those who cannot tolerate oral medications, the intravenous (IV) route of administration is preferred. […] Consultation with a pulmonologist or infectious disease specialist is strongly recommended in cases of Legionnaires disease (LD).

• #2 Legionnaires’ Disease: Causes, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/17750-legionnaires-disease

  Legionnaires disease is treated with antibiotics. You may get antibiotics through your veins (IV) or in a pill that you swallow. If you’re having trouble breathing, your provider may give you treatments to help you get enough oxygen. You’ll probably have to stay in the hospital while you’re treated. […] You may also receive extra oxygen through a tube in your nose or a mask. In serious cases, you may need to have a machine breathe for you until you can do it on your own again (mechanical ventilation). […] Building managers can reduce the risk of Legionnaires disease by maintaining and properly disinfecting water and ventilation systems. […] You can reduce your risk at home by making sure shower heads, faucets, hot tubs and humidifiers are properly cleaned. […] Legionnaires disease can make you very sick, and you’ll probably need to be treated in the hospital. Fortunately, it can be treated with antibiotics.

• #2 Legionnaires Disease | Treatment & Management | Point of Care

  https://www.statpearls.com/point-of-care/24176

  Legionnaires disease is an atypical pneumonia frequently clinically different from other bacterial pneumonia. The predominant symptoms of Legionnaires disease include fever, cough, dyspnea, headache, and fatigue. […] The diagnosis of legionellosis is based on clinical features, laboratory tests, and imaging studies. Treatment of Legionnaires disease comprises antibiotics effective against intracellular bacteria such as fluoroquinolones, macrolides, or tetracyclines. […] Legionnaires disease remains a critical public health concern due to its potential for outbreaks, high mortality rates in untreated cases, and the challenges associated with diagnosis and control. […] Supportive care is paramount when treating patients with Legionnaires disease. Oxygen therapy is of particular importance for patients in respiratory distress or hypoxemia. Fluid supplementation is imperative in patients with severe illness, hyponatremia, or acute kidney injury.

• #2 Legionnaires’ Disease: Update on Diagnosis and Treatment

  https://pmc.ncbi.nlm.nih.gov/articles/PMC9124264/

  Most published studies evaluating antibiotic treatment for Legionnaires disease are observational and consequently susceptible to bias and confounding. […] Delayed antibiotic treatment in Legionella pneumonia is a factor associated with a worse prognosis. […] It is recommended that antibiotics directed against Legionella spp. be included promptly in the empirical therapy of severe cases of CAP and in cases of immunocompromised patients. Inadequate or delayed antibiotic treatments in Legionella pneumonia have been associated with worse prognosis. […] The current guidelines for CAP recommend either a fluoroquinolone (levofloxacin or moxifloxacin) or a macrolide (preferably azithromycin) as first-line therapy for Legionnaires disease. […] The optimal duration of antibiotic therapy for Legionnaires disease has not been established, and it may vary according to the antimicrobial agent used, disease severity, and response to therapy.

• #2 Legionella Infection Treatment & Management: Approach Considerations, Medical Care, Consultations

  https://emedicine.medscape.com/article/965492-treatment

  Most patients with Legionnaires disease (LD) require initial hospitalization for intravenous antibiotics. […] Closely monitor patients for signs of shock and/or respiratory or multiorgan failure and the need for ICU care. […] Patients who begin to steadily improve can be switched to oral antibiotics. […] Continue to monitor patients in the hospital for at least 1 day after switching to oral antimicrobial therapy because relapse is possible. […] Patients with Pontiac fever do not require hospitalization. […] Outpatient treatment with oral antibiotics may be considered for selected patients with mild disease if they can be closely monitored for signs of deterioration. […] Continue outpatient treatment after the patient is discharged from the hospital until antibiotic therapy is completed and symptoms resolve.

• #2 Legionnaire’s Disease Nursing Diagnosis & Care Plan – NurseStudy.Net

  https://nursestudy.net/legionnaires-disease-nursing-diagnosis/

  The patient will report decreased fatigue and increased energy levels within 3 days. […] The patient will demonstrate improved tolerance for activities of daily living within 5 days. […] The patient will maintain oxygen saturation 92% during activities within 48 hours. […] The patient will maintain oxygen saturation 92% on prescribed oxygen therapy. […] The patient will demonstrate arterial blood gas values within normal limits within 48 hours. […] The patient will report decreased shortness of breath and improved breathing comfort within 72 hours. […] Patient and family will verbalize understanding of Legionnaires disease, its treatment, and prevention within 48 hours. […] The patient will demonstrate adherence to prescribed treatment plan throughout the hospital stay. […] Patient and family will identify at least three strategies for preventing future Legionnaires disease infections before discharge.

• #2 Legionnaires’ Disease | Vermont Department of Health

  https://www.healthvermont.gov/disease-control/other-reportable-diseases/legionnaires-disease

  Talk to your health care provider if you believe you might have been exposed to Legionella and have symptoms. Be sure to mention if you have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks. The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread. Building owners and managers can develop a water management program to reduce their buildings risk for growing and spreading the bacteria.

• #2 Legionellosis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/airborne/legionellosis.shtml

  Legionellosis is a serious lung infection caused by the bacteria Legionella. This infection is also known as Legionnaires Disease. […] Routine home maintenance can prevent growth of the bacteria. […] Water Heaters: Most manufacturers recommend that water heaters be flushed every year. This helps reduce the risk of bacteria growth. […] Showers: Remove the shower head and manually clean it. This can be done by soaking it in a mixture of 1 tablespoon household bleach to 1 gallon of water for about two hours. […] Humidifiers: Humidifiers should be cleaned and disinfected regularly. Always unplug the humidifier first. Clean the inside using a mixture such as 1 tablespoon household bleach to 1 gallon of water, and dry. […] CPAP Machines and Nebulizers: Use distilled water only and clean regularly. Follow the manufacturers instructions for cleaning.

• #2 Nursing Facility Infection Control Requirement – Legionnaires Disease | CMS Compliance Group

  https://cmscompliancegroup.com/blog/sc-legionnaires-disease/

  The Centers for Medicare & Medicaid Services (CMS) issued a S&C letter for all Medicare certified healthcare facilities regarding its expectation that facilities have water management policies and procedures in place to reduce the risk of growth/spread of Legionella and other opportunistic pathogens in building water systems. CMS notes that Legionella outbreaks have been linked to poorly maintained water systems in buildings with large/complex systems, including nursing homes and hospitals. […] Since nursing facilities often service the at-risk population, as part of their Infection Prevention and Control Program, they must develop and adhere to P&Ps that inhibit microbial growth in their building water systems to reduce the risk of growth and spread of Legionella. To be compliant, providers must conduct a facility risk assessment to identify potential locations where waterborne pathogens could grow and spread in the water system. Facilities must also implement a water management program that considers the ASHRAE industry standard and CDC toolkit. The program must contain control measures. Testing protocols and acceptable ranges for the control measures must be specific, results documented, and corrective actions taken when necessary.

• #2 Mitigate Legionella in Health Care Facilities | Chardon Labs

  https://www.chardonlabs.com/resources/how-to-mitigate-legionella-outbreaks-in-health-care-facilities/

  Health care facilities like hospitals and nursing homes are common settings for Legionella growth. They have a higher risk of Legionnaires disease outbreaks than other facilities for a couple of reasons: […] Nursing homes and hospitals accommodate people with an increased risk of Legionellosis, such as older individuals, people with chronic illnesses or those with weak immune systems. Naturally, health care facilities are more prone to Legionnaires disease outbreaks than other buildings. […] For the above reasons, the Centers for Disease Control and Prevention (CDC) advises hospitals and nursing homes to implement robust water management plans (WMPs). These programs aim to keep Legionella and other pathogens from infiltrating their water systems and causing outbreaks in health care facilities.

• #2 Legionnaires’ disease in communities & healthcare facilities

  https://www.health.ny.gov/publications/6595/

  Legionnaires disease is a disease caused by Legionella bacteria. […] Symptoms of Legionnaires disease can include: cough, shortness of breath, high fever, muscle aches, headaches. […] Legionnaires disease is a form of pneumonia. […] People at higher risk of getting sick after being exposed are: those 50 years of age or older, current or former smokers, those with a chronic lung disease (like chronic obstructive pulmonary disease or emphysema), those with a weakened immune system from diseases like cancer, diabetes, or kidney failure, those who take drugs that suppress (weaken) the immune system (like after a transplant operation or chemotherapy). […] Hospitals, nursing homes and other regulated health care facilities in New York State (including New York City) are required to report all suspected and confirmed cases of Legionnaires disease to the local health department where the patient resides.

• #2 Task Force/Recommendations For Long-Term Care Facilities | Texas DSHS

  https://www.dshs.texas.gov/legionellosis-legionnaires-disease/legionellosis-legionnaires-disease-task-force-recommendations/task-force-recommendations-long

  Environmental testing should be conducted whenever there are one or more definite nosocomial cases or two or more possible nosocomial cases. […] Prevention strategies for Legionella pneumonia should be developed and implemented by all LTCFs in Texas as part of their legionellosis control plan. […] The following preventive measures should be initiated immediately whenever one definite or two possible nosocomial Legionella cases occurring within a 6 month period are identified: […] Remediation efforts should be initiated immediately to reduce levels of Legionella colonization in the facility’s water system.

• #2 Legionnaires’ disease in communities & healthcare facilities

  https://www.health.ny.gov/publications/6595/

  An investigation is required if the reported case is a patient or resident who spent time in a regulated healthcare facility, such as a hospital or nursing home. This investigation includes an environmental assessment of the facility and potential sampling for Legionella in the potable (drinking) water system. The purpose of the investigation is to try to learn the source of the exposure so it can be addressed to prevent further illness. […] Health care facilities may be required to provide alternate sources of water to their patients or residents and staff, sanitize their water systems, modify their systems, or a combination of these measures.

• #2 Department of Health | Communicable Disease Service | Legionellosis (Legionnaires’ Disease and Pontiac Fever)

  https://www.nj.gov/health/cd/topics/legion.shtml

  Report within 24 hours of Diagnosis to the Local Health Department. […] Maintaining Building Water Systems Prevents Legionnaires Disease […] CDC Memo (June 2017): Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires Disease.

• #2 Legionellosis (Legionnaires’ Disease and Pontiac Fever) | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/legionellosis.htm

  Legionnaires’ disease is not normally spread from person to person. […] Treatment depends on whether or not the person has Pontiac fever or Legionnaires’ disease. Pontiac fever requires supportive care only and will go away on its own. Legionnaires’ disease is treated with antibiotics. […] Most people who get sick need care in a hospital but make a full recovery. However, about 1 out of 10 people who get Legionnaires disease die from the infection. […] Legionnaires’ disease can be prevented by minimizing growth in building water systems. This is accomplished with development and implementation of a comprehensive water management program complaint with American Society of Heating, Refrigerating, and Air Conditioning Engineers (ASHRAE) Standard 188. Centers for Medicare Medicaid Services requires hospitals, and long-term care facilities to implement a water management program meeting this industry standard.

• #2 Mitigate Legionella in Health Care Facilities | Chardon Labs

  https://www.chardonlabs.com/resources/how-to-mitigate-legionella-outbreaks-in-health-care-facilities/

  Your WMP should also outline a response plan in case a Legionella outbreak occurs in your facility. Creating and following a comprehensive WMP is a multi-step process requiring ongoing documentation, reporting and monitoring. […] Facilities that house older individuals and people with weakened immune systems are advised to have a WMP. […] To protect the health and safety of both employees and patients, health care facilities should comply with water system standards to mitigate Legionella. […] The Joint Commission released a standard (EC.02.05.02) that went into effect in January 2022. EC.02.05.02 mandates that medical facilities have a WMP to reduce the risk of Legionella and other waterborne pathogens.

• #2 About Legionnaires’ Disease – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/basics.html

  Legionnaires disease is a serious type of pneumonia (lung infection) caused by Legionella bacteria. […] If you have symptoms of pneumonia, it is important to see a health care provider right away. Legionnaires disease is treated with antibiotics. […] The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread in building water systems and devices through good maintenance strategies. These strategies include monitoring water temperatures and disinfectant levels and preventing stagnant water conditions.

• #2 Legionnaires’ Disease and Legionella in Healthcare Facilities and Nursing Homes – Legionella Control Systems

  https://legionellacontrolsystems.com/legionnaires-disease-and-legionella-in-healthcare-facilities-and-nursing-homes/

  Both the Centers for Medicare Medicaid Services and the Centers for Disease Control and Prevention deem it essential that hospitals, nursing homes and other relevant healthcare facilities have a water management program. The program should be effective in limiting Legionella from growing and spreading in their facility, and include Legionella testing as warranted. […] An additional benefit of a comprehensive water management program is that it can have additional benefits in the control of other water-related healthcare-associated infections and pathogens including gram-negative bacteria such as Pseudomonas, Burkholderia, Stenotrophomonas, as well as nontuberculous mycobacteria. […] According to the CDC, 9 out of 10 US healthcare-associated outbreaks could be prevented with effective water management. […] If you manage a healthcare facility or nursing home, contact Legionella Control Systems right now about reducing your risk by creating or enhancing your Water Management Program. […] Contact Legionella Control Systems for CDC Legionella risk assessment and Legionella testing.

• #2 Legionnaires’ Disease Treatment in New Jersey | ID Care

  https://idcare.com/infection/legionnaires-disease/

  Legionnaires’ disease can be treated with antibiotics. It’s important to begin treatment early to increase the chances of a full recovery. Even after the infection is gone, some people suffer from weakness and other long-term neurologic and/or neuromuscular impairments. […] Legionnaires’ disease is a serious illness that should be treated by a doctor who specializes in infectious diseases. ID Care has a team of over 40 experienced physicians to treat a wide variety of infectious diseases, including Legionnaires’ disease. To come in for Legionnaires’ disease treatment, please contact one of our New Jersey locations for an appointment today.

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