Legionnaires Disease on Rise in US--2016 Update

Laura A. Cooley, MD, MPHTM


June 13, 2016

Editorial Collaboration

Medscape &

Treatment and Surveillance of Legionnaires Disease

If your patient has Legionnaires disease, see the most recent guidelines for treatment of community-acquired pneumonia. If your patient has Pontiac fever, antibiotic therapy should not be prescribed. It is a self-limited illness that does not benefit from antibiotic treatment. Recovery usually occurs within 1 week.

Reporting Legionnaires Disease

Legionellosis is a nationally notifiable disease in the United States that is monitored through three surveillance systems at the national level. With improved diagnosis and continued good reporting, public health experts can better understand the true burden of legionellosis.

Timely identification and reporting of legionellosis cases allows public health officials to quickly identify and stop potential clusters and outbreaks. Outbreaks among travelers can be difficult to detect because of the low attack rate, long incubation period, and the dispersal of people from the source of the outbreak, so collecting and reporting information about overnight travel in the 14 days prior to onset is important.

Healthcare facility exposures can be difficult to ascertain if the patient has not been in the same facility for the entire incubation period or was discharged prior to onset and readmitted. Outpatient, inpatient, employee, and visitor exposures to a healthcare facility should be assessed for every Legionnaires disease patient and reported because they can help determine the scope and source of a healthcare-associated outbreak. Timely reporting of healthcare-associated cases ensures that steps can be taken to protect these highly susceptible populations.

Prevention of Legionellosis

The key to preventing legionellosis is maintenance of the water systems in which Legionella may grow, including drinking water systems, hot tubs, decorative fountains, and cooling towers. If Legionella are found, facility staff should be prepared to eliminate them, especially if the facilities serve people at increased risk for legionellosis. CDC encourages all building owners and especially healthcare facility administrators to develop comprehensive Legionella water management programs. Learn more about components of a Legionella water management program by viewing CDC's toolkit.

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