Legionella bacteria can cause a debilitating, respiratory infection known as Legionnaire’s disease as well as a milder infection known as Pontiac fever. To prevent mortality, legionella treatment for Legionnaire’s disease must be fast and include antibiotics such as quinolones, ketolides, and macrolides, and in more severe cases treatment will continue with intravenous fluids and oxygen therapy. Pontiac fever has similar symptoms to the flu, does not typically need antibiotic therapy, and resolves on its own within two to five days. For the safety of the public, the source of the legionella outbreak must be identified and contained, and the public needs to be informed about the contamination.
Legionnaire’s disease is a severe form of pneumonia accompanied by headaches, diarrhea, and vomiting. The key to controlling the mortality rates of this legionella infection is to treat the suspected infection immediately, even before a test confirms its presence. For most infections, treatment with special antibiotics, pain relievers, and sometimes anti-diarrhea medications is all that is needed. In some cases, the infection can become so severe that intravenous fluids, electrolytes, and oxygen therapy are needed.
During an infection, legionella bacteria are engulfed by white blood cells in the lungs, multiply within these cells until the cells bursts, and then the bacteria spreads to infect more white blood cells. This type of infectious cycle requires special antibiotics which can penetrate cells to destroy the legionella bacteria. For adults, quinolones, ketolides, and macrolides antibiotics are the standard treatment and capable of accessing the intracellular legionella and destroying it. In children, legionella treatment begins with intravenous azithromycin, and if the response is good the delivery method can be switched to pills. If the azithromycin response is poor, the antibiotic rifampin is added to the legionella treatment.
Pontiac fever is a mild infection caused by legionella bacteria. This illness typically lasts two to five days and is characterized by fever, muscle ache, and headache. Pontiac fever does not usually require any special legionella treatment other than to control the symptoms with over-the-counter cold or flu remedies, consume plenty of fluids to counter any fluid loss from the fever, and rest. In some cases, Pontiac fever may be treated with antibiotics if Legionnaire's disease is suspected.
Legionella bacteria is transmitted by breathing in contaminated water particles or ingesting contaminated water. Humidifiers, respiratory equipment, spas, and water distributing systems, such as shower heads and faucets, can become contaminated and spread the infection. This route of contamination often results in many people contracting the infection at about the same time. Part of the treating a legionella outbreak includes identifying the source of the contamination, treating it, and educating the public about the signs of a legionella infection.