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Legionnaires' Disease: It's In The Water

Legionnaires' Disease: It's In The Water

For an disease that’s not been around very long, Legionnaires’ Disease (LD) has caused a significant amount of illness, and in some cases, death. The most recent outbreak has occurred in individuals who attended the North Carolina Mountain State Fair in Fletcher, Sept. 6–15, 2019.

As of September 24, 2019, there are 9 confirmed cases of Legionnaires’ disease in Buncombe County (NC) residents, including one fatality caused by the illness.

In July of 1976, the American Legion held a conference in Philadelphia.

  • By August 12, 31 people become infected with a mysterious illness, killing 2

  • In all, 34 of the 221 people who fell ill died. It wasn’t until January of 1977 that researchers were able to pinpoint the source

  • The bacterium was named Legionella pneumophila, after the American Legion convention

 There are over 40 types of Legionella bacteria. The majority of human infections are caused by Legionella pneumophila. Legionella is an aquatic bacteria naturally found in freshwater environments. It becomes a health concern when it grows and spreads in human-made water systems, such as

  • Showers and faucets

  • Cooling towers (air-conditioning units for large buildings)

  • Hot tubs

  • Decorative fountains and water features

  • Hot water tanks and heaters

  • Large plumbing systems

Home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionella growth.

 After Legionella grows and multiplies in a water system, the contaminated water is spread in droplets small enough for people to breathe in. People can get LD when they breathe in these contaminated droplets. In general, people do not spread LD to other people, however this may be possible in rare cases.

 Legionellosis is a respiratory disease caused by Legionella bacteria. It causes a serious type of pneumonia (lung infection) called Legionnaires’ Disease.


  • Cough, which may be contain blood

  • Shortness of breath

  • High fever

  • Muscle aches

  • Headaches

Symptoms usually begin 2 to 10 days after exposure but may begin 2 weeks after.

 A milder form of the disease is known as Pontiac fever/disease. The first identified cases occurred in 1968 in Pontiac, Michigan, among people who worked at and visited the city’s health department. It is an acute, flu-like illness usually lasting 2–5 days. Symptoms include fever, chills, headache, fatigue, and muscle pain. No deaths are associated with this type of infection.


Legionnaires' Disease requires treatment with antibiotics (drugs that kill bacteria in the body), and in most cases, can be treated successfully. Healthy people usually get better after being sick, but hospitalization is often required. Possible complications include lung failure and death. About 1 out of every 10 people who get sick from LD will die.

 Prevention: The key to preventing legionellosis is maintenance of the water systems in which Legionella grow, such as hot tubs and building water systems. There are no vaccines that can prevent LD.

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