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Legionnaires disease: historical perspective.
1Department of Pathology, University of Vermont, College of Medicine, Burlington 05405.
Clinical Microbiology Reviews
|January 1, 1988
Summary
Legionella bacteria, identified after a 1976 epidemic, cause respiratory disease. Environmental sources like water systems are key, and cell-mediated immunity is crucial for defense.
Area of Science:
- Microbiology
- Infectious Diseases
- Public Health
Background:
- The 1976 Philadelphia epidemic revealed a new bacterial family, Legionellaceae, responsible for respiratory illness.
- Legionella bacteria, first isolated in 1943, were later linked to earlier unsolved respiratory disease outbreaks.
- Legionellaceae are now recognized as significant causes of both sporadic and epidemic respiratory infections.
Observation:
- Environmental sources, including cooling towers and potable water systems, harbor Legionella bacteria.
- Geographic variations in infection frequency have been observed, with water systems being a primary concern.
- The exact transmission route from drinking water remains undetermined.
Findings:
- Legionellaceae are gram-negative, facultative, intracellular pathogens.
- Alveolar macrophages are the primary replication site for these bacteria.
- Cell-mediated immunity is the main host defense, while humoral immunity's role is less understood.
Implications:
- Erythromycin is the recommended antibiotic for treating Legionella infections.
- Identifying and eliminating environmental sources of Legionella is critical for infection control.
- Further research is needed to clarify transmission routes and the role of humoral immunity.
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