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Health Officials Investigate Cases of Legionnaire's Disease


Posted Date: 10/31/2019

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October 31, 2019

To: Northeast Texas Clinicians

From: NET Health Public Health Emergency Preparedness Department - Disease Surveillance Division

Subject: Increase in Legionnaires’ disease cases in Northeast Texas

This memo provides clinicians with information regarding the increase in reported Legionnaires’ disease

cases in Northeast Texas and recommendations for diagnosis and reporting. Background:

State and local health agencies are investigating cases of Legionnaires’ disease in individuals who attended the East Texas State Fair held in Tyler, TX, Sept. 20-29, 2019. Public health officials are currently investigating whether and how people might have been exposed to Legionella bacteria at this event.

Recommendations:

Clinicians should consider Legionellosis in patients who attended the East Texas State Fair and present with symptoms consistent with Legionnaires’ disease within 2-10 days or Pontiac fever within 1-3 days of their last visit to the East Texas State Fair.

  • Legionnaires’ disease is pneumonia caused by Legionella bacteria and is very similar to other types

of pneumonia, with symptoms that include cough, shortness of breath, fever, muscle aches or headaches. Patients at highest risk include those aged ≥50 years, current or former smokers, and those with chronic lung disease (such as emphysema or COPD) or a weakened immune system.

  • Pontiac fever is a milder, self-resolving infection caused by the same bacteria. Primary symptoms include fever and muscle aches.

Diagnosis:

  • The preferred diagnostic tests for Legionnaires’ disease are the Legionella urinary antigen test and culture of lower respiratory secretions (e.g., sputum, bronchoalveolar lavage) on selective media. Sputum should ideally be obtained prior to antibiotic administration, but antibiotic treatment should not be delayed to facilitate this process. The urinary antigen test can detect Legionella infections in some cases for days to weeks after treatment.
  • Testing is not recommended for individuals who attended the fair but do not have symptoms of

Legionnaires’ disease or Pontiac fever.

  • Serological assays can be nonspecific and are not typically recommended. Reporting:

Physicians are required to report all suspected Legionnaires’ disease cases to public health. These cases can be reported to the NET Health Disease Surveillance Branch at 903-595-1350.

Additional information about Legionnaires’ disease is available at https://www.cdc.gov/legionella/index.html https://epi.dph.ncdhhs.gov/cd/diseases/legionellosis.html

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October 31, 2019

To: Northeast Texas Clinicians

From: NET Health Public Health Emergency Preparedness Department - Disease Surveillance Division

Subject: Increase in Legionnaires’ disease cases in Northeast Texas

This memo provides clinicians with information regarding the increase in reported Legionnaires’ disease

cases in Northeast Texas and recommendations for diagnosis and reporting. Background:

State and local health agencies are investigating cases of Legionnaires’ disease in individuals who attended the East Texas State Fair held in Tyler, TX, Sept. 20-29, 2019. Public health officials are currently investigating whether and how people might have been exposed to Legionella bacteria at this event.

Recommendations:

Clinicians should consider Legionellosis in patients who attended the East Texas State Fair and present with symptoms consistent with Legionnaires’ disease within 2-10 days or Pontiac fever within 1-3 days of their last visit to the East Texas State Fair.

  • Legionnaires’ disease is pneumonia caused by Legionella bacteria and is very similar to other types

of pneumonia, with symptoms that include cough, shortness of breath, fever, muscle aches or headaches. Patients at highest risk include those aged ≥50 years, current or former smokers, and those with chronic lung disease (such as emphysema or COPD) or a weakened immune system.

  • Pontiac fever is a milder, self-resolving infection caused by the same bacteria. Primary symptoms include fever and muscle aches.

Diagnosis:

  • The preferred diagnostic tests for Legionnaires’ disease are the Legionella urinary antigen test and culture of lower respiratory secretions (e.g., sputum, bronchoalveolar lavage) on selective media. Sputum should ideally be obtained prior to antibiotic administration, but antibiotic treatment should not be delayed to facilitate this process. The urinary antigen test can detect Legionella infections in some cases for days to weeks after treatment.
  • Testing is not recommended for individuals who attended the fair but do not have symptoms of

Legionnaires’ disease or Pontiac fever.

  • Serological assays can be nonspecific and are not typically recommended. Reporting:

Physicians are required to report all suspected Legionnaires’ disease cases to public health. These cases can be reported to the NET Health Disease Surveillance Branch at 903-595-1350.

Additional information about Legionnaires’ disease is available at https://www.cdc.gov/legionella/index.html https://epi.dph.ncdhhs.gov/cd/diseases/legionellosis.html