innovative methods to control, investigate, and monitor for legionella : a panel discussion
DESCRIPTION
Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion. Introduction—Mark Bergtholdt Water Management Plans—Brooke Winter Investigation as a way of preventing—Mark Bergtholdt Using a Rapid Bacteria Screening Method to Assess Legionella Risk—Lisa Rogers. - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/1.jpg)
Innovative Methods to Control, Investigate, and Monitor for
Legionella: A Panel Discussion
![Page 2: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/2.jpg)
• Introduction—Mark Bergtholdt• Water Management Plans—
Brooke Winter• Investigation as a way of
preventing—Mark Bergtholdt• Using a Rapid Bacteria
Screening Method to Assess Legionella Risk—Lisa Rogers
![Page 3: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/3.jpg)
Introduction: What is Legionella and why is it important
Mark Bergtholdt
![Page 4: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/4.jpg)
Discovered in 1976 at an
American Legion Convention
in Philadelphia
Attendees becameill with pneumonia
![Page 5: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/5.jpg)
221
Total Cases
2/3 Hospitalized
34Deaths
![Page 6: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/6.jpg)
Bacteria Legionella pneumophila
were found to be the cause
![Page 7: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/7.jpg)
Legionella:What it is and where does it come from?
![Page 8: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/8.jpg)
Organism CharacterizationLegionella is a bacteria
43 or more identified species of Legionella
Multiple Serogroups, with over 60 serogroups presently identified for the
genus
![Page 9: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/9.jpg)
Legionella Pneu-mophila, Serogroup 1Other L. pneu-mophila serogroups
70%20-30%
5-10%
![Page 10: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/10.jpg)
Grow best at 68 to 115o Fahrenheit(Water supply systems often kept at 77 to
108oF)
Can be found in natural surface waters and in buildings
Infect/replicate in both protozoa and human white blood cells
The protozoa/blood cells infected with Legionella burst and release the bacteria into
the water
Ecology of Legionella
![Page 11: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/11.jpg)
35-46˚C (95-115˚F)
Legionella’s optimalgrowth
temperature
![Page 12: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/12.jpg)
<20˚C (68˚F)Predominantly dormant,
but still viable
60˚C (140˚F)90% Kill in 2
Minutes
![Page 13: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/13.jpg)
Legionella fuses with the amoeba inside a membrane-bound
vacuole and replicates
Legionella releases from the amoeba,
exiting as the amoeba dies
Legionella enters the amoeba
![Page 14: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/14.jpg)
Legionella attaches to biofilm
![Page 15: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/15.jpg)
Replication occurs
![Page 16: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/16.jpg)
Legionella reaches maturation
![Page 17: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/17.jpg)
Some Legionella form new colonies
![Page 18: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/18.jpg)
Others continue to end fixture
![Page 19: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/19.jpg)
Legionella are found in the biofilms thataccumulate in the built environment:
![Page 20: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/20.jpg)
How Legionella causes
human infections
![Page 21: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/21.jpg)
The bacteria travel downstream to locationswhere it is aerosolized, such as:
![Page 22: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/22.jpg)
Susceptible Individual:
![Page 23: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/23.jpg)
Susceptible Individual:50+ years of age
![Page 24: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/24.jpg)
Susceptible Individual:50+ years of ageHas Chronic Lung Disease
![Page 25: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/25.jpg)
Susceptible Individual:• 50+ years of age• Has Chronic Lung Disease• Is a current or former smoker
![Page 26: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/26.jpg)
Susceptible Individual:50+ years of ageHas Chronic Lung DiseaseIs a current or former smokerIs immunocompromised
![Page 27: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/27.jpg)
How does a bacteria that enters an amoeba infect Humans?
![Page 28: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/28.jpg)
The Legionella replicates inside the white blood cellLegionella releases from the white blood cell, exiting as the cell dies.
Legionella is engulfed by the white blood cell
Legionella go on to infect other white blood cells in the lung causing a pneumonia like illness
![Page 29: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/29.jpg)
Incubation Period2 day -14 day
![Page 30: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/30.jpg)
High feverHeadacheChills
Muscle pain
Dry CoughDifficulty breathing
![Page 31: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/31.jpg)
Symptoms are severe; the individual will usually visit a physician
Legionnaires’ disease may be diagnosed as common pneumonia
![Page 32: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/32.jpg)
Sputum culture orurine antigen testis used for positive identification
![Page 33: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/33.jpg)
18,0008,000
Hospitalizations
Annually
to
![Page 34: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/34.jpg)
4,000
Deaths Annually
![Page 35: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/35.jpg)
Legionnaires’ disease is under reported
![Page 36: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/36.jpg)
Legionnaires’ disease is under reported• Patients sometimes recover without medical assistance
![Page 37: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/37.jpg)
Legionnaires’ disease is under reported• Patients sometimes recover without medical assistance
• Patients are not tested for Legionellosis by the physician
![Page 38: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/38.jpg)
Legionnaires’ disease is under reported• Patients sometimes recover without medical assistance
• Patients are not tested for Legionellosis by the physician
• Patients are misdiagnosed
![Page 39: Innovative Methods to Control, Investigate, and Monitor for Legionella : A Panel Discussion](https://reader036.vdocuments.site/reader036/viewer/2022081520/56815fe8550346895dceebb0/html5/thumbnails/39.jpg)
Reporting of Legionellosis
In Summary
• Legionella is a bacteria that needs a host to replicate.
• It is found in water and replicates in warm water
• It infects humans when the water containing the bacteria is aerosolized and inhaled by the person.
• It is an under reported disease