Legionnaires disease cases on the increase in USA

The Centre for Disease Control (CDC) of the USA reported recently that the number of cases of Legionnaires disease caused by the Legionella bacterium had increased in recent years. In New York city alone cases had risen by 230% between 2002 and 2009. The report, Legionnaires’ Disease Incidence and Risk Factors, New York, USA, further stated that there was a clear linkage between poverty and susceptibility to the disease with people in deprived areas being 2.5 times more likely to contract the disease. There could be several reasons for this linkage. Firstly the quality of housing: primarily poor maintenance of water systems and lack of awareness of and attention to risk factors especially in design of buildings, but also in ongoing maintenance and treatment of water systems. Environment might also be a factor. Temperatures rise during summer months providing ideal conditions for the development of biofilms within which the parasitic Legionella bug proliferates.

Underlying health factors will also be a cause. Legionnaires disease develops in people with a lower immune system. This can in turn be related to poor lung condition, low resistance and general poor health as associated with low quality diet.

While the solution to these problems are neither quick nor easy, there is no doubt that better management of buildings is the first line of improvement. Rapid testing could play a part in identifying problems so that effort can be focused. It is reprehensible to suggest that higher disease rates should be a call for action. Action should come before the cases develop. The report is a call for action. Rapid testing can provide a focus for effective action and should be employed to do so before the disease burden develops. It is basic management to measure the impact and effectiveness of a treatment. This involves testing and rapid testing can be linked directly to need and action.