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By NewsDEsk  @bactiman63

New York City health officials are advising providers to test for Legionella in adults with pneumonia, particularly patients who are > 50 years or have lung disease, immune-suppression, or a history of smoking.

Legionella pneumophila bacteria/CDC

Legionnaires’ disease follows a seasonal pattern in New York City, with an increased number of cases
reported from June to October each year.  NYC sees between 200 and 500 cases of Legionnaires’ disease each year.

While it remains a relatively rare infection, the rate of Legionnaires’ disease is increasing significantly in NYC. From 2007-2017, there was an 8.1% average increase in the rate of Legionnaires’ disease cases citywide each year.

The rate of Legionnaires’ disease increased significantly in all boroughs and demographic groups over this period.

Providers should test for Legionella when evaluating adults with symptoms of pneumonia. Testing should include both urine antigen testing (UAT) and Legionella sputum/respiratory culture.

Legionella is a ubiquitous aquatic organism that grows in warm environments (77°–108°F). Exposure occurs through inhalation of contaminated aerosols from devices such as cooling towers, whirlpool spas, showers, and faucets, and through aspiration of contaminated water.

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Groups at higher risk include persons > 50 years old, cigarette smokers, and persons with chronic lung disease, or persons with immunocompromising conditions. The case-fatality rate is estimated to be 10% for community-acquired Legionnaires’ disease. Recommended treatment options include macrolide or quinolone antibiotics.

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