Legionnaires' Disease

Legionellosis is an infection that is caused by a bacterium.The bacterium thrives in the mist that is sprayed from air-conditioning ducts.The bacterium can infest an entire building.The illness takes two distinct forms: Legionnaires' disease and Pontiac fever.Legionnaires' disease is the more severe form and can be fatal.Pontiac fever is the far milder form of the illness.Symptoms of Legionnaires' disease include fever, chills, and a cough.At its worst, Legionnaires' disease can cause severe pneumonia and respiratory failure.Although antibiotics are effective for treatment, the most useful approach is prevention.

Legionellosis is an infection that is caused by the bacterium Legionella pneumophila. The disease has two distinct forms:

Pneumonia Pneumonia is inflammation of one or both lungs with consolidation. Pneumonia is frequently but not always due to infection. The infection may be bacterial, viral, fungal or parasitic. Symptoms may include fever, chills, cough with sputum production, chest pain, and shortness of breath.Diarrhea Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.Headache Headaches can be divided into two categories: primary headaches and secondary headaches. Migraine headaches, tension headaches, and cluster headaches are considered primary headaches. Secondary headaches are caused by disease. Headache symptoms vary with the headache type. Over-the-counter pain relievers provide short-term relief for most headaches.Chronic Cough Chronic cough is a cough that does not go away and is generally a symptom of another disorder such as asthma, allergic rhinitis, sinus infection, cigarette smoking, GERD, postnasal drip, bronchitis, pneumonia, medications, and less frequently tumors or other lung disease. Treatment of chronic cough is dependant upon the cause.Fever Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.ARDS (Acute Respiratory Distress Syndrome) Acute respiratory distress syndrome (ARDS) is a lung condition in which trauma to the lungs leads to inflammation of the lungs, accumulation of fluid in the alveolar air sacs, low blood oxygen, and respiratory distress. Causes of ARDS include: pneumonia, aspiration, severe blow to the chest, sepsis, severe injury with shock, drug overdose, and/or inflamed pancreas. Treatment for ARDS include extra oxygen, and/or medication.




Chronic Cough »

Chronic cough is a cough that persists. Chronic cough is not a disease in itself; rather it is a symptom of an underlying condition. Chronic cough is a common problem and the reason for many doctor visits.

Some common causes of chronic cough include asthma, allergic rhinitis, sinus problems (for example sinus infection), and esophageal reflux of stomach contents. In rare occasions, chronic cough may be the result of aspiration of foreign objects into the lungs (usually in children). It is very important to see a doctor who may order a chest X-ray if a chronic cough is present. The following are common causes of chronic coughing.

Cigarette smoking actually is the most common cause of chronic cough. Asthma is a disease of airways, resulting in difficulty breathing or wheezing often characterized by abnormal breathing...

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Cluster of travel-associated Legionnaires' disease in Lazise, Italy, July to August 2011

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How Legionnaires' bacteria proliferate, cause disease

ScienceDaily (Nov. 17, 2011) — A University of Louisville scientist has determined for the first time how the bacterium that causes Legionnaires' disease manipulates our cells to generate the amino acids it needs to grow and cause infection and inflammation in the lungs.

The results are published online on Nov. 17 in Science.

Yousef Abu Kwaik, Ph.D., the Bumgardner Endowed Professor in Molecular Pathogenesis of Microbial Infections at UofL, and his team believe their work could help lead to development of new antibiotics and vaccines.

"It is possible that the process we have identified presents a great target for new research in antibiotic and vaccine candidates, not only for Legionnaires' disease but in other bacteria that cause illness," he said.

According to the Centers for Disease Control and Prevention, Legionnaires' disease is a lung infection caused by the bacterium called Legionella. The bacterium got its name in 1976, when many people who went to a Philadelphia convention of the American Legion suffered from an outbreak of pneumonia of unknown causes that was later determined to be caused by the bacterium. Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires' disease in the U.S. There is no vaccine currently available for it.

For two years, the researchers examined Legionella which is an intracellular bacterium that exists in amoebae in the water systems; it is transmitted to humans through inhalation of water droplets. Cooling towers and whirlpools are the major sources of transmission. The bacterium uses the amoeba's cellular process to "tag" proteins, causing them to degrade into their basic elements of amino acids. These amino acids are used by the bacteria as the main source of energy to grow and cause disease.

"The bacteria live on an 'Atkins diet' of low carbs and high protein, and they trick the host cell to provide that specialized diet," Abu Kwaik said.

The same process occurs in a host -- animal or human -- who inhales the bacterium and is diagnosed with Legionnaires' disease. However, the bacteria do not tag the proteins, but rather trick the host into tagging the proteins for degradation to generate the amino acids.

In the laboratory, Abu Kwaik and his team saw that by inactivating the bacterial virulence factor responsible for tricking the cell into tagging proteins for degradation in mice models, the pulmonary disease was totally prevented. This was totally due to disabling the bacteria from generating amino acids, he said.

The process was then reversed, and the disease became evident when the mice, infected by the disabled bacteria, were injected with amino acids to compensate for the inability of the altered bacteria.

"Bacteria need to live on high protein and amino acids as sources of nutrition and energy in order to replicate in a host. This is what causes pulmonary disease," Abu Kwaik said. "No one has known how they generate sufficient sources of nutrients from the host to proliferate. Our work is the first to identify this process for any bacteria that cause disease."

He added that the type of host infected does not appear to affect the process. "Whether in a single-cell amoeba or a multi-cellular mammal, Legionella seems to know what to do; the process is the same, and is highly conserved through evolution. By interfering with the bacterium's sources of nutrients, we can stop it from thriving and causing disease."

Examining nutrient sources for organisms with the goal of stopping them from acquiring nutrients is a relatively new arena of basic research that deserves further study, he said. "We went after the basics -- the food and energy source -- which are prerequisite for the bacteria to grow and cause disease. It is not a process that is well understood yet, but by first discovering how an organism gets nutrients by tricking the host into degrading proteins, and then interfering with that process, we can, in effect, starve it to death and prevent or treat the disease."

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Journal Reference:

Christopher T. D. Price, Tasneem Al-Quadan, Marina Santic, Ilan Rosenshine, and Yousef Abu Kwaik. Host Proteasomal Degradation Generates Amino Acids Essential for Intracellular Bacterial Growth. Science, 17 November 2011 DOI: 10.1126/science.1212868

Note: If no author is given, the source is cited instead.

Disclaimer: This article is not intended to provide medical advice, diagnosis or treatment. Views expressed here do not necessarily reflect those of ScienceDaily or its staff.

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Correction for O'Connor et al., Minimization of the Legionella pneumophila genome reveals chromosomal regions involved in host range expansion [Correction]

MICROBIOLOGY Correction for “Minimization of the Legionella pneumophila genome reveals chromosomal regions involved in host …

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Legionella secreted effectors and innate immune responses

Legionella secreted effectors and innate immune responses - Luo - 2011 - Cellular Microbiology - Wiley Online LibrarySkip to Main Content

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PUBLICATIONSBROWSE BY SUBJECTRESOURCESABOUT US LOGIN Enter e-mail address Enter password REMEMBER ME NOT REGISTERED ?FORGOTTEN PASSWORD ?INSTITUTIONAL LOGIN > Home > Microbiology & Virology > Microbiology & Virology > Journal Home > Early View > Abstract JOURNAL TOOLS Get New Content Alerts Get RSS feed Save to My Profile Get Sample Copy Recommend to Your Librarian JOURNAL MENUJournal HomeFIND ISSUESCurrent IssueAll Issues FIND ARTICLES Early ViewAccepted Articles GET ACCESS Subscribe / Renew FOR CONTRIBUTORS Author GuidelinesSubmit an Article ABOUT THIS JOURNAL NewsOverviewEditorial BoardPermissionsAdvertiseContact SPECIAL FEATURES Virology Virtual Special IssueFaculty of 1000PostersWiley Job NetworkParasitology Virtual Special Issue You have free access to this contentLegionella secreted effectors and innate immune responsesZhao-Qing LuoArticle first published online: 10 NOV 2011

DOI: 10.1111/j.1462-5822.2011.01713.x

© 2011 Blackwell Publishing Ltd

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Cellular MicrobiologyEarly View (Online Version of Record published before inclusion in an issue)

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How to CiteLuo, Z.-Q. (2011), Legionella secreted effectors and innate immune responses. Cellular Microbiology. doi: 10.1111/j.1462-5822.2011.01713.x

Author Information

Department of Biological Sciences, Purdue University, 915 West State Street, West Lafayette, IN 47907, USA

*Correspondence: Zhao-Qing Luo,

*Correspondence: E-mail luoz@purdue.edu; Tel. (+1) 765 496 6697; Fax (+1) 765 494 0876.

Publication HistoryArticle first published online: 10 NOV 2011Accepted manuscript online: 11 OCT 2011 03:50AM ESTReceived 1 August, 2011; revised 3 October, 2011; accepted 5 October, 2011. SEARCH Search Scope All contentPublication titlesIn this journalIn this issue Search String Advanced >Saved Searches > SEARCH BY CITATION Volume: Issue: Page: ARTICLE TOOLSGet PDF (300K)Save to My ProfileE-mail Link to this ArticleExport Citation for this ArticleGet Citation AlertsRequest Permissions AbstractArticleReferencesCited By View Full Article (HTML) Get PDF (300K) Summary

Legionella pneumophila is a facultative intracellular pathogen capable of replicating in a wide spectrum of cells. Successful infection by Legionella requires the Dot/Icm type IV secretion system, which translocates a large number of effector proteins into infected cells. By co-opting numerous host cellular processes, these proteins function to establish a specialized organelle that allows bacterial survival and proliferation. Even within the vacuole, L. pneumophila triggers robust immune responses. Recent studies reveal that a subset of Legionella effectors directly target some basic components of the host innate immunity systems such as phagosome maturation. Others play essential roles in engaging the host innate immune surveillance system. This review will highlight recent progress in our understanding of these interactions and discuss implications for the study of the immune detection mechanisms.

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Tumor Necrosis Factor-alpha (TNFα) Blockers: Label Change - Boxed Warning Updated for Risk of Infection from Legionella and Listeria

including Remicade (infliximab), Enbrel (etanercept), Humira (adalimumab), Cimzia (certolizumab pegol), and Simponi (golimumab)

AUDIENCE: Rheumatology, Gastroenterology, Oncology

ISSUE: FDA notified healthcare professionals that the Boxed Warning for the entire class of Tumor Necrosis Factor-alpha (TNFa) blockers has been updated to include the risk of infection from two bacterial pathogens, Legionella and Listeria. In addition, the Boxed Warning and Warnings and Precautions sections of the labels for all of the TNFa blockers have been revised so that they contain consistent information about the risk for serious infections and the associated disease-causing pathogens.

Patients treated with TNFa blockers are at increased risk for developing serious infections involving multiple organ systems and sites that may lead to hospitalization or death due to bacterial, mycobacterial, fungal, viral, parasitic, and other opportunistic pathogens.

BACKGROUND: The class of TNFa blockers are used to treat Crohn's disease, ulcerative colitis, rheumatoid arthritis, ankylosing spondylitis, psoriatic arthritis, plaque psoriasis, and/or juvenile idiopathic arthritis.

RECOMMENDATION: The risks and the benefits of TNFa blockers should be considered prior to initiating therapy in patients with chronic or recurrent infection and patients with underlying conditions that may predispose them to infection. See the Drug Safety Communication for a listing of recommendations for healthcare professionals and patients, as well as a data summary.

Healthcare professionals and patients are encouraged to report adverse events or side effects related to the use of these products to the FDA's MedWatch Safety Information and Adverse Event Reporting Program:

Complete and submit the report Online: www.fda.gov/MedWatch/report.htm
Download form or call 1-800-332-1088 to request a reporting form, then complete and return to the address on the pre-addressed form, or submit by fax to 1-800-FDA-0178
Read the MedWatch safety alert, including a link to the FDA Drug Safety Communication, at:

http://www.fda.gov/Safety/MedWatch/SafetyInformation/SafetyAlertsforHumanMedicalProducts/ucm270977.htm

Posted: September 2011

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Disease cases in Britain linked to travel

Published: Oct. 7, 2011 at 6:27 PM

LONDON, Oct. 7 (UPI) -- Nine cases of Legionnaire's disease in Britain have been linked to travel to the Greek island of Corfu since August, health authorities say.

The Health Protection Agency advising people to be aware of the symptoms of Legionnaire's disease -- which can lead to pneumonia and is sometimes fatal -- if they are traveling to the island, the BBC reported Friday.

"We are concerned that U.K. residents traveling to Corfu should be aware of this potential risk, however we are not suggesting that people change their holiday plans," Nick Phin of the Legionnaire's disease department at the HPA said.

The HPA cannot rule out a U.K. source of the infections and is still investigating, he said.

Symptoms may not appear until two weeks after infection and generally start as a "flu-like" illness, the HPA said, but the disease can be treated with antibiotics.

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