The legionella – bacterium that infected the former president of the European Parliament David Sassoli – leads to a disease called legionellosis in 90% of cases. More than 60 different species of Legionella have been identified, divided into 71 serotypes. These bacteria are present in natural and artificial aquatic environments, such as spring waters, including thermal waters, rivers, lakes, muds, etc. It is from these natural environments that bacteria reach artificial ones, such as city pipes and water systems.
Legionellosis – disease that comes from legionella – is normally acquired by the respiratory route by inhalation, aspiration or microaspiration. The infection can be treated using antibiotics, but in some cases this could be fatal. This depends on factors such as “The severity of the disease, the appropriateness of the initial antibiotic treatment, the place where the infection was acquired, the patient’s previous conditions”, as stated on the ISS website.
LEGIONELLA: WHAT IS THE BACTERIUM THAT INFECTED SASSOLI
The legionella it’s the bacterium he infected David Sassoli, president of the European Parliament who died at 65. The Istituto Superiore di Sanità dedicates an entire page of its website to an in-depth study on the subject, first of all saying that the genus Legionella was so named in 1976, after an epidemic had spread among the participants in the gathering of the American legion at the Bellevue Stratford Hotel in Philadelphia. On that occasion, 221 people contracted this previously unknown form of pneumonia and 34 of them died. The source of the bacterial contamination was identified in the hotel’s air conditioning system.
To cause legionella disease, the so-called legionellosi, in 90% of cases it is this bacterium, of which more than 60 different species have been identified, divided into 71 serotypes. “The legionnaires – reads on the portal – they are present in natural and artificial aquatic environments: spring waters, including thermal ones, rivers, lakes, muds. From these environments they reach artificial ones, such as city pipes and building water systems, such as tanks, pipes, fountains and swimming pools, which can act as amplifiers and disseminators of the microorganism, creating a potential risk situation for human health “.
LEGIONELLA, HOW DOES THE CONTAGION HAPPEN?
As regards the modalities of contagion from legionella, the ISS explained that it is normally acquired via the respiratory route through inhalation, aspiration or microaspiration of aerosol or of particles derived by drying. The death rate related to Legionella infection depends on some specific factors (the severity of the disease, the appropriateness of the initial antibiotic treatment, the place where the infection was acquired, the patient’s previous conditions) and can vary from 40-80% in untreated immunosuppressed patients to 5-30% in case of an appropriate treatment of the disease. Overall, the lethality of legionellosis is between 5% and 10%.
Legionellosis can manifest itself in two distinct forms: the Legionnaire’s Malattia, which frequently includes a more acute form of pneumonia, and Pontiac fever. “The Malattia of the Legionnaire – reports the ISS portal –, after an incubation period ranging from 2 to 10 days (on average 5-6 days), it manifests itself as an infectious pneumonia, with or without extrapulmonary manifestations. The pneumonitis syndrome has neither clinical nor radiological characteristics of specificity. In severe cases it can arise abruptly with fever, chest pain, dyspnoea, cyanosis, productive cough associated with the semeiological physical objectivity of pulmonary consolidation “. On the other hand, Pontiac fever, after an incubation period of 24-48 hours, manifests itself in an acute flu-like form without lung involvement and resolves in 2-5 days. The prodromes are general malaise, myalgia and headache, quickly followed by fever, sometimes with a cough and a red throat. Diarrhea, nausea, and mild neurological symptoms such as dizziness or photophobia may be present.
LEGIONELLA, HOW IS IT TREATED?
It is again the ISS that dedicates a chapter to the treatment of Legionella, underlining that the treatment of Legionella, being a illness of bacterial origin, mainly through antibiotic therapies. Pontiac fever has a benign evolution even in the absence of a specific chemotherapy treatment, while all the other diseases caused by Legionella species, from the most common pneumonia to the less frequent extra-pulmonary infections, require specific treatment to reduce the probability of an unfortunate outcome. .
What are the antibiotics to use? “Quinolones, macrolides and, with less efficiency, tetracyclines. On the contrary, all beta-lactamines, carbapenems, aminoglycosides and chloramphenicol are useless for the treatment of legionellosis, as they do not reach intracellular concentrations capable of exerting an antibacterial effect “.
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