title: Legionnaires' disease.
abstract: Since first identified in early 1977, bacteria of the genus Legionella are recognised as a common cause of community-acquired pneumonia and a rare cause of hospital-acquired pneumonia. Legionella bacteria multisystem manifestations mainly affect susceptible patients as a result of age, underlying debilitating conditions, or immunosuppression. Water is the major natural reservoir for Legionella, and the pathogen is found in many different natural and artificial aquatic environments such as cooling towers or water systems in buildings, including hospitals. The term given to the severe pneumonia and systemic infection caused by Legionella bacteria is Legionnaires' disease. Over time, the prevalence of legionellosis or Legionnaires' disease has risen, which might indicate a greater awareness and reporting of the disease. Advances in microbiology have led to a better understanding of the ecological niches and pathogenesis of the condition. Legionnaires' disease is not always suspected because of its non-specific symptoms, and the diagnostic tests routinely available do not offer the desired sensitivity. However, effective antibiotics are available. Disease notification systems provide the basis for initiating investigations and limiting the scale and recurrence of outbreaks. This report reviews our current understanding of this disease.
authors.affiliation: Infectious Disease Division, Winthrop-University Hospital, Mineola, NY, USA; School of Medicine, State University of New York, Stony Brook, NY, USA. Electronic address: bacunha@winthrop.org.
authors.forename: Burke A
authors.initials: BA
authors.lastname: Cunha
authors.affiliation: Division of Clinical Microbiology and Infectious Disease, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain.
authors.forename: Almudena
authors.initials: A
authors.lastname: Burillo
authors.affiliation: Division of Clinical Microbiology and Infectious Disease, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón, Madrid, Spain; Universidad Complutense de Madrid, Madrid, Spain; CIBER de Enfermedades Respiratorias (CIBERES CB06/06/0058), Madrid, Spain.
authors.forename: Emilio
authors.initials: E
authors.lastname: Bouza
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology / Q000627:therapeutic use; D001431:Bacteriological Techniques; D046508:Culture Techniques; D004196:Disease Outbreaks; D004197:Disease Reservoirs; D006801:Humans; D015994:Incidence; D055256:Infectious Disease Incubation Period; D007875:Legionella / Q000145:classification / Q000472:pathogenicity; D007877:Legionnaires' Disease / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy* / Q000635:transmission; D012307:Risk Factors; D014881:Water Supply
chemical_list: D000900:Anti-Bacterial Agents