Portugal Legionnaires’ disease outbreak kills nine and sickens dozens

According to the ECDC (The European Centre for Disease Prevention and Control), an epidemiological investigation is ongoing, including clinical and environmental assessment and sampling for subsequent subtyping and isolate comparison. Two cooling towers have been closed.

Legionella bacteria can cause a serious type of pneumonia called Legionnaires’ disease. The bacteria can also cause a less serious illness called Pontiac fever. Legionnaires’ disease is very similar to other types of pneumonia, with symptoms that include cough, shortness of breath, fever, muscle aches, and headaches. Less common symptoms include diarrhea, nausea, and confusion. Symptoms usually begin two to ten days after being exposed to the bacteria, but it can take longer so people should watch for symptoms for about two weeks after exposure.

Pontiac fever symptoms are primarily fever and muscle aches; it is a milder infection than Legionnaires’ disease. Symptoms begin between a few hours to three days after being exposed to the bacteria and usually last less than a week. Pontiac fever is different from Legionnaires’ disease because someone with Pontiac fever does not have pneumonia.

Most healthy people exposed to Legionella don’t contract Legionnaires' disease. People at increased risk of contracting Legionnaires' disease are:

  • People 50 years or older
  • Current or former smokers
  • People with a chronic lung disease (like chronic obstructive pulmonary disease or emphysema)
  • People with weak immune systems or who take drugs that weaken the immune system (like after a transplant operation or chemotherapy)
  • People with cancer
  • People with underlying illnesses such as diabetes, kidney failure, or liver failure

In general, people do not spread the bacteria to other people. Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, and decorative fountains. People get infected when they breathe in a mist or vapor containing the bacteria.

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