Chapter 3.2.9 : and Legionnaires’ Disease

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This chapter details the ecology of Legionnaires' disease and a description of its history in regards to public health. Also included are methods for detection in environmental samples, identification and environmental approaches to controlling legionellosis.

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Image of FIGURE 1

Gimenez stain of the ciliated protozoan infected with . Chains of multiplying cells are contained within vesicles, as observed in human phagocytic cells infected with . Magnification, ×1,650. doi:10.1128/9781555818821.ch3.2.9.f1

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Image of FIGURE 2

Overview of procedures for the culture of water samples to detect . doi:10.1128/9781555818821.ch3.2.9.f2

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Image of FIGURE 3

Two colonies and a non- bacterial colony as seen through a dissecting microscope upon primary isolation (4 days of incubation). Note the white “cut-glass” appearance of the center of the colony and the purple iridescence which borders it. The iridescence can be one of several colors; the significance of the colors is unknown. doi:10.1128/9781555818821.ch3.2.9.f3

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Image of FIGURE 4

Algorithm for speciating and subtyping genus-confirmed isolates. There are numerous commercial vendors of reagents to perform DFA or slide agglutination to quickly determine whether an isolate is species and, if so, whether it belongs to serogroup 1 (Lp1) or serogroups 2–14 (Lp2–14). Lp1 isolates may be further subtyped by SBT, serology with a panel of monoclonal antibodies, and/or fragment analyses such as PFGE. Commercial antisera also exist to specifically serotype Lp2–14 isolates. Subtyping Lp2–14 isolates may be achieved by SBT and/or fragment analyses. Speciating nonpneumophila spp. isolates is accomplished by employing species-specific antisera in DFA or slide agglutination tests or by sequencing the gene. Genes for all seven of the genes used in SBT are generally not present in nonpneumophila species, so the only way to reliably subtype these isolates is by fragment analyses. may not display cysteine auxotrophy. When performing comprehensive environmental surveys or where epidemiological evidence suggests the involvement of this species in cases of disease, it may be advantageous to subject suspect colonies to the nonpneumophila spp. branch (far right) of the algorithm.There are no commercially available sources of the international panel for monoclonal antibody subtyping. However, limited supplies may be obtained for research or public health surveillance purposes from the developers ( ). doi:10.1128/9781555818821.ch3.2.9.f4

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Characteristic of Legionnaires’ disease and Pontiac fever

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
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Sources known to transmit via aerosols

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9
Generic image for table

Components and supplements of BCYE agar for culturing from the environment

Citation: Lucas C, Fields B. 2016. and Legionnaires’ Disease, p 3.2.9-1-3.2.9-13. In Yates M, Nakatsu C, Miller R, Pillai S (ed), Manual of Environmental Microbiology, Fourth Edition. ASM Press, Washington, DC. doi: 10.1128/9781555818821.ch3.2.9

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