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Classifying Indoor Air Problems: What Can Go Wrong?
Published in H.E. Burroughs, Shirley J. Hansen, Managing Indoor Air Quality, 2020
H.E. Burroughs, Shirley J. Hansen
This is a relatively mild clinical form of Legionnaires’ disease. Often related to specific worker activity it can occur with a high attack rate from a common source, such as cleaning steam turbine engines. Fever, malaise, headache, chills, myalgia, nausea and diarrhea are also features of Pontiac fever. Respiratory symptoms, such as sore throat and a slight cough, may be present, but pneumonia is not associated with the disease. This nonpneumonic form of Legionnaires’ disease has a shorter incubation period, 5 to 66 hours, and an almost 100 percent attack rate. No age or sex distinction is evident. Outbreaks occur in summer. No fatalities have been reported. The milder form of the disease is thought to be brought on by residual non-viable components of the Legionella bacteria, such as chemical endotoxins that remain in inhaled aerosol.
Air Sampling
Published in Martin B., S.Z., of Industrial Hygiene, 2018
The outbreak in Plant 2 was very similar to the previously reported fever outbreaks in Pontiac, Michigan, and it was called Pontiac fever by the investigators because of its unknown etiology. Pontiac fever is a severe influenza-like illness associated with exposure to aerosols of contaminated water. The first recognized fever outbreak occurred in an Oakland County health department building in Pontiac, Michigan, and was traced to the airborne spread of Legionella from a contaminated air-conditioning system. The organism was isolated retrospectively from frozen samples of condenser water and from lung tissue of guinea pigs exposed to an aerosol of evaporative condenser water. Since this initial outbreak was recognized, several other common source outbreaks of Pontiac fever have been described. The attack rate for Pontiac fever is high, usually 95 to 100%, and the incubation period short, 5 to 66 hours. Cardinal symptoms include fever, chills, myalgias, headache, and malaise. Nonproductive cough, diarrhea, nausea, vomiting, chest pain, dizziness, and sore throat are also commonly reported in outbreaks of Pontiac fever. Physical examination is generally unremarkable except for fever and tachypnea. The illness is generally considered benign and self-limited, with spontaneous resolution after 1 to 5 days, and no fatalities have been reported.
Biological hazards
Published in Sue Reed, Dino Pisaniello, Geza Benke, Principles of Occupational Health & Hygiene, 2020
Margaret Davidson, Ryan Kift, Sue Reed
Inhalation fevers (flu-like illnesses) are caused by the inhalation of microbially contaminated aerosols from agricultural dust, air humidifiers or other aerosols contaminated with Legionella bacteria. The following are examples of inhalation fevers: Humidifier fever can occur in buildings with humidification systems or air-conditioning. Symptoms appear within four to twelve hours of exposure, and the illness is self-limiting (resolves without treatment), with recovery occurring in a matter of days.Pontiac fever results from exposure to Legionella pneumophila and other Legionella species. This is a variant of legionellosis that is mild, self-limiting and does not result in pneumonia (Tortora, Funke and Case, 2016). Toxic alveolitis, known as ODTS, occurs as a result of exposure to high levels of organic dust and endotoxin (Donham and Thelin, 2016), fungal spores and fragments, including mouldy hay, silage and corn (Madelin and Madelin, 1995). The symptoms of OTDS include fever, shivering, dry cough, chest tightness, dyspnoea, headache, muscular and joint pain, fatigue, nausea and general malaise, which typically disappear after 24 hours but may persist for up to seven days (Douwes, Eduard and Thorne 2008). Many occupations have been associated with increased risk of ODTS, including farmers, veterinarians, biofuel workers and waste management workers, including those involved in composting (Basinas, Elholm and Wouters, 2017; Madsen et al., 2012; Pearson et al., 2015).
Legionnaires’ disease in dental offices: Quantifying aerosol risks to dental workers and patients
Published in Journal of Occupational and Environmental Hygiene, 2021
Kerry A. Hamilton, Aditya Kuppravalli, Ashley Heida, Sayalee Joshi, Charles N. Haas, Marc Verhougstraete, Daniel Gerrity
Opportunistic infections, such as those leading to Legionnaires’ disease or the milder condition known as Pontiac Fever, primarily affect individuals with underlying conditions or weakened immune systems, but may also infect healthy individuals who are exposed to sufficiently high doses of an opportunistic pathogen (Fields et al. 2002). Legionnaires’ disease is a severe form of pneumonia that results from inhaling or aspirating Legionella spp. bacteria present in water and is most commonly associated with L. pneumophila (CDC 2020a). Some individuals such as those with a history of heavy smoking or lung disease may be more prone to aspiration, further increasing the likelihood of their infection and adverse health outcomes (Muraca et al. 1988). The case fatality rate for Legionnaires’ disease is ∼10% and up to ∼25% in healthcare-associated cases, making these infections a serious concern for public health (CDC 2020b). Approximately 10,000 cases of Legionnaires’ disease were reported in the United States in 2018, however, the disease tends to be underdiagnosed (CDC 2020c). Outbreaks have been linked to recreational and potable water exposures, especially in the built environment and as a result of exposure to water fixtures that create aerosols, including medical and dental equipment (Hamilton et al. 2018).
Adhesion of Legionella pneumophila on glass and plumbing materials commonly used in domestic water systems
Published in International Journal of Environmental Health Research, 2018
Abdelwahid Assaidi, Mostafa Ellouali, Hassan Latrache, Mustapha Mabrouki, Mohammed Timinouni, Hafida Zahir, Safae Tankiouine, Abouddihaj Barguigua, El Mostafa Mliji
Legionella pneumophila is a Gram-negative and pathogen bacterium which causes two distinct types of disease : Legionnaire’s Disease (LD) a severe form of pneumonia, as well as Pontiac Fever which includes a flu-like and self-limiting illness; resulting from the inhalation of aerosols loaded with bacteria (Pierre et al. 2017; Springston and Yocavitch 2017). In the environment, L. pneumophila is mostly found in natural and artificial water systems, it’s frequently detected in the plumbing systems of different institutions, such as hospitals, hotels and health resorts (Tesauro et al. 2010; Oder et al. 2015), which could adhere to various surfaces, survive within biofilms and free-living amoebae (Borella et al. 2005; Temmerman et al. 2006; Taylor et al. 2009). It is estimated that 95 % of the overall biomass in water systems is located on the inner surface of the pipe walls as a biofilm; while only 5 % occurs in the water phase (Flemming et al. 2002). One the many advantages of biofilms to Legionella is protection from the stressful environmental conditions (Borella et al. 2005). Biofilms on pipes surfaces are considered to be the most important source of water contamination and a potential risk to the human’s health (Abdel-Nour et al. 2013). It is known that the most strategy for bacteria to live is adhering onto surface and forming biofilms (Aparna and Yadav 2008). Bacterial attachment to surface is one of the first stages in the development of biofilm. As established biofilms are difficult to eradicate, so prevention of the bacterial adhesion is an alternative approach to control biofilm formation. The mechanisms of attachment under different conditions need to be established. Several studies are reported that the adhesion of bacteria to surfaces is influenced by many factors, the most important of which are the physicochemical properties and interactions between the support and the bacterial surface including hydrophobicity, electron donor/acceptor character, electrostatic, Van der Waals and Lewis acid/base interactions (Bellon-Fontaine et al. 1996; Briandet et al. 1999; Krepsky et al. 2003; Pagedar et al. 2010; Hamadi et al. 2014). Moreover, the physical properties of materials (roughness, nature …), growth medium and environmental conditions (pH, temperature, ionic strength) play also a crucial role in bacterial adhesion process (Donlan 2002; Bengourram et al. 2009; Oder et al. 2015). The purpose of this research was to investigate the effect of physicochemical properties of substratum and materials roughness on the adhesion of L. pneumophila serogroup1 and L. pneumophila serogroup2–15 on glass and six plumbing materials commonly used in the building water systems such as galvanized steel, stainless steel, copper, Polyvinyl chloride (PVC), Polypropylene Random Copolymer (PPR) and Cross-linked polyethylene (PEX-c).