Legionnaires' disease: The infective dose paradox
The species of Legionella bacteria that cause legionnaires' disease are widely distributed in aquatic habitats. Infection via inhalation of aerosols containing bacteria is the main, though contested, mode of transmission. Most outbreaks have been associated with aerosols from evaporative cooling systems and complex hot water systems. There are several gaps in the understanding of the transmission of legionnaires' disease. One area of uncertainty is the size of the infective dose of the organism required to produce disease in human beings. Animal experiments suggest that a high dose is required, and the fact that there is no person-to-person spread supports this view. However, low concentrations of legionellae seem to be emitted from water systems, and epidemiological evidence indicates that infection can occur at some distance from the source of aerosol. Environmental concentration of legionellae might have been underestimated because of technical obstacles to detection. There are difficulties in culturing this slow-growing and unusually fastidious organism. Thus, the preferred culture media contain antimicrobial agents that inhibit completing organisms.
- OSTI ID:
- 6201438
- Journal Information:
- Lancet; (United States), Vol. 342:8862; ISSN 0099-5355
- Country of Publication:
- United States
- Language:
- English
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