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QUESTIONS

AND ANSWERS
What is Legionnaires' Disease?
Legionnaires' disease is a common
name for one of the several
illnesses caused by a bacterium
called Legionella. Legionnaires'
disease is an infection of the lungs
that is a form of pneumonia.
What causes Legionnaires'
disease?
Legionnaires' disease is caused by
inhaling water in the form of an
aerosol contaminated with a rod-
shaped bacteria named Legionella
Pneumophila. There are over 30
different species of Legionella,
many of which can cause disease.
Legionella pneumophila is the most
common species that causes
disease.
What are the symptoms of
Legionnaires' disease?
Early symptoms of the illness are
much like the flu. After a short
period of time (in some cases a
day or two), more severe pneu-
monia-like symptoms may ap-
pear. Not all individuals with
Legionnaires' disease experience
the same symptoms. Some indi-
viduals will only have flu-like
symptoms, while with others, the
disease can be fatal.
Legionnaires' Disease
Where do Legionella bacteria
originate?
Legionella bacteria, in low levels,
are widely present in the environ-
ment, in lakes, streams, and ponds.
At these low levels, the chance of
getting Legionnaires' disease from
a water source is very slight. The
problem arises when high concen-
trations of the organism grow in
water sources that can produce
aerosols. Water heaters, cooling
towers, and warm, stagnant water
can provide ideal conditions for
the growth of this organism, and
can create the aerosols that can be
inhaled.
Does everyone who inhales
Legionella into the lungs develop
Legionnaires' disease?
No. Most people have resistance to
the disease. It is thought that less
than 5 out of 100 people who are
exposed to high levels of Legionella
will develop Legionnaires' disease.
Are some people at a higher risk
of developing Legionnaires'
disease?
Yes, some people have a lower
resistance to the disease and are
more likely to develop Legion-
naires' disease. Some of the factors
that can increase your risk of
getting the disease include:
organ transplants (kidney, heart,
etc.)
age (older persons are more
likely to get disease)
heavy smoking
individuals with weakened
immune systems (cancer pa-
tients, HIV positive individuals)
underlying medical problem
(respiratory disease, diabetes,
cancer, renal dialysis, etc.)
certain drug therapies (corticos-
teroids)
heavy drinking
(Continued on Reverse Side)
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SUBSIDIARIES AND AFFILIATES IN PRINCIPAL LOCATIONS AROUND THE WORLD
Bulletin 297
How common is Legionnaires'
disease?
In the United States, it is estimated
that there are approximately
25,00050,000 cases of Legion-
naires' disease every year. This
means about 1 to 2 cases per year
occur among a group of 10,000
people.
Can the Legionella bacterium
cause other diseases?
Yes. In addition to Legionnaires'
disease, the same bacteria also
causes a flu-like disease called
Pontiac fever.
How does Pontiac fever differ
from Legionnaires' disease?
Unlike Legionnaires' disease,
which can be a serious, even
deadly form of pneumonia,
Pontiac fever only produces flu-
like symptoms. These symptoms
may include: fever, headache,
tiredness, loss of appetite, muscle
and joint pain, chills, nausea, and
dry cough. Full recovery occurs
for Pontiac fever in 2 to 5 days
without antibiotics. No deaths
have been reported for Pontiac
fever.
Registered Trademarks of Nalco Chemical Company 1995, 1998 Nalco Chemical Company
All Rights Reserved Printed in U.S.A. 2-98
What common types of water are
of greatest concern?
Water aerosols from cooling towers
or evaporative condensers, evapo-
rative coolers (swamp coolers),
humidifiers, misters, showers,
sinks, and whirlpool baths can be
contaminated with the organism
and if inhaled can cause the disease.
Can Legionnaires' disease be
prevented?
Legionella bacteria are so wide-
spread there is always going to be a
chance of inhalation, but at low
level and of minimal concern.
Identifying possible sources of high
risk, designing a practical control
strategy, then implementing and
managing this strategy can reduce
the potential for growth of the
bacteria and the subsequent risk
of disease.
How can Nalco help me prevent
Legionnaires' disease?
Your Nalco representative can work
with you to identify high risk areas,
design a control strategy suitable to
your plant, and help you to imple-
ment this strategy particularly in
high-risk plant items such as
cooling towers and evaporative
condensers.
Are there other differences
between Legionnaires' disease
and Pontiac fever?
Yes. Unlike Legionnaires' disease,
which causes disease in only a small
percentage of the persons who are
exposed, Pontiac fever will cause
disease approximately 90% of the
time. Additionally, the time from
exposure to the organism before the
disease occurs (incubation period) is
generally less for Pontiac fever than
for Legionnaires'. Pontiac fever
symptoms can appear within one to
three days after exposure.
What water conditions are best for
growth of the Legionella?
Warm, stagnant water provides
ideal conditions for growth of the
organism. At water temperatures
between 68 and 122F, the organism
can multiply. Temperatures of 90 to
105F are ideal for growth. Rust
(iron), scale, and other microorgan-
isms can also promote the growth of
Legionella pneumophila in water.

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