Legionnaires' Disease

Legionnaires' disease is a bacterial infection which typically causes pneumonia but may also involve other organ systems. The disease is usually transmitted by airborne droplets from contaminated water sources, such as cooling towers, air conditioners, whirlpools, and showers. Cases may occur sporadically or in outbreaks linked to specific locations, such as hotels or other public facilities. Small outbreaks have been reported from cruise ships, sometimes associated with onboard whirlpool spas. Legionnaires' disease is not transmitted from person to person.
The incubation period ranges from two to ten days. Symptoms may include fever, cough, chest pain, difficulty breathing, headache, muscle pains, and diarrhea. Numerous complications have been reported, including kidney failure, liver failure, respiratory failure, muscle inflammation (rhabdomyolysis), abnormal bleeding (disseminated intravascular coagulation), and death. Legionnaires' disease may be treated with either azithromycin or a quinolone antibiotic, such as ciprofloxacin or levofloxacin. There is no vaccine.
The European Working Group on Legionella Infections monitors cases of Legionnaires' disease in returning travelers in order to identify hotels, resorts, and other accommodations where Legionella outbreaks may be occurring.
From the European Working Group on Legionella Infections
About Legionnaires' Disease
Legionnaires' Disease and Travel
Minimising the risk: information for hoteliers
Information for tour operators
From the World Health Organization (WHO)
Legionellosis
Legionnaires' Disease, Europe, 1999
Legionnaires' Disease in Europe 1998
Legionnaires' Disease in Europe 1997
From the Centers for Disease Control
Legionnellosis
Cruise-Ship--Associated Legionnaires Disease, November 2003--May 2004
Legionnellosis
From the U.K. Health Protection Agency
Legionnaires' Disease
From Eurosurveillance
Travel-Associated Legionnaires' Disease in Europe: 2005
Travel-Associated Legionnaires' Disease in Europe: 2003
Launch of new European guidelines for control and prevention of travel associated legionnaires' disease