Why Is Legionnaires’ Disease Back? + How to Prevent It

October 30, 2017

After a convention of the American Legion in Philadelphia, Pennsylvania, in 1976, hundreds of attendees fell ill with pneumonia-like symptoms and fevers reaching 107 degrees. More than 200 fell ill and 34 died. The outbreak caused panic throughout the country; some thought it was domestic terrorism while Congress held hearings to push for answers.

It took six months for a team of investigators from the Centers for Disease Control and Prevention (CDC), along with local authorities, to determine the cause: The bacteria-laced mist had spread through a landmark hotel’s air conditioning system. Then guests inhaled it during the conference. Legionella bacteria was identified, and the disease became known as “Legionnaires’ disease.” (1)

The first noticeable symptoms are often that of a cold or the flu, but symptoms can quickly transition causing a severe form of pneumonia. But you can’t get this disease by shaking hands or hugging; it is caused by inhaling the Legionella bacteria. A milder disease also caused by the same bacteria, Pontiac fever, presents more like the flu. While Pontiac fever typically goes away on its own, Legionnaire’s disease can be fatal if left untreated, or if treated with the wrong antibiotics. (2) In fact, the death rate ranges anywhere between 5 and 50 percent.

According to the CDC, in 2015 about 6,000 cases of the disease were reported. However, they stress that this disease is under-diagnosed and that the number of actual cases may be much higher. In fact, in a recent report, the CDC indicates that somewhere between 8,000 and 18,000 people each year will be hospitalized with this disease. (3)

Cases of Legionnaire’s disease continue to rise in the United States with the media highlighting recent outbreaks in Michigan, California, Illinois and New York. It is suspected that the increase in the number of cases may be due to an aging plumbing infrastructure, an aging population or even climate change. While effective diagnostic tests are available, researchers believe they are underutilized and better communication and education of healthcare providers needs to be conducted when a patient presents with symptoms. (4)

While this disease can be fatal, the vast majority of those diagnosed can be effectively treated and cured with antibiotics. However, treatment often requires hospitalization to protect against complications. Since those with compromised immune systems and other underlying health conditions are most at risk, keeping a watchful eye on their care is recommended.

Natural treatments can help ease the symptoms and provide some relief. However, it is imperative that if you believe you’ve been exposed to the Legionella bacteria and you experience symptoms, that you seek medical attention immediately.

What Is Legionnaires’ Disease?

Legionnaires’ disease is an acute, pneumonia-like bacterial infection that can be fatal. It is caused by the Legionella bacteria, a genus of at least 60 different species. It is transmitted through inhalation of mist or vapor that contains the bacteria.

While the bacteria can be found in freshwater environments like streams, ponds and lakes, it is typically not high enough in concentration in freshwater to cause this disease. As with the original outbreak in Philadelphia, the bacteria are often transmitted through plumbing systems, air conditioning systems, fountains and hot tubs.

Signs & Symptoms

The most common Legionnaires’ disease symptoms start to appear between two and 10 days after exposure to the Legionella bacteria. Rarely, symptoms may not appear for 14 days. Common symptoms of this form of pneumonia include: (5)

Cough with mucus
Shortness of breath
Fever greater than 103 F
Muscle aches
Headaches
Diarrhea
Nausea
Confusion
Chest pain

Pontiac fever, the milder form of the disease, presents more like a typical case of the flu where patients experience fever and muscle aches. It typically resolves on its own within a few days. (6)

Causes & Risk Factors

This highly infectious disease is caused by the Legionella bacteria. These bacteria are found throughout the world in plumbing systems, air conditioning units, hot tubs, water fountains, water features and hot water tanks. The bacteria become airborne through a fine mist that is inhaled, causing the infection. There are some anecdotal cases of patients aspirating infected water and becoming infected, but this is rare.

This bacterium grows most prolifically in warm water, like that of a hot tub. Warm temperatures make it difficult to keep chlorine levels strong enough to work against these potentially deadly germs. Testing water before you get in a hot tub is easy. Use pool test strips to verify free chlorine levels of 2 to 4 parts per million or bromine levels of 4 to 6 parts per million and a pH of 7.2–7.8. (7)

Of concern is a recent study from Arizona State University on the Legionella bacteria in windshield wiper fluid. Researchers evaluated windshield fluid from school buses throughout Arizona and found that 84 percent of the fluid was contaminated with the bacteria. Researchers note that a recent outbreak in the United Kingdom was also linked to car windshield fluid. It is surmised that the heat of the engine provides the warmth for Legionella to thrive. (8)

Outbreaks of Legionnaire’s disease most often occur in buildings with complex water systems like resorts and hotels, cruise ships, long-term care facilities and hospitals. The CDC recently warned that roughly 20 percent of all cases were “probably or definitely” acquired in health care facilities. (9, 10)

According to the CDC, the following populations are at a heightened risk for this disease: (11)

Being over 50 years of age.
Current or former smokers.
People with cancer, and those being treated with chemotherapy, immunotherapy or radiation.
Those with underlying medical conditions like diabetes, liver failure or kidney failure.
Individuals with a chronic lung disease like obstructive pulmonary disease or emphysema.
People with a weakened immune system and those who have had an organ transplant.

Conventional Treatment

Before treatment begins, a confirmed diagnosis is necessary. You will most likely be referred to an infectious disease specialist who will carefully consider the results from a chest X-ray, urine test and sputum samples. During your initial appointment, be sure to inform the medical team if in the last two weeks you have used a hot tub, stayed in a hotel, been on a cruise or been hospitalized.

Legionnaires’ disease can be effectively cured with antibiotics. This is typically done on an in-patient basis where the antibiotics can be given intravenously and you can be monitored closely. Your medical team will be watching for signs that the infection is worsening and for any indication that organ failure is imminent. Once stabilized, patients are often switched to oral antibiotics. Close monitoring at this time is crucial as relapse is possible. Commonly prescribed antibiotics include: (12, 13 )

Azithromycin
Rifampin
Doxycycline
Ciprofloxacin
Levofloxacin
Trimethoprim and sulfamethoxazole

12 Natural Treatments to Aid in Recovery

Curing Legionnaires’ disease is possible, with proper medical intervention. Remember, this disease can cause organ failure and death, so immediate care and proper antibiotics are a must. In severe cases, a patient may temporarily be hooked up to a ventilator to breathe while the proper antibiotics work on clearing the lung infection. In addition, many people experience long-term impairment and experience a decrease in quality of life after successfully fighting this disease. Common challenges that linger include chronic fatigue, neurological symptoms and neuromuscular symptoms. (14)

Again, Legionnaire’s disease is a medical emergency that often requires hospitalization. This isn’t something you should try to remedy on your own at home. However, there are natural treatments and complementary therapies that can help reduce symptoms and aid in the recovery process once the patient is out of the woods with conventional treatment.

Natural Treatments to Support Legionnaires’ Disease Symptoms

These are natural ways to support the body recovering from Legionnaire’s disease, however, conventional treatment is necessary to combat this aggressive and potentially life-threatening infection.

Fermented food
N-acetyl cysteine
Astragalus
Ginseng
Tea tree oil
Magnesium & potassium supplements
Mucus-reducing foods
Topical cough suppressant
Natural cough drops
Peppermint oil
Exercise

1. Fermented foods. The traditional treatment for Legionnaires’ disease is antibiotics. In addition to killing the Legionella bacteria, they will also kill the friendly bacteria that live in your gut. This can lead to digestive upset and candida infections. Adding fermented foods into the diet can help.

2. N-Acetyl Cysteine. A powerful amino acid shown to improve lung function and thin mucus, N-acetyl cysteine may make it easier to expectorate after conventional treatment. Take up to 1,200 milligrams a day while fighting congestion and then reduce to 600 milligrams a day to help with lingering fatigue and shortness of breath. (17, 18)

While considered likely safe for most adults, it is not recommended for people with asthma, a bleeding disorder or those with a scheduled surgery as it may slow blood clotting. In addition, do not take N-acetyl cysteine if you take nitroglycerin or activated charcoal. (19)

3. Astragalus. Recovering from Legionnaires’ disease symptoms requires treating mind and body. Astragalus is an adaptogen with anti-inflammatory powers that boost the immune system. Research shows that it helps to lower fatigue and can help to fight respiratory infections while protecting the body against physical, mental and emotional stress. (20)

Astragalus and other adaptogen herbs are not recommended for people with autoimmune diseases, those taking lithium or immunosuppressants. Take a high-quality tincture, capsule or tablet as directed.

4. Ginseng. Neurological symptoms may continue in the months following treatment. To improve mood, reduce stress, improve concentration and cognitive function, ginseng may help. According to a study published in the journal Nutrition Reviews, ginseng may benefit cognition. Authors agreed ginseng has potential as a future treatment. (21)

For stress and fatigue, take 500 milligrams twice each day until symptoms abate. Select a high-quality supplement made from Chinese red panax ginseng or a Korean ginseng available from a reputable source.

5. Tea Tree Oil. Heralded for its antiseptic powers, tea tree oil has been used for generations to treat bacterial infections and respiratory tract infections, just to name two conditions. When recovering from Legionnaires’ disease symptoms, diffusing tea tree oil may soothe sinuses and your lungs.

In addition, according to research published in the Journal of Microbiological Methods, tea tree oil can be used as a disinfectant in water systems. (22) If you live in a dry climate and often use a humidifier, it may be wise to add a few drops of tea tree oil to keep bacteria levels in check.

6. Magnesium & Potassium Supplements. Deficiency of these two essential minerals is common. Getting enough is more important than ever while recovering from Legionnaires’ disease symptoms. For fatigue, 500 to 1,000 milligrams of magnesium each day may help improve energy levels. If you experience diarrhea, lower the dosage in 200 milligram increments until you can tolerate it. (25)

Potassium is just as essential as common signs of deficiency mimic the symptoms often experienced during recovery. This includes fatigue, depression and poor neurological functioning. According to the Mayo Clinic, 1,600 to 2,000 milligrams of potassium is adequate for adults. Good sources of this essential mineral include acorn squash, spinach, lentils, watermelon and raisins. (26)

7. Mucus-Reducing Foods. If you experience an increase in mucus in your lungs, limiting your exposure to foods known to encourage mucus production such as refined sugar, conventional dairy (including cheeses), wheat, alcohol and soy is a good start.

In addition, it is important to add foods recognized for reducing mucus in the body. This includes bone broth, pumpkin seeds, pineapple, ginger, leafy greens, berries, citrus fruits, wild-caught salmon, celery, watercress and parsley.

8. Topical Cough Suppressant. Coughing during and after treatment is common and can be painful in some circumstances. If you are avoiding foods that cause excess mucus production, and enjoying foods that reduce mucus, that is half the battle. To complement these practices, applying a vapor rub on the chest several times a day can help relieve discomfort.

Commercial vapor rubs can contain chemicals you just don’t want introduced into your system, but my recipe for a homemade vapor rub contains ingredients that are safe and effective for children and adults alike. Olive oil, coconut oil and beeswax provide the base while the essential oils of peppermint and eucalyptus provide the vapor effect that helps to clear sinus passages and reduce coughing.

9. Natural Cough Drops. In addition to the vapor rub, sucking on a natural cough drop can help prevent coughing fits and relieve sore throat pain that is associated with healing after any type of pneumonia or lung ailment. Avoid commercially available cough drops as they often contain dangerous artificial sweeteners and other chemicals.

Instead, try making your own with your favorite herbs like eucalyptus, frankincense, peppermint or thyme. Slippery elm bark is one of the best for sore throats, and sweetening homemade natural cough drops with honey adds to their healing powers.

10. Peppermint Oil. Known for soothing digestive upset, relieving headaches, boosting energy and improving mental focus, peppermint essential oil is a must while recovering from Legionnaires’ disease. It is shown to have antimicrobial activity, improve energy and exercise performance, improve mental exhaustion and support healthy lung function. (27, 28)

A study published in The Journal of Alternative and Complementary Medicine found that inhaling essential oils may reduce the level of mental fatigue and burnout. In this randomized, controlled, double-blind pilot study, subjects in the aromatherapy group had a much greater reduction of fatigue and mental exhaustion. This shows that just opening the bottle and sniffing deeply for several breaths, several times each day, can be beneficial. (29)

11. Exercise. While it may sound counterintuitive for those with persistent fatigue, exercising regularly can help. Researchers from the Department of Human Physiology at Vrije Universiteit Brussel in Belgium report that individuals who include five to 15 minutes of aerobic activity, five days each week, report less fatigue. Authors of the report encourage gradually increasing exercise to 30 minutes each session. (30)

In addition to aerobic exercise, yoga and Pilates may help to promote healing while improving cognitive function and reducing stress and depression. When recovering from this severe of an illness, listen to your body and avoid pushing too hard until your body is ready.

Precautions

It is estimated that 1 in 10 diagnosed with Legionnaires’ disease will die due to complications. That number rises dramatically if the patient contracts the disease while staying at a hospital or long-term care facility. In these cases, 1 in 4 will die.

Antibiotics are required to cure the disease. Natural treatments can help soothe symptoms and aid throughout the recovery phase.

Key Points

Cases of Legionnaires’ disease continue to increase with researchers pointing to aging plumbing infrastructure, an aging population and even climate change as factors.
This disease is infectious, but is not contagious from person to person.
Currently, it is estimated that 1 in 10 infected people will die from this disease.
The Legionella bacteria responsible for this disease thrive in warm water found in hot tubs, plumbing systems, air conditioning systems and even automobile windshield washer fluids.
The disease spreads through the inhalation (or, rarely, the aspiration) of infected water.
Cruise ships, hotels and resorts, hospitals and long-term care facilities, water features and water fountains all have the potential to harbor the Legionella bacteria.
This disease is curable; however, it does require antibiotics and, often, a hospital stay.
Fatigue, neurological function and neuromuscular symptoms may persist for months or even years after treatment.

12 Natural Treatments to Help Recovery