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Hospital acquired infant Legionellosis

According to a case study recently published in Emerging Infectious Diseases, two male infants were diagnosed with a Legionella infection after aspirating contaminated water used at their respective hospitals to make their formula. Both babies were delivered at separate hospitals via cesarean section at 38 weeks after an uneventful pregnancy. On postpartum days seven and eight, respectively, they developed a fever, poor appetite and rapid breathing, and were subsequently brought back to the hospital for evaluation. The infants’ sputum samples were cultured and Legionella pneumophila serotypes 5 and 1, respectively, were identified. Hot and cold water sources were also tested at both hospitals. The tests results were “indistinguishable” between the infants’ profile and from the cold water source of the hot/cold water dispenser used for making formula, showing that the cold water tap was the source of the Legionella exposure. Both infants were treated with antibiotics and were eventually discharged. 

Legionnaire’s disease (LD) is a form of pneumonia caused by exposure to the aquatic bacteria known as Legionella pneumophila.  You can be exposed to Legionella by inhalation of aerosolized Legionella contaminated water droplets or by aspiration or choking on Legionella contaminated drinking water.  LD develops 2-14 days after exposure and symptoms include fever, cough, shortness of breath, flu-like symptoms such as chills and body aches, and confusion or other mental changes.  LD is diagnosed by a medical provider and antibiotics are required for treatment. Fortunately, not everyone who is exposed to Legionella will develop the illness and the disease is not spread from person to person.

Typically, if building related LD is confirmed, a full scale investigation should commence. The many steps involved in such an investigation include determining if your building has water systems contaminated with Legionella by conducting a building investigation, risk assessment and causation analysis.  An expert response team of medical and environmental specialists can identify areas susceptible to the growth of Legionella, manage the incident, perform medical evaluations or surveillance activities (if necessary), conduct town hall meetings, and help create a remediation and preventive maintenance plan if Legionella source is found. 

For more information relating to Legionella, Legionnaire’s disease and potential solutions, please contact us at

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