Increased risk of Legionella pneumonia as community-acquired pneumonia after heavy rainfall in 2018 in west Japan

Mitsui, Miho; Ito, Akihiro; Ishida, Tadashi; Takahashi, Hiromasa; Nakanishi, Yosuke; Yamazaki, Akio; Washio, Yasuyoshi

doi:10.1016/j.jiac.2021.05.018

Cited by 4 publications

(3 citation statements)

References 30 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Heavy precipitation, flooding, and storms could introduce contamination, such as nutrients and organic carbon, into source water and soils, improving conditions for OP growth, making source water harder to treat and changing patterns of dispersal and generation of environmental aerosols (Blanc et al, 2021;Gleason et al, 2016;Simmering et al, 2017). Rainfall shows a strong association with cases of legionellosis (Beauté et al, 2016;Braeye et al, 2020;Fisman et al, 2005;Garcia-Vidal et al, 2013;Gleason et al, 2016;Hicks et al, 2007;Mitsui et al, 2021;Passer et al, 2020). As with temperature, legionellosis cases lag several days to two weeks behind a precipitation event (Beauté et al, 2016;Braeye et al, 2020;Fisman et al, 2005;Passer et al, 2020).…”

Section: Precipitation and Storm Eventsmentioning

confidence: 99%

“…Wind can also facilitate dispersal of bioaerosols from more distant sources over large areas. Flooding events driven by increased rainfall have also been found to be associated with elevated legionellosis cases, which may be due to exposures to OP contaminated mud or aerosolized dust during clean up and remediation (European Center for Disease Prevention and Control (ECDC), 2021; Mitsui et al, 2021;Oda et al, 2019). Flooding can increase turbidity and nutrient content and decrease oxygen in receiving waters, which could increase NTM in surface waters and shallow groundwater, and generally enhance growing conditions for OPs while making water more difficult to treat (Blanc et al, 2021;Mapili et al, 2022;Zhang & Lu, 2021).…”

Section: Precipitation and Storm Eventsmentioning

confidence: 99%

See 1 more Smart Citation

Climate change and opportunistic pathogens (OPs) in the built environment

O’Keeffe¹

2022

Environ. Health Rev.

View full text Add to dashboard Cite

Table 1: Characteristics of selected opportunistic pathogens (OPs) of concern in Canada.Legionella spp. Description: Gram-negative bacteria, found in natural water systems and soils, have been detected in most large building water systems and some 10%-30% of home water systems in the United States. Legionella bacteria can be present in water storage containers, pipes, or outlets. Optimal growing conditions: Preference for warm water (e.g., 25-45 °C), high water age, low disinfectant residual, and often associated with biofilms or free-living amoeba (FLA). Routes of transmission: Inhalation or accidental aspiration of aerosolized contaminated water droplets into the lungs from faucets, showerhead, water misters, decorative fountains, hot tubs, cooling towers, etc. Outcome of infection: Legionellosis, includes Legionnaires' disease (LD), a severe pneumonia with a fatality rate of about 10%, and Pontiac fever, a milder flu-like illness. L. pneumophila is the cause of most cases of LD. Groups most at risk: Smokers, over-50s, men, immune-compromised persons, and those with conditions like chronic obstructive pulmonary disease, coronary artery disease, dementia, diabetes, kidney disease, and neurological diseases. Pseudomonas spp. Description: Gram-negative bacteria that can form or join biofilms and colonize plumbing. Found in building water system at point of use areas (e.g., faucets, drains, and showerheads) more often than distribution systems, and can colonize humidifiers, respiratory equipment, swimming pools, hot tubs, and water baths. Optimal growing conditions: Tolerate a range of temperatures (4-42 °C), with an optimum around 37 °C, and reduced virulence below 30 °C; optimal pH around 7.2 and tolerate low dissolved oxygen, low nutrient, and stagnant waters. Grow well in poorly disinfected systems, but also resist disinfectants and can survive in FLA. Routes of transmission: Direct ear and skin contact in swimming pools, hot tubs, and whirlpools; inhalation of aerosols dispersed from faucets, showerhead, etc.; indirect transfer from contaminated devices or fomites. More commonly found in plumbing fixtures than in distribution systems. Outcome of infection: Most infections (80%) associated with P. aeruginosa and P. maltophila range from minor eye, skin, and ear conditions (e.g., swimmer's ear), to bacteremia in immune-compromised individuals or other susceptible patients. A major cause of healthcare-acquired pneumonia, wound infections, and urinary tract infections, and a cause of morbidity and mortality for cystic fibrosis patients. Groups most at risk: Children with cystic fibrosis, hospitalized patients at risk of hospital-acquired pneumonia, newborns, burn patients, patients with invasive devices, and those with underlying pulmonary disease. Nontuberculous mycobacterium (NTM) Description: NTM are a group of more than 190 known species of OP found in natural waters and soil, and building water systems. Includes Mycobacterium avium complex, a group of related bacteria that includes both M. avium and M. intrac...

show abstract

Section: Precipitation and Storm Eventsmentioning

confidence: 99%

Section: Precipitation and Storm Eventsmentioning

confidence: 99%

Climate change and opportunistic pathogens (OPs) in the built environment

O’Keeffe¹

2022

Environ. Health Rev.

View full text Add to dashboard Cite

show abstract

“…Flooding can also cause medical complications such as waterborne infections (13) , hypothermia (14) , wounds (14) , respiratory infections (15) , gastrointestinal infections (14) , and mental illness (16) . By contrast, however, there are few reports on the health effects of torrential rains (17) , (18) , which are common in Japan.…”

Section: Introductionmentioning

confidence: 99%