The Pan American Health Organization (PAHO) has been informed by the Argentina Ministry of Health that legionella has been confirmed as the cause of a cluster of pneumonia cases associated with a health clinic in the province of Tucuman, Argentina.

To date, a total of 11 cases have been identified, including four deaths in patients with comorbidities.

Legionella, in particular bacterium L. pneumophila, is associated with outbreaks of severe pneumonia. The most common form of transmission is inhalation of contaminated aerosols produced in conjunction with water sprays, jets or mists. Infection can also occur by aspiration of contaminated water or ice, particularly in susceptible patients in hospital environments. Treatment includes the administration of antibiotics for several weeks or months. 

The Argentina Ministry of Health and the provincial health authorities are working to identify the source and implement appropriate control measures. They are collecting environmental samples, conducting risk assessments, and implementing actions in the healthcare clinic related to the outbreak.

PAHO is providing support to Argentinian health authorities from its Headquarters and the PAHO Country Office in Argentina to investigate and characterize the outbreak.

The PAHO and World Health Organization Representative in Argentina, Eva Jane Llopis, accompanied Argentina’s Minister of Health Carla Vizzotti to a site visit today.

In agreement with the national and provincial authorities, PAHO will also send a multidisciplinary team of experts next week to support surveillance, infection control measures within hospital care, and the identification of the origin of the outbreak at the hospital infrastructure level.

The update specifically mentioned Legionella pneumophila, which is one of a legion of different Legionella bacteria species that also includes L. longbeachae, L. feeleii, L. micdadei, and L. anisa. Legionella can hang out in amoebae that live in wet environments such as air conditioning systems, cooling towers, hot tubs, plumbing systems, humidifiers, ice-making machines, fountains, misting systems, whirlpool spas, ventilators, potting mixes, and composts. This is yet another reason why you shouldn’t shove potting mix or compost up your nose.

When the bacteria enters your lungs via your inhaling contaminated water droplets or soil, the result can be a milder illness called Pontiac Fever with symptoms developing a few hours to 3 days after exposure to the bacteria. Or a more severe illness, dubbed Legionnaire’s Disease, with symptoms developing two to 10 days after exposure. The severity of the illnesses in this outbreak suggests that it’s been an outbreak of Legionnaire’s Disease. It’s called Legionnaire’s Disease not because it will turn you into a Legionnaire and wear those hats that they wear. Instead, it got its name from where the bacteria was first identified: at a three-day American Legion convention at the Bellevue-Stratford Hotel in Philadelphia, Pennsylvania, in 1976.

Not everyone exposed to the Legionella bacteria will end up getting ill. You are more likely to develop Legionnaire’s Disease if you have a weaker immune system (e.g., 50 years or older, have a chronic disease, or are on medications that suppress the immune system) or weaker lungs (e.g., suffering chronic obstructive pulmonary disease). That doesn’t mean that you should say, “bring it on,” to Legionella bacteria. Even if you are perfectly healthy, you can still get Legionnaire’s Disease, although the likelihood would be significantly less.

The key to treating Legionnaires’ disease is getting the right antibiotics as soon as possible. As the World Health Organization (WHO) relates, the overall death rate from Legionnaires’ disease is between 5 and 10%. However, this death rate can bounce up to 5 to 30% if you have a weaker immune system and even further up to 40 to 80% if you have don’t get proper treatment in time. That’s why doctors should look for evidence of Legionella in your urine, blood, or sputum as soon as should as Legionnaires’ disease is in any way suspected.

That being said, authorities aren’t going to say something like YOLO and not continue to act with urgency. Now, they are trying to identify the source of the outbreak as soon as possible to prevent further people from getting sick. After all, you don’t want some water system to keep spraying Legionella into the air like a mist machine at a Phantom of the Opera show. The Argentina Ministry of Health and local health authorities have been collecting environmental samples in and around the private clinic in San Miguel de Tucumán in northwestern Argentina where the health care workers affected by the outbreak worked. This may help identify what needs a-fixing. They’ll want to make sure that there’s no more “airing” on the side of the Legionella bacteria.