Legionnaires’ disease – Symptoms and treatments

Legionnaires’ disease can be fatal, but if treated with antibiotics it can be cured. It is caused by inhaling small droplets of polluted water, so it can't be spread directly amongst people. The initial symptoms include muscle pain and a fever. A persistent cough develops a little later when the disease infects the lungs.

Causes of the disease

Workers in buildings like hotels, museums, offices, and hospitals are most at risk. These places are vulnerable to contamination because of their large and complicated water supply systems through which Legionnaires’ disease can spread. Air-conditioning systems and hot and cold water services can push the disease around this type of building. But strict regulations designed to lower the risk of an outbreak are in place, so in the UK only 200 – 300 cases are reported each year.


Antibiotics are used to cure the disease. Erythromycin or clarithromycin will often be prescribed. These are taken as tablets or through an intravenous drip. If the symptoms are severe, you may need to take antibiotics for 21 days, but in most cases the course is between 7 and 10 days. These drugs can cause dizziness and sickness. Diarrhoea is another common side effect, as are a loss of appetite, headaches, and a shortness of breath.

Hospital treatment of legionnaires’ disease

If your symptoms are severe, you may need to be admitted to hospital. Pre-existing diseases like diabetes could also lead to hospital treatment. This is also commonplace for the elderly, as hospital admission will allow the doctors to monitor your progress whilst you recover from the disease. You may be given oxygen, and fluids may be administered intravenously during your treatment. The doctor may also want to monitor your heart rate and blood pressure.

Final word

Although legionnaires’ disease kills around 10% of suffers, it is very serious for vulnerable people like the elderly or those with a pre-existing medical condition. To prevent the disease occurring, NHS guidelines recommend that water in the system is cooled to below 20°C or heated to above 60°C. Another recommendation is that water is not allowed to stagnate and should be kept free of impurities.

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