1.3 Transmission exist naturally in water and moist soil. Transmission to humans normally Legionella occurs via inhalation or aspiration of droplets of water containing Legionella (aerosols). Person-to person transmission does not occur (Dennis and Lee, 1988, Fitzgeorge 1993, Fields, 1996, Stout and Yu 1997, Belyi, 1999). Wound et al., infection may be caused by direct entry of into damaged skin, and has been Legionella observed after immersion of a wound in contaminated water (Brabender 1983, et al., Lowry 1991). et al., Transmission hazards have been associated with water distribution systems, cooling towers, humidifiers, whirlpool spas, car wash systems, vegetable water sprayers, and windscreen wiper water. As reviewed by Rathore and Alvarez, (2009), transmission hazards have also been associated with respiratory therapy equipment, nasogastro tubes, dental unit water lines and potting compost (Breiman 1990, Kool et al., et al., 1998, Seenivasan 2005, Kumar 2010, Pravinkumar 2010, et al., et al., et al., www.hcinfo.com, www.nhs.uk). Disease is mainly caused by the transmitted residing within phagosomes of Legionella alveolar macrophages, they multiply intracellularly until the cell ruptures. Liberated then infect other macrophages (Microbiology Third Edition, Legionella 1996). Immuno-compromised people are at increased risk of contracting disease from because their cell-mediated immunity against is impaired Legionella Legionella (Greenberg 2006). et al., 4
1.3 Transmission Legionella exist naturally in water and moist soil. Transmission to humans normally occurs via inhalation or aspiration of droplets of water containing Legionella (aerosols). Person-to person transmission does not occur (Dennis and Lee, 1988, Fitzgeorge et al., 1993, Fields, 1996, Stout and Yu 1997, Belyi, 1999). Wound infection may be caused by direct entry of Legionella into damaged skin, and has been observed after immersion of a wound in contaminated water (Brabender et al., 1983, Lowry et al., 1991). Transmission hazards have been associated with water distribution systems, cooling towers, humidifiers, whirlpool spas, car wash systems, vegetable water sprayers, and windscreen wiper water. As reviewed by Rathore and Alvarez, (2009), transmission hazards have also been associated with respiratory therapy equipment, nasogastro tubes, dental unit water lines and potting compost (Breiman et al., 1990, Kool et al., 1998, Seenivasan et al., 2005, Kumar et al., 2010, Pravinkumar et al., 2010, www.hcinfo.com, www.nhs.uk). Disease is mainly caused by the transmitted Legionella residing within phagosomes of alveolar macrophages, they multiply intracellularly until the cell ruptures. Liberated Legionella then infect other macrophages (Microbiology Third Edition, 1996). Immuno-compromised people are at increased risk of contracting disease from Legionella because their cell-mediated immunity against Legionella is impaired (Greenberg et al., 2006). 4
Birgitta-Bedford-Thesis-2012.docx