Pneumonia in Argentina: Legionellosis to blame?

NEW PNEUMONIA. 22 cases of pneumonia possibly linked to Legionella (a bacterium) have been reported in a clinic in Argentina. 6 people died. The tracks of the flu or the Covid have been ruled out. What do we know about this mysterious disease? What are the warning symptoms?

  Pneumonia in Argentina: Legionellosis to blame?

[Updated September 7, 2022 at 9:50 a.m.] from case of pneumonia strict ' of unknown origin ' have been reported in Tucuman, in the Northwestern Argentina , said Dr. Luis Medina Ruiz, Provincial Minister of Health, at a press conference September 1, 2022. These cases so far 'very localized' worry the health authorities. According to the first analyzes of the samples, it would not be you you Covid , or a flu . This pneumonia is linked to Legionella , a bacterium found in fresh and warm water. The victims were able to catch it' through water or air conditioning “, recalls the Minister. As of September 6, 2022, 22 cases have been recorded , reports the ministry, whose most are healthcare workers from the private clinic of San Miguel de Tucumán as well as patients hospitalized in the same establishment. To date, 6 deaths are to be deplored : 2 medical staff and 4 patients. A priori, all had comorbidities or some risk factors such as a history of respiratory disease, smoking, obesity or diabetes. So what do we know about this pneumonia? What symptoms are described? What can we fear? Status to date.

What is this pneumonia observed in Argentina?

The disease reported in several people in the private clinic of Tucuman is suggestive of acute pneumonia , an acute respiratory infection affecting the lungs . It is often due to a bacterium or a virus but for the moment, its origin has not been determined. She seems bilateral , in other words, touching both lungs.

How many cases of mystery pneumonia?

For the moment, the cases of mysterious pneumonia have not gone beyond the walls of the private clinic in Tucuman. No cases have been reported outside of this facility. These are adults . As of September 6, 2022:

  Letter from Tucuman in Argentine
Letter from Tucuman in Argentine
  • 22 people showed symptoms of pneumonia between August and September 2022. All cases have been placed in isolation, some in hospital, others at home when their state of health permitted.
  • Of these cases, 6 died: 2 staff members, a 70-year-old patient, who had been ' hospitalized and operated on for a gallbladder problem, and re-operated twice. From then on, an infectious lung disease occurred, the date of which coincides with the onset of symptoms in the other patients, around August 20 “, describes the minister. This patient could 'in principle be the '' patient zero '', but this has yet to be confirmed. On September 4, 2022, the provincial Ministry of Health announced the death of 3 other patients: a 64-year-old patient, an 81-year-old patient and another patient whose age was not communicated.

A 'intense search of all health personnel' of the clinic was launched to follow the evolution of this localized epidemic. Nevertheless, the situation seems under control car a priori, ' there is no patient who has an epidemiological link with the patients. Regarding the close contact group, the staff who shared the workspace, who were around twenty people, are closely monitored. The most important thing is that if anyone has had a working relationship during these days with these patients and has symptoms, they come to our on-call services and report it”, says the Minister of Health.

What are the symptoms of this mysterious pneumonia?

According to the Ministry of Health, it would be a bilateral pneumonia (concerning both lungs) with common clinical characteristics and the same source of origin. Affected patients presented more or less severe symptoms:

  • A high fever
  • A severe respiratory condition (breathing difficulties, cough, etc.)
  • Of the vomiting
  • diarrhea
  • Body aches

In principle, all patients had some type of comorbidities , such as: smoking, chronic obstructive pulmonary disease (COPD), history of respiratory symptoms, obesity, diabetes or high blood pressure.

  Diagram of'une pneumonie
Diagram of pneumonia

What is the possible cause of this mysterious pneumonia?

Leads to Covid, Hantavirus infection, certain strains of Legionella or influenza have so far been ruled out

' Its etiology (its cause, editor's note) has not yet been found ', responds Dr. Ruiz. Among the possible causes and advanced by the provincial Minister of Health: an infectious agent toxic or environmental causes. Analyzes are in progress on the clinic's water and air conditioning systems. It would potentially be linked to the legionella , a bacterium present in warm or hot freshwater. Legionella causes legionellosis , a severe lung infection. On the other hand, the tracks of Covid, d Hantavirus infection were discarded (the diagnostic tests carried out on the samples taken were all negative). Same for the track the flu (type A and B influenza virus) . ' We leave no closed hypothesis, we have more than thirty possible germs capable to detect them and they give negative results, but we must also take into account that there can often be a previous intake of antibiotics may mask the etiology. We continue to carry out the research protocol for blood cultures, sputum cultures, urine cultures and all the viruses and bacteria that we have in the province' , he added. In-depth examinations are underway at the Argentine reference laboratory, the Malbran Institute in Buenos Aires. The results are expected in the coming days.

Is this pneumonia contagious?

First, 'it would not be a disease that results in person-to-person transmission, because close contacts of these patients have no symptoms.' , explained Hector Sale, the president of the Medical College of the province of Tucuman, on Wednesday August 31.

What is the treatment for this mysterious pneumonia?

Diagnoses are carried out in hospitalized people to try to best determine the type of germ or bacteria and in order to best adapt antibiotic regimen when needed . ' Legionellosis is a disease that develops in some people with risk factors and those over 50, sometimes with severity, and in younger people without risk factors, it is often self-limiting. It means that the disease is cured and controlled by its own immunity , without the need to take antibiotics “, indicates the ministry in a statement of September 6, 2022.

The Ministry of Public Health reported on the health situation of the bilateral pneumonia outbreak, September 1, 2022, Ministry of Public Health.