Legionella is found naturally in freshwater environments, like lakes and streams, according to the Centers for Disease Control and Prevention (CDC). They can become a health concern when they grow and spread in human-made building water systems, such as:

• showerheads and sink faucets
• cooling towers (structures that contain water and a fan as part of centralized air cooling systems for building or industrial processes)
• hot tubs that aren’t drained after each use
• decorative fountains and water features
• hot water tanks and heaters
• large plumbing systems.

Outdoors, Legionella survive in soil and water but rarely cause infections, according to the Mayo Clinic.

“Usually it’s in the environment, and usually (it affects) someone with a weakened immune system,” Lynch said. “There are usually a few deaths a year, and usually in the elderly. It’s opportunistic.”

Test results are negative
Two rounds of environmental and water sampling tests performed by state officials and a private water-management company have yet to locate the Legionella source.

“PMMA communities follow detailed policies to ensure the best outcomes for these kinds of challenges,” said Bill Taylor, chief operations officer for Presbyterian Manors Mid-America. “The organization has a simple and straightforward philosophy when it comes to the matter of resident, employee and public safety: safety first.”

Cause for concern
Missouri health officials are advising that if you are a resident, visitor or employee of Fulton Presbyterian Manor and you are feeling pneumonia- or flu-like symptoms, you should visit your health-care provider.

Legionnaires FAQs

Who is at risk?
Anyone can get the disease, but those at the highest risk of infection include:

• people 50 or older
• smokers (current or former)
• heavy drinkers of alcoholic beverages
• people with chronic lung disease
• people with weakened immune systems.

Are there complications?
After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

• respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
• septic shock: this can occur when Legionella produce toxins that enter the blood stream and cause a drop in blood pressure, leading to loss of adequate blood supply to the organs.
• kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
• endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
• pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

What are the symptoms?
Legionnaires’ disease usually develops two to 10 days after exposure to Legionella. It frequently begins with the following signs and symptoms:

• headache
• muscle pain
• chills
• fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other signs and symptoms develop, including:

• cough, which can bring up mucus and sometimes blood
• shortness of breath
• chest pain
• gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
• confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

What is Pontiac fever?
A mild form of Legionnaires’ disease, called Pontiac fever, can produce similar symptoms, including a fever, chills, headache, and muscle aches. Pontiac fever, however, doesn’t infect the lungs, and symptoms usually clear within two to five days.