NEW PNEUMONIA. 22 cases of pneumonia probably 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?
[Mis à jour le 7 septembre 2022 à 9h50] Cases of severe pneumonia”of unknown origin” have been reported in Tucuman, in the Northwestern Argentinasaid Dr. Luis Medina Ruiz, Provincial Minister of Health, at a press conference September 1, 2022. These cases for now “very localized” worry the health authorities. According to the first analyzes of the samples, it would not be neither Covid nor 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 recordedreports the ministry, whose most are healthcare workers from the private clinic of San Miguel de Tucuman 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 ofacute 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 bilateralin 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:
- 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.
- Among these cases, 6 died: 2 staff members, a 70-year-old patient, who had been “hospitalized and operated for a gallbladder problem, and reoperated 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 because 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.)
- Vomitings
- diarrhea
- Body aches
In principle, all patients had some type of comorbiditiessuch as: smoking, chronic obstructive pulmonary disease (COPD), a history of respiratory symptoms, obesity, diabetes or high blood pressure.
What is the possible cause of this mysterious pneumonia?
The tracks of Covid, an infection with a Hantavirus, certain strains of Legionella or the flu have for the moment been ruled out.
“Its etiology (its cause, editor’s note) has not yet been found“, answers Dr. Ruiz. Among the possible causes and advanced by the provincial Minister of Health: an infectious agenttoxic or environmental causes. Analyzes are in progress on the clinic’s water and air conditioning systems. It would potentially be linked to the legionellaa bacterium present in warm or hot freshwater. Legionella causes legionellosis, a severe lung infection. On the other hand, the tracks of covid, Hantavirus infection were discarded (the diagnostic tests carried out on the samples taken were all negative). Same for the track influenza (influenza virus type A and B). “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 that can 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?
A priori, “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, 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 immunitywithout the need to take antibiotics“, indicates the ministry in a statement of September 6, 2022.
Source : El ministerio de Salud Pública informó sobre la situation sanitaria del brote de neumonía bilateral, September 1, 2022, Ministerio de Salude Publica.