Information for the General Public
What is legionella?
Legionella is a type of bacteria naturally found in freshwater environments as well as human-made water systems including but not limited to hot tubs, decorative fountains, and/or cooling towers. Legionella can cause legionnaire's disease, a serious type of pneumonia infection, or Pontiac fever, a more mild respiratory illness.
What are symptoms of legionnaire's disease?
Although Legionella can cause serious infections, most healthy people who are exposed to Legionella don’t get sick. It usually takes 2 to 14 days after being exposed to Legionella. Symptoms may include:
- Cough
- Shortness of breath
- Fever
- Chills
- Muscle aches
- Headaches
How can legionnaire's disease spread?
Small water droplets or mist from freshwater sources including hot tubs, decorative fountains, and/or cooling towers can contain Legionella bacteria, which people can breathe in without knowing. Legionnaire’s disease does not spread from person to person.
Resources
Information for Healthcare Providers
Legionnaires' disease is characterized by illness with pneumonia diagnosed radiographically or clinically. Clinical symptoms may vary but include acute onset of lower respiratory illness with fever or cough.
Risk factors
- Over the age of 50 years
- Chronic lung disease
- Immunocompromised
- Smoking
Reporting
Legionellosis is reportable in Orange County within seven calendar days of identification. To report a case, health care providers/facilities should contact Communicable Disease Control Division at (714) 834-8180 or fax reports to (714) 560-4050.
Laboratory testing
Recommended testing for Legionnaires’ disease includes PCR or culture of lower respiratory specimens and urine antigen. Lower respiratory specimens should ideally be obtained prior to start of antibiotics or as soon as possible after treatment has started. The urine antigen test can detect Legionella infections in some cases for days to weeks after treatment. Urine antigen testing detects Legionella pneumophila serogroup 1, the most common cause of Legionnaires’ disease.
Resources
- CDPH: Information for Health Professionals and Clinical Laboratories
- CDC: Clinical Guidance for Legionella Infections
- CDC: What Clinicians Need to Know about Legionnarie's Disease
Latest News
Legionella in Westminster
Last Update: 1/23/2025
Total number of confirmed cases: 7
The OC Health Care Agency (HCA) was notified of seven confirmed cases of Legionnaire’s Disease (LD) among residents living in a community in a northwestern corner of Westminster. The cases developed symptoms between October 29 and November 8, 2024. Investigations have begun by the HCA’s Disease Control and Epidemiology team and HCA’s Environmental Health Services to identify potential sources of the infections which could include cooling towers, pools, spas, or other water sources in the area.
The risk to anyone who lives or visits Westminster is very small, however, the HCA recommends that individuals who live and work in this area and who become ill with pneumonia-like illness visit their healthcare provider and discuss this advisory. People who are more likely to experience severe illness from Legionnaires’ disease include individuals 50 years and older, those with weakened immune systems, those with chronic respiratory conditions (e.g. asthma, COPD) and smokers.
Additionally, the HCA is asking businesses and property owners to review their water management practices, especially those with cooling towers, hot tubs, or fountains. The following steps are recommended to help mitigate the spread of Legionella:
- Review, maintain and/or establish a water management program.
- Disinfection of cooling towers and water systems to prevent bacteria growth.
- Perform routine water system maintenance and maintain records and logs.
- Perform Legionella testing through accredited laboratories, particularly following any remediation efforts.
Tiburon Homes Legionella Outbreak
Last Updated: 1/23/2025
Total number of confirmed cases: 6
Six confirmed cases of Legionella infection were identified with symptoms having developed between September 28 and October 12, 2024. No additional cases have been identified over the last 3 months. An extensive investigation conducted by HCA, which is now concluded, did not identify a source for this outbreak. HCA has worked to identify and assure the appropriate maintenance of any potential Legionella sources in the community. After carefully reviewing the data collected during the investigation, the Centers for Disease Control’s guidance, and consultation with CDPH, HCA believes that there is currently no evidence of an elevated risk of Legionella infection for Tiburon residents.
To report any suspect Legionella cases or a potential environmental source, or for any questions, please call the HCA Communicable Disease Division at (714) 834-8180.
Frequently Asked Questions
- Legionnaires’ Disease – Frequently Asked Questions (English)
- Legionnaires’ Disease – Frequently Asked Questions (Spanish)
- Legionnaires’ Disease – Frequently Asked Questions (Vietnamese)
Other Resources
Last Updated: 1/23/2025