36 May 2014
ten, but most signs point to a bleak landscape
unless a significant effort is made to change
course. A few committees of dedicated profes-
sionals in the healthcare, public health, engi-
neering, and industrial hygiene sectors have
been trying to develop guidelines that will help
reduce LD cases. Unfortunately, these com-
mittees of volunteers are not always working in
concert and typically take much longer to reach
consensus than one would hope. Progress will
probably be slow and the task arduous as long
as we rely upon the existing framework of public
health surveillance and voluntary guidelines.
In the next and final article of this series we will
discuss the future of Legionnaires' disease, in-
cluding its control and prevention. We will focus
on proposed changes to the current paradigm,
abandoning failed dogma, and changing the
course of public health policy to prevent this
most preventable of diseases.
References
1 Baldwin, GC, Tashkin, DP, Buckley, DM,
Pakr, AN, Dubinett, SM, and Roth, MD, Mari-
juana and Cocaine Impair Alveolar Macrophage
Function and Cytokine Production. AM J Resp
Crit Care Med, Vol 156, pp 1606-1613. 1997
2 Nguyen, LT, Picard-Bernard, V, Perriot,
J. Legionnaires Disease in Cannabis Smokers.
CHEST 138(4):989-991. 2010
3 Nielsen K1, Bangsborg JM, Høiby N.,
Susceptibility of Legionella species to five
antibiotics and development of resistance by
exposure to erythromycin, ciprofloxacin, and
rifampicin. Diagn Microbiol Infect Dis. 2000
Jan;36(1):43-8. (http://www.ncbi.nlm.nih.gov/
pubmed/10744366)
4 Vincent, Grayson K. and Victoria A. Vel-
koff, 2010, THE NEXT FOUR DECADES, The
Older Population in the United States: 2010 to
2050, Current Population Reports, P25-1138,
U.S. Census Bureau, Washington, DC. (https://
www.census.gov/prod/2010pubs/p25-1138.pdf)
5 Sydnor ER1, Bova G, Gimburg A, Cos-
grove SE, Perl TM, Maragakis LL., Electronic-
eye faucets: Legionella species contamination
in healthcare settings. Infect Control Hosp
Epidemiol. 2012 Mar;33(3):235-40