Transplanted Lungs Potentially Spread Deadly Legionella Infection to Organ Recipients: CDC Study

The individuals received lungs from the same donor who had drowned to death.

The U.S. Centers for Disease Control and Prevention (CDC) headquarters in Atlanta, Ga., on Aug. 25, 2023. Madalina Vasiliu/The Epoch Times

Two recipients of organ transplants are believed to have died from the donated organs getting infected with a deadly bacteria, according to the CDC.

“In June 2022, two cases of Legionnaires disease were reported in patients, each of whom had received a lung transplant from the same donor, who had drowned in a river … Evidence suggest that the source of infection was likely the transplanted lungs,” the U.S. Centers for Disease Control and Prevention (CDC) said in a Sept. 15 report. Legionnaires’ disease is a type of pneumonia caused by the bacteria Legionella.

The infection is caused by breathing in small water droplets contaminated with the bacteria. Around one in ten people with the disease die from the infection. This is the first time that an organ transplant is believed to have spread Legionella bacteria.

“Clinicians caring for patients who received organs from donors who drowned in fresh water should consider infection with Legionella” in case the patients develop health complications after operation, the CDC said.

“Prompt diagnosis and treatment of Legionnaires’ disease increases the likelihood of a full recovery.”

The two cases of Legionnaires disease were found in people who had received lungs from a 30- to 39-year-old man who fell into a river and was submerged for around five minutes. Organ recovery took place within seven days of the drowning.

“At the time, exposure to Legionella was not suspected, and no testing for Legionella was performed on any donor specimens before or after organ recovery,” the report said.

The first patient, a woman aged 70-79 years, received a right lung transplant from the donor in May 2022. The second patient, a man aged 60-69 years, received a left lung transplant from the donor on the same day.

Individuals who receive organ transplants are especially vulnerable to infections as they take medications to suppress their immune systems to prevent it from attacking the transplanted organs.

While the study did not find “confirmatory clinical or genomic evidence” to prove that the transplanted lungs were the source of Legionella infection which killed the patients, it outlined three factors of why the donated lungs are to blame.

First, the two patients had different species of Legionella, which can potentially be explained by the donor’s death in the river, where the water is likely to contain a more diverse species of the bacteria.

Secondly, a review of records at the hospital where the transplants were conducted suggested that water parameters remained within expected ranges, finding no indication that the water may have been infected by the Legionella bacteria.

Thirdly, no other Legionnaires’ disease was reported from the transplant facility within 12 months of the two cases. “Given the tight clustering in time, identification of additional cases would be expected if the source was the hospital facility’s water system or cooling towers.”

Infection Symptoms and Death Risk

According to the CDC, Legionella bacteria are found naturally in freshwater environments. The bacteria becomes a health concern when spread into human-made building water systems like showerheads, hot water tanks, hot tubs, decorative fountains, and plumbing systems. Legionella can also grow in the windshield wiper fluid tank of a vehicle.

Legionella pneumophila bacteria which are responsible for causing the pneumonic disease Legionnaires' disease in a 1978 electron microscope image. Francis Chandler/CDC via AP

Once the bacteria gets into the systems, it can spread via droplets which people breathe in. Except in some rare circumstances, people do not generally spread the infection to others.

Individuals who are 50 years or older, those who are current or former smokers, people with cancer, weak immune systems, chronic lung disease, and those with underlying illnesses like kidney failure, diabetes, and liver failure are at increased risk of getting sick when exposed to Legionella.

“Most healthy people exposed to Legionella do not get sick,” the CDC said.

Symptoms of Legionnaires’ disease include shortness of breath, muscle aches, headaches, fever, and cough. Symptoms usually become manifest two to 14 days after getting exposed to the bacteria.

While around one in 10 people who get the infection die from disease complications, the rate shoots up to one out of four for people who get infected during a stay at a healthcare facility.

In the Sept. 15 report, the CDC said that “Legionnaires disease incidence has increased substantially during the past decade, reaching a peak of 2.71 cases per 100,000 persons in 2018.”

“Most cases are not associated with a known source, although approximately 18 percent have a reported health care facility–associated exposure.”

Three additional recipients had received transplanted organs from the same donor—heart, liver, and right kidney. Though the patients experienced some complications, there was no indication of Legionella infection, the report said.