Title : Legionella, scientific considerations on this pathogen threatening the civilized world. Why not Albania?
Abstract:
Introduction: Legionellosis is an infectious pathology caused by bacteria of the genus Legionella. L. Pneumophilia was recognized as the cause of the disease in 1976. Water reservoirs are its transmitting agents. There are risk factors and predisposing conditions. Travel is a serious risk factor. Albania is a well-known tourist destination with a high number of visitors accommodated in the numerous hotels of our main cities. Our country is located in the typical Mediterranean climate zone with considerable amounts of rainfall and solar radiation, all of which make legionella a real threat to our health.
Goal:To contribute to a better understanding of Legionella and its role in public health with a potential epidemic risk.
Method: The basis of the work was scientific findings on epidemiology, imaging or laboratory diagnostic methods, treatment and the role of Legionella in public health. We conducted a scientific narrative search in PubMed, Cochrane, Google Scholar, Scopus, Web of Science using keywords such as “legionnaires disease”, “risk factors”, “air conditioning”, “tourist” etc. We collected scientific sources published by the IHP, the Tourism Association, the Ministry of Culture. Our country has legislation and guidelines for the control of Legionella.
Results and Discution: Legionella are found everywhere in the world, in environmental reservoirs such as cooling systems, drinking or domestic water systems, industrial chillers, hydromassage spas, Turkish baths, etc. Legionella spread far and wide through aerosols. There are risk factors and predisposing conditions such as cancerous diseases, autoimmune diseases, HIVAIDS, etc. Legionellosis occurs as Pontiac Fever and Legionnaires' Disease. The latter manifests itself with pulmonary (pneumonia, cavitary abscesses, etc.) and extrapulmonary (neurological, renal, gastroenterological) involvement that results in respiratory, multiorgan failure, septic shock and death. The bacterium is known to cause sporadic, epidemic, hospital-acquired, atypical pneumonia. Diagnosis is based on clinical data, imaging and laboratory confirmation. Travel and tourism are risk factors. Albania is an attractive tourist destination as it was visited by 9 million tourists in the period January - August 2025 alone. This and the weather conditions create a breeding ground for Legionella. Legionella is a notifiable disease by the entire public and private healthcare system and the Institute of Public Health monitors this bacterium.
Conclusion: Legionella is a ubiquitous bacterium, so it constitutes a real threat to public health in the world and here of course. Legionnaires' disease is an under-reported infectious pathology also in Albania, so the professional construction of an epidemiological, diagnostic algorithm will help clinicians, including infectologists.
Keywords: legionella, risk factors, water systems, air conditioning, tourism, public health.
