By Keith Roach, M.D.
Signal Contributing Writer
Dear Dr. Roach ’m 73, male and have been swimming a mile in inside pools every day for 10 years. Two months ago, I caught Legionella pneumonia and was in the hospital for three weeks. They said I was critical. I’m afraid to go back to swimming for fear that I’ll die if I get that disease again. What are my chances of getting it again if I return to daily swimming?
Answer egionnaires’ disease is caused by Legionella pneumophila, a bacteria species that lives in water, especially warm water. Legionella is a dangerous infection. It most commonly affects those over 50 or those with other risk factors, including smoking, alcohol use and a suppressed immune system from a medication or medical condition.
Pools are an occasional cause for Legionella infection; hot tubs are more common. Air conditioning systems and cooling towers are responsible for most large outbreaks. Infection occurs when the aerosolized water droplets contaminated with the bacteria are inhaled deep in the lungs where they can cause infection. I don’t know if an investigation was done in your case, but large outbreaks are a significant concern, and often trigger a response by public health officials. The swimming pool is a possibility.
A properly cleaned and treated pool poses little risk. You should discuss your diagnosis with the operator of the pools where you swam in the week or two prior to getting sick, so the water can be tested. I would point them to tinyurl.com/CDC-legionella-pool for information appropriate to aquatics professionals.
Swimming is a great form of exercise, and you should feel safe and comfortable in your pool.
Dear Dr. Roach Does a person with Eustachian tube dysfunction have to be careful when washing her or his hair? I am concerned that the water that gets into the ear can be felt going down the throat. Or is that another problem?
Answer he ear has three compartments: external, middle and inner. The external ear is all of the part you can touch, all the way to the tympanic membrane (eardrum). It is watertight. The middle ear is the location of three bones that connect the eardrum to the cochlea, the organ of hearing. The cochlea and the organ of Corti, from which you derive your sense of balance, comprise the inner ear.
The Eustachian tube runs from the middle of the ear into the back of the throat, and it allows the pressure in the ear to equalize with the pressure in the atmosphere. Eustachian tube dysfunction is when the tube fails to open, causing pressure changes in the ear. This often comes with reduced hearing and a sensation of ear pressure, and sometimes with ear pain, itching or tinnitus, the sensation of ringing in the ears or other noise. Eustachian tube dysfunction is a complicated issue I can’t explain fully here.
However, showering with Eustachian tube dysfunction is not a problem. A sensation of water going down the throat during showering could possibly be from a wide-open hole in the eardrum, but it is more likely a referred sensation, meaning the body is misinterpreting the data from its own nerves.
Dr. Roach regrets that he is unable to answer individual questions, but will incorporate them in the column whenever possible. Readers may email questions to [email protected]
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