Immunology

Legionella organisms live inside cells of all types, from various protozoa and freshwater amoebae in the external environment to various phagocytic cells in the human body. Given the location of Legionella inside cells, it might be expected that cell-mediated immunity is more important t^jpi humoral (antibody-mediated) immunity, and such seems to be the case in legionellosis.

This may explain why people with defective cellular immunity are particularly susceptible to legionellosis and why so few people exposed in an epidemic of Legionnaires' disease become sick even though usually fewer than 20 percent (and often fewer than 5 percent) have preexisting elevations of titers of specific antibody to Legionella.

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