Aspiration vs swallowing water?

If I swallow water contaminated with Legionella pneumophila and the water goes to my esophagus instead of my trachea because I don’t aspirate, can I still get Legionnaires’ disease although the bacteria didn’t enter my lungs?

Good question.

The answer is no. That is the reason so many patients who are exposed to water with Legionella don’t contract Legionnaires’ disease. The ones who do contract Legionnaires’ disease tend to have risk factors for aspiration – the most notable of which is cigarette smoking.