When Paul Copeland developed fevers, aches, and breathing difficulties in July this year, he thought he had COVID-19.
But the Brisbane man soon discovered it was a potentially deadly bacteria from his garden that had caused his debilitating symptoms.
"To get to the point where you can't walk and you can't talk, it's pretty bad," Mr Copeland said.
"I'd never been that sick. My skin was sore, my hair was sore."
Mr Copeland went to hospital where COVID-19 was ruled out, but a chest X-ray showed pneumonia.
He was treated and sent home but returned the next day when his condition worsened.
"I was in hospital for another four days," Mr Copeland said.
"I wasn't coughing a lot, but I just had no air, and my oxygen levels were quite low. "
A niggling thought about a weekend gardening job led Mr Copeland to ask doctors whether handling soil could have caused his illness.
Mr Copeland had used buckets to carry soil down a narrow path along the side of his house and top up garden beds in his backyard.
He thinks that's how he inhaled Legionella longbeachae bacteria, which are typically associated with potting mixes and garden soils.
"When I mentioned the dirt and the landscaping they've gone back and done another test and that's come back positive," he said.
A spike in cases
Cases of people developing Legionella longbeachae infections have been much higher in Queensland and New South Wales this year, compared to the previous five years.
Queensland has recorded 88 cases so far this year – more than three times the 2017-21 average for this time of the year. Two of this year's cases have died.
NSW has reported 86 cases in 2022, compared to an average of 56 in the first 10 months of the year during 2017-21.
Experts believe the real figures are likely to be much higher with some infections going undiagnosed.
Queensland Chief Health Officer (CHO) John Gerrard, who worked as an infectious disease specialist on the Gold Coast before becoming the CHO, said higher than usual rainfall this year may be to blame.
But another theory is that people are gardening more during the COVID-19 pandemic.
"I haven't seen any data on this, but I'm told people have been using potting mixes more," Dr Gerrard said.
Although all ages and genders are at risk, Ipswich Hospital infectious disease physician Candice Holland said men older than 50 were particularly vulnerable to Legionella longbeachae infections.
"We see it in both men and women, but more in men," Dr Holland said.
"I don't think we fully understand what the factors are that lead to men becoming more unwell with this condition."
Dr Holland said smokers made up 18 per cent of Queensland's Legionella longbeachae cases this year.
People with pre-existing medical conditions are also highly susceptible to becoming unwell with Legionellosis, but otherwise healthy young people are not immune.
"It can be a very significant infection. It can make people very sick and require admission to hospital, a prolonged stay in the intensive care ward," Dr Holland said.
"It is very serious and people should take the appropriate precautions when they are handling potting mix.
"There's all sorts of nasties that live in the soil so regardless of your age or medical conditions, you should make sure you keep yourself safe when you're doing the gardening.
"I think it's a great thing to be outside and be active and gardening, but just do it in a way which allows you to not get unwell from those soil and dirt-based bugs."
Doctors advise precautions
Ideally, people should wear gloves and a mask when they are working with garden soil or potting mix and wash their hands after gardening.
Dr Gerrard also advised gardeners to open potting mix bags away from their faces and to avoid shaking the bag before emptying it.
"The other thing is to wet the potting mix … so it doesn't generate dust," he said.
Paul Copeland recovered from his Legionella longbeachae infection after taking antibiotics and resting for two weeks.
But returning to his previous level of physical activity has taken much longer.
"I've only just started going back to the gym in the last week," he said.
"I always had mild asthma and I've found since having Legionnaires' my asthma is a lot more severe so I'm constantly looking at my Ventolin and preventers.
"Hopefully there's no long-term effects."
As for the next landscaping job at home, he's off the hook.
"I've got a get-out-jail-free card for the rest of my life – no need to do manual labour ever again," he said with a laugh.
