Materiały źródłowe

• #1 Legionnaires’ disease – Wikipedia

  https://en.wikipedia.org/wiki/Legionnaires%27_disease

  Legionnaires’ disease acquired its name in July 1976, when an outbreak of pneumonia occurred among people attending a convention of the American Legion at the Bellevue-Stratford Hotel in Philadelphia. Of the 182 reported cases, mostly men, 29 died. On 18 January 1977, the causative agent was identified as a previously unknown strain of bacteria, subsequently named Legionella, and the species that caused the outbreak was named Legionella pneumophila. Following this discovery, unexplained outbreaks of severe respiratory disease from the 1950s were retrospectively attributed to Legionella. Legionnaires’ disease also became a prominent historical example of an emerging infectious disease. […] Outbreaks of Legionnaires’ disease receive significant media attention, but this disease usually occurs in single, isolated cases not associated with any recognized outbreak. When outbreaks do occur, they are usually in the summer and early autumn, though cases may occur at any time of year. Most infections occur in those who are middle-aged or older. National surveillance systems and research studies were established early, and in recent years, improved ascertainment and changes in clinical methods of diagnosis have contributed to an upsurge in reported cases in many countries. Environmental studies continue to identify novel sources of infection, leading to regular revisions of guidelines and regulations. About 8,000 to 18,000 cases of Legionnaires’ disease occur each year in the United States, according to the Bureau of Communicable Disease Control.

• #2 Microbiology, epidemiology, and pathogenesis of Legionella infection – UpToDate

  https://www.uptodate.com/contents/microbiology-epidemiology-and-pathogenesis-of-legionella-infection

  Legionnaires’ disease, which refers to pneumonia caused by Legionella spp […] Pontiac fever, which is an acute, self-limited febrile illness that is typically acquired during outbreaks.

• #3 Legionnaires Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430807/

  Legionellae are ubiquitous and transmitted to humans via aerosolized contaminated water from the environment or building water systems. The true incidence of Legionnaires disease is unknown; many countries lack appropriate diagnostic, surveillance, or reporting methods. In the United States, legionellae are the most common cause of waterborne infections; 60% to 65% of reported cases are sporadic and acquired from the environment. The source of the bacterium usually remains unidentified. […] However, legionellae can cause disease outbreaks from contaminated water sources within large buildings and facilities, such as hotels, hospitals, and long-term care facilities. Legionnaires disease has been reported as a travel-associated infection, most commonly associated with hotels with contaminated water systems or hot tubs. The reported incidence of travel-related or healthcare-associated legionellosis in the United States is 20%.

• #4 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Overview | Occupational Safety and Health Administration

  https://www.osha.gov/legionnaires-disease

  Legionnaires’ disease and Pontiac Fever are collectively known as Legionellosis, a disease caused by Legionella bacteria. Around 6,000 Legionnaires’ disease cases are reported each year in the United States. However, scientists believe the reported totals are much lower than the actual cases due in part to the difficulty in distinguishing Legionnaires’ disease from other types of pneumonia. The most recent U.S. population-based study estimated that 8,000-18,000 people are hospitalized each year with Legionnaires’ disease. […] Managing Legionella and preventing worker exposures and Legionellosis cases depend on implementing an effective water management program. […] Improperly maintained water systems, such as domestic or industrial water systems or large HVAC systems, are among the leading sources of worker exposure to the bacteria that cause Legionnaires’ disease.

• #5 Legionnaires Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430807/

  Data from the Centers for Disease Control indicates that the reported incidence of Legionnaires disease in the United States has rapidly increased since 2000. In 2018, 9,933 cases of Legionnaires disease were reported to the CDC; the case fatality rate was 10%. However, many infections go undiagnosed, and underreporting is common. […] Approximately 10% of the global legionellosis cases are diagnosed within the United States, resulting in 8 to 18,000 annual hospitalizations. Recent data indicate that the prevalence of Legionnaires disease is increasing worldwide and estimate the actual number of infections to be 1.8 to 2.7 times higher than reported. The epidemiology of Legionnaires disease varies by geographic region, season, and population. In the United States, the disease is more common in Ohio, Pennsylvania, New York, and Illinois. In the European Union/European Economic Area, the notification rates increased from 1.2 to 1.4 per 100,000 people between 2012 and 2016 to 1.8 to 2.2 per 100,000 between 2017 and 2019. The disease has also been reported in Asia, Africa, and Latin America.

• #6

  https://jglobalbiosecurity.com/articles/10.31646/gbio.201

  Legionnaires disease was first detected in 1976 when an outbreak occurred in Philadelphia, USA. […] Surveillance is important to understand the transmission, pathogenesis, and complications, and to quickly identify the outbreaks, new cases and epidemiologic links between cases. […] EPIWATCH reported approximately 28 cases during September to December 2020, 349 cases in 2021 and 114 cases during January to October 2022, which is a decrease in case numbers, possibly due to underreporting during the ongoing COVID-19 pandemic. […] Annual case numbers may be 1.8 to 2.7 times higher than reported, due to potential underdiagnosis and the requirement for confirmation of infection source before a diagnosis can be made.

• #7 Legionnaires’ Disease

  https://dphhs.mt.gov/publichealth/cdepi/diseases/Legionellosis

  Legionnaires’ disease is a serious type of pneumonia caused by Legionella bacteria. […] The number of cases of Legionnaires’ disease reported in both the US and Montana has increased over the past two decades. […] Health departments reported nearly 10,000 cases of Legionnaires disease in the United States in 2018. However, because Legionnaires disease is likely underdiagnosed, this number may underestimate the true incidence. A recent study estimated that the true number of Legionnaires disease cases may be 1.82.7 times higher than what is reported.

• #8

  https://www.who.int/news-room/fact-sheets/detail/legionellosis

  The identified incidence of Legionnaires disease varies widely according to the level of surveillance and reporting. […] In Europe, Australia and the USA there are about 1015 cases detected per million population per year. […] Delay in diagnosis and administration of appropriate antibiotic treatment, increasing age and presence of co-existing diseases are predictors of death from Legionnaires disease. […] The death rate as a result of Legionnaires disease depends on the severity of the disease, the appropriateness of initial anti-microbial treatment, the setting where Legionella was acquired, and host factors (for example, the disease is usually more serious in patients with immuno-suppression). The death rate may be as high as 4080% in untreated immuno-suppressed patients and can be reduced to 530% through appropriate case management and depending on the severity of the clinical signs and symptoms. Overall the death rate is usually within the range of 510%.

• #9 Legionnaires’ disease – Annual Epidemiological Report for 2021

  https://www.ecdc.europa.eu/en/publications-data/legionnaires-disease-annual-epidemiological-report-2021

  In 2021, the highest annual notification rate of Legionnaires disease to date in the EU/EEA was observed, at 2.4 cases per 100 000 population. […] The rates are heterogenous across the EU/EEA region, with age-standardised rates varying by country between 15 cases per 100 000 population. […] Four countries (Italy, France, Spain, and Germany) accounted for 75% of all the notified cases. […] Males aged 65 years and above were the most affected group (8.9 cases per 100 000 population). […] Only 11% of the cases were reported as culture-confirmed. […] The majority of the cases were considered to be community-acquired. […] Occurrence of at least one outbreak of Legionnaires disease was reported by eight of the 27 EU/EEA countries reporting data to the outbreak reporting scheme. […] A total of 19 outbreaks involving 137 confirmed cases were reported.

• #10 Legionnaires’ Disease Surveillance and Public Health Policies in Italy: A Mathematical Model for Assessing Prevention Strategies

  https://www.mdpi.com/2073-4441/16/15/2167

  Legionella is the pathogen that causes Legionnaires’ disease, an increasingly prevalent and sometimes fatal disease worldwide. In 2021, 97% of cases in Europe were caused by Legionella pneumophila. We present a mathematical model that can be used by public health officials to assess the effectiveness and efficiency of different Legionella monitoring and control strategies to inform government requirements to prevent community-acquired Legionnaires’ disease in non-hospital buildings. […] The burden of Legionnaires’ disease in the European Union/European Economic Area (EU/EEA) has increased in the last decade, with notification rates rising from 1.2–1.4 per 100,000 population in 2012–2016 to 2.4/100,000 in 2021. In the same report, Italy was noted as having one of the highest rates at 4.6 cases per 100,000 population in 2021. Legionnaires’ disease has a high individual and a high population burden, ranking as the fifth highest of infectious diseases in Europe, according to annual disability-adjusted life years.

• #11 Legionnaires’ Disease Surveillance and Public Health Policies in Italy: A Mathematical Model for Assessing Prevention Strategies

  https://www.mdpi.com/2073-4441/16/15/2167

  Despite significant prevention efforts, data from the Italian Institute of Health suggest that cases in Italy have continued to rise and were 13% higher just one year later in 2022, at 5.19 cases per 100,000, returning to pre-pandemic levels. In addition, fatality rates for community-acquired cases, at 15.1% in 2022, are well above the EU/EEA country average of 9% for all cases with known outcomes. […] The fact that Italy has the third fastest aging population in the world is likely to exacerbate this pattern, making an analytical assessment of Italy’s Legionnaires’ disease prevention policy options particularly important and timely. […] The World Health Organization has recommended adopting Water Safety Plan principles for risk assessment and management of water from the source to the tap. Similarly, EU Directive 2020/2184 establishes minimum requirements to protect human health from the negative effects of contamination of waters.

• #12 Estimating the burden of illness caused by domestic waterborne Legionnaires’ disease in Canada: 2015–2019 | Epidemiology & Infection | Cambridge Core

  https://www.cambridge.org/core/journals/epidemiology-and-infection/article/estimating-the-burden-of-illness-caused-by-domestic-waterborne-legionnaires-disease-in-canada-20152019/6887823DCF9CA05E0F93D841FD315A7E

  The estimated incidence of domestically acquired waterborne LD in Canada was 3.06 (90% CrI: 2.024.76) illnesses per 100,000 population per year. […] LD was underascertained in Canada, with an estimated 2.8 illnesses, 2.5 hospitalizations, and 2.5 deaths occurring in the population for every case, hospitalization, and death that was reported in surveillance, respectively. […] The primary diagnostic test for LD can only detect Legionella pneumophila serogroup 1; this resulted in greater underreporting and underdiagnosis of disease caused by other serogroups and species (non-serogroup 1 L. pneumophila and non-L. pneumophila).

• #13 Trends in the incidence and mortality of legionellosis in Japan: a nationwide observational study, 1999–2017 | Scientific Reports

  https://www.nature.com/articles/s41598-021-86431-8

  This study examined temporal trend, seasonality, and geographical variations of legionellosis incidence and mortality in Japan. […] Increasing legionellosis incidence occurred in Japan during 1999-2017, with declining estimated fatality rates. […] Legionellosis, clinically classified into Legionella pneumonia (Legionnaires disease) and Pontiac fever, is caused by Legionella species, which grow in free-living, ubiquitous, freshwater and soil amoebae. […] Since the first clinical isolation of the organism from humans in the United States in 1977, growing numbers of legionellosis has been documented worldwide through surveillance systems to track the disease across North America, New Zealand, Australia, Europe, and other countries. […] The trend in the estimated fatality rate of legionellosis is shown in Fig. 6. The overall estimated fatality rates decreased continuously at a rate of 5.9% (95% CI; 8.1, 3.5) annually from 1999 to 2017, without a trend change point.

• #14 Legionellosis – Epidemiology

  https://www.vdh.virginia.gov/epidemiology/epidemiology-fact-sheets/legionellosis/

  Most healthy people exposed to Legionella dont get sick. […] People at increased risk of getting sick include current or former smokers, people 50 years or older, and people with specific health issues or conditions. […] Legionella bacteria are found naturally in the environment. The bacteria can become a health concern when they grow and spread in human-made building water systems like showerheads and sink faucets, hot tubs, decorative fountains and water features, and cooling towers. People most commonly get sick by breathing in mist, or small droplets of water that contain the bacteria. […] In general, the bacteria do not spread from person to person. […] The key to preventing legionellosis is to reduce the risk of Legionella growth and spread. Building owners and managers can use a water management program to help control Legionella.

• #15 About Legionnaires’ Disease – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/basics.html

  Legionnaires disease is a serious type of pneumonia (lung infection) caused by Legionella bacteria. […] The bacteria are found naturally at low levels in freshwater environments, but they present a risk to human health when they grow and spread from human-made water systems. […] Legionnaires disease is spread by small water droplets in the air that contain Legionella bacteria. […] The bacteria can be spread by devices that create water mist such as hot tubs, showers, decorative fountains, and cooling towers. […] People at increased risk for infection include those age 50 years or older and current or former smokers. […] Other risk factors include chronic health conditions such as lung, kidney, or liver disease, diabetes, cancer, and conditions and medications that affect the immune system.

• #16 Legionellosis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/legionellosis

  Legionnaires disease was named after an outbreak that occurred in Philadelphia in 1976, among people attending a convention of the American Legion. […] Legionellosis has a worldwide distribution with cases reported from North America, Australia, Africa, South America and Europe. […] An estimated 8,000 to 18,000 people develop Legionnaires disease in the United States each year. […] Most of these are single, isolated cases not associated with an outbreak. […] Outbreaks usually occur in the summer and fall, though cases occur year-round. […] Serologic surveys have shown a prevalence of antibodies to Legionella pneumophila serogroup 1 at a titer of 1:128 in 1-20% of the population, thus many infections go unnoticed. […] The illness most often affects older people and males, especially those who smoke or have chronic lung disease.

• #17 Health: Infectious Disease Epidemiology & Prevention Division: Legionellosis

  https://www.in.gov/health/idepd/diseases-and-conditions-resource-page/legionellosis/

  Legionnaires’ (LEE-juh-nares) disease is a serious type of pneumonia caused by Legionella bacteria that may lead to hospitalization or death. Infection occurs when a person breathes in water droplets from the air (i.e., mist or vapor) that contain the Legionella bacteria. […] People can get Legionnaires’ disease by breathing in mist containing Legionella bacteria or, in rare cases, by drinking water that contains the Legionella bacteria and it „goes down the wrong pipe” into the lungs. […] Symptoms of Legionnaires’ disease start about 2-14 days after exposure to the bacteria. Common symptoms include: […] Legionnaires’ disease infection happens when a person breathes in water droplets from the air (i.e., mist or vapor) that contain the Legionella bacteria. In general, the bacteria are not spread from one person to another person.

• #18 Legionnaires Disease – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK430807/

  Legionellosis demonstrates seasonal variation and is more prevalent in the summer and early fall when the water temperatures are warmer. The disease affects people of all ages; morbidity and mortality rates are higher in older adults and persons with chronic lung disease, weakened immune systems, and those who use tobacco. […] The epidemiology of Legionnaires disease is essential for public health surveillance and intervention. By identifying the sources and risk factors of the infection, health authorities can implement appropriate measures to prevent and control the spread of the disease. These measures include proper maintenance and disinfection of water systems, environmental sampling and testing for Legionella bacteria, prompt reporting and investigation of cases and outbreaks, and effective antibiotic treatment. By applying these measures, the morbidity and mortality of Legionnaires disease can be reduced.

• #19 Legionella Infection: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/965492-overview

  Legionnaires disease is believed to have worldwide distribution and to cause 2-15% of all CAP cases requiring hospitalization. […] A study that used data from the European Surveillance System reported that about 68% of cases of healthcare-associated Legionnaires disease were hospital-acquired and nearly 32% were associated with other healthcare facilities. […] Males are more than twice as likely as females to develop Legionnaires disease. […] Middle-aged and older adults have a high risk of developing Legionnaires disease, whereas it is rare in young adults and children. Among children, more than one third of reported cases have occurred in infants younger than 1 year.

• #20 Legionellosis Surveillance and Trends | Legionella | CDC

  https://www.cdc.gov/legionella/php/surveillance/index.html

  Legionellosis (Legionnaires’ disease and Pontiac fever) is a nationally notifiable condition in the United States. […] CDC conducts national surveillance for legionellosis using two surveillance systems. […] Legionnaires’ disease is on the rise. […] CDC monitors legionellosis cases through two surveillance systems at the national level. […] In general, reported cases of Legionnaires’ disease have been increasing since the early 2000s, with a peak in 2018. While reported cases dropped during the first year of the COVID-19 pandemic, they rebounded starting in 2021. […] Legionnaires’ disease incidence has been increasing since 2000. […] Data from surveillance systems were combined to provide a more comprehensive understanding of the national burden of Legionnaires’ disease. […] Strong surveillance helps to quickly identify new cases, epidemiologic links between cases, and the need for outbreak investigations.

• #21 Legionnaires’ disease in Scotland – surveillance report 2023 – Legionnaires’ disease in Scotland – Publications – Public Health Scotland

  https://publichealthscotland.scot/publications/legionnaires-disease-in-scotland/legionnaires-disease-in-scotland-surveillance-report-2023/

  Legionnaires’ disease cases peaked in quarter three (July to September) of 2023, driven mainly by community-acquired cases. […] During 2023, 94.4% of cases were aged 40 years and older; comparable to the age distribution reported for Europe by ECDC in 2021, where 91% of Legionnaires’ disease cases were in those aged 45 years and older. […] In 2023, there were three reported deaths in Legionnaires’ disease cases equating to a case fatality rate (CFR) of 5.6%. […] Public Health Scotland (PHS) has conducted enhanced surveillance of Legionnaires’ disease alongside the Scottish Microbiology Reference Laboratory (SMiRL) since 1994 collecting demographic data, clinical and microbiological information, and risk factors. […] This allows us to identify and monitor trends, detect outbreaks, identify potential sources of infection and inform measures to reduce the public health risk. […] Surveillance in Scotland is integrated with that of the rest of the UK.

• #22 Legionnaires’ Disease – Taiwan Centers for Disease Control

  https://www.cdc.gov.tw/En/Category/ListContent/bg0g_VU_Ysrgkes_KRUDgQ?uaid=5mVQDYNe5TOnrD9idUUL2w

  Legionnaires’ disease belongs to opportunistic infections. […] In recent years, the annual number of confirmed Legionnaires disease cases is about 40 to110 in Taiwan. […] The monthly distribution of Legionnaires’ disease cases shows that the number of cases peaks in the summer. […] Regarding the age distribution of Legionnaires’ disease cases, Taiwan has the same trend with other countries, with the incidence increasing with age. […] Legionnaires’ disease Surveillance in Taiwan. […] The current focus of infection control and prevention on Legionnaires disease in Taiwan is elevating the management in relatively high risk places (hospitals).

• #23 Legionnaires Surveillance

  https://portal.ct.gov/DPH/Epidemiology-and-Emerging-Infections/Legionnaires-Surveillance

  The Connecticut Department of Public Health (CT DPH) began routine legionellosis surveillance in 1997. Since then, annually reported cases have ranged from 15-201. […] The CT DPH uses the national surveillance case definition to determine case status. Legionellosis is reportable to the CT DPH by physicians and laboratories, and to the patients local health department. […] To identify possible common sources of exposure, staff of the CT DPH Epidemiology and Emerging Infections Program conduct follow-up on all confirmed legionellosis cases by contacting the healthcare provider of record, and conducting patient interviews.

• #24 Legionellosis (Legionnaires’ Disease) | Texas DSHS

  https://www.dshs.texas.gov/notifiable-conditions/invasive-and-respiratory-diseases-and-conditions/legionellosis-legionnaires-disease

  From 2010 to 2019, the number of legionellosis cases reported to DSHS gradually increased from a low of 111 cases in 2011 to a high of 421 cases in 2019, followed by a drop to 316 cases in 2020. […] In Texas, the highest age-specific rates of legionellosis are typically found among middle aged and older adults. Although legionellosis cases are rarely reported in children in Texas, two cases of legionellosis were reported in 2019. […] The task force was composed of state and local public health officials (epidemiologists, environmental) and university and hospital representatives (physicians, infection control practitioners, facility engineer). […] Current outbreak investigation guidelines for legionellosis are available. […] It is estimated that around 10,000 people develop the disease each year in the United States. An additional unknown number are infected with Legionella bacteria but have only a minor illness or no illness at all. The disease can occur in outbreaks or as single cases.

• #25 Methods for Legionnaires’ Disease Surveillance | LD Investigations | CDC

  https://www.cdc.gov/investigate-legionella/php/data-research/index.html

  Legionellosis, which includes Legionnaires’ disease, is a nationally notifiable disease. […] Strong surveillance helps to quickly identify new cases, epidemiologic links between cases, and the need for outbreak investigations. […] Outbreak investigations are critical for detecting sources of transmission and implementing control measures. […] CDC monitors legionellosis cases through two surveillance systems at the national level: National Notifiable Diseases Surveillance System (NNDSS) and Supplemental Legionnaires’ Disease Surveillance System (SLDSS). […] SLDSS collects extended information on cases beyond the limited information CDC receives in NNDSS. This extended information includes exposure to travel and healthcare facilities, as well as laboratory confirmation data. […] CDC uses the additional information collected in SLDSS to better understand the epidemiology of legionellosis.

• #26 Methods for Legionnaires’ Disease Surveillance | LD Investigations | CDC

  https://www.cdc.gov/investigate-legionella/php/data-research/index.html

  Public health officials should report legionellosis outbreaks through the National Outbreak Reporting System (NORS). […] The goals of surveillance are to detect outbreaks by recognizing cases with similar locations/exposures, monitor and describe incidence and trends, understand risk factors for infection, identify opportunities for control and prevention, and monitor effectiveness of interventions implemented during outbreaks. […] Strong surveillance helps to quickly identify new cases, epidemiologic links between cases, and the need for outbreak investigations. Such investigations are critical for detecting sources of transmission and implementing control measures to prevent additional cases. […] Within their respective jurisdictions, public health officials are best positioned to systematically track Legionnaires’ disease cases and detect outbreaks.

• #27 Eurosurveillance | Legionnaires’ disease in Europe, 2011 to 2015

  https://www.eurosurveillance.org/content/10.2807/1560-7917.ES.2017.22.27.30566

  Under the coordination of the European Centre for Disease Prevention and Control (ECDC), the European Legionnaires disease Surveillance Network (ELDSNet) conducts surveillance of Legionnaires disease (LD) in Europe. Between 2011 and 2015, 29 countries reported 30,532 LD cases to ECDC (28,188 (92.3%) confirmed and 2,344 (7.7%) probable). […] The age-standardised rate of all cases increased from 0.97 cases/100,000 population in 2011 to 1.30 cases/100,000 population in 2015, corresponding to an annual average increase of 0.09 cases/100,000 population (95%CI 0.020.14; p=0.02). […] Five countries (Austria, Czech Republic, Germany, Italy, and Norway) had increasing age-standardised LD notification rates over the 2011-15 period, but there was no increase in notification rates in countries where the 2011 rate was below 0.5/100,000 population.

• #28

  https://www.gov.uk/government/publications/legionnaires-disease-national-surveillance-scheme

  The national surveillance scheme has a reporting form for Legionnaires’ disease in England and Wales. […] The national surveillance scheme: detects clusters or outbreaks of legionella infection in England and Wales or abroad […] identifies sources of infection so that control measures can be applied to prevent further cases […] offers legionella surveillance information. […] Report all confirmed cases of Legionellosis to the national surveillance scheme for Legionnaires disease using this form. […] Updated the guidance on disease surveillance of Legionnaires’ disease.

• #29

  https://www.gov.uk/government/collections/legionnaires-disease-guidance-data-and-analysis

  Legionnaires disease is a notifiable disease in England and Wales. Health professionals must inform local health protection teams of suspected cases. PHE collects data on notifiable diseases. This data helps healthcare professionals track identify clusters and prevent outbreaks whilst monitoring trends in disease occurrence over time. […] Legionellosis in residents of England and Wales: 2017 to 2023 report […] Legionnaires’ disease: local summaries for England and Wales, 2016 […] Legionnaires disease in residents of England and Wales: 2016 […] Legionnaires disease in England and Wales: 2016 […] Legionnaires’ disease monthly surveillance reports: 2020 […] Legionnaires’ disease monthly surveillance reports: 2019 […] Legionnaires’ disease monthly surveillance reports: 2018 […] Legionnaires’ disease monthly surveillance reports: 2017

• #30 Legionnaires’ disease – Annual Epidemiological Report for 2021

  https://www.ecdc.europa.eu/en/publications-data/legionnaires-disease-annual-epidemiological-report-2021

  The travel-associated Legionnaires disease (TALD) surveillance scheme observed a 38% increase in cases compared with 2020. […] Similar to previous years, 90% of the TALD cases occurred in individuals aged 45 years and above. […] A similar age distribution was observed in the annual retrospective data collection of cases of Legionnaires disease.

• #31 Legionellosis | Georgia Department of Public Health

  https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/legionellosis

  Outbreaks occur when two or more people become ill following shared exposures, such as patients in hospitals, nursing homes, and long-term care facilities. […] Other outbreaks have been linked to aerosol sources in the community, with the most frequently reported sources being whirlpool spas, cooling towers, decorative fountains, and water used for drinking and bathing (such as those in gyms and communal showers). […] Cases of Legionellosis may be associated with travel on a cruise ship or staying overnight in a hotel or other public accommodation. CDC defines travel-associated outbreaks as two or more Legionnaires disease cases associated with the same travel accommodation in a 12-month period.

• #32 Legionnaires’ Disease /Pontiac Fever | Disease Outbreak Control Division

  https://health.hawaii.gov/docd/disease_listing/legionellosis-legionnaires-disease/

  Legionellosis is the most common cause of waterborne disease outbreaks in the United States. […] Outbreaks occur when two or more individuals are exposed to Legionella bacteria in the same location and get sick around the same time. […] Nationally, over 10-15% of reported cases of Legionnaires disease are travel-related. […] An outbreak of travel-associated Legionnaires disease and Pontiac fever: the need for enhanced surveillance of travel-associated legionellosis. […] Active Bacterial Core surveillance for legionellosis United States, 2011-2013. […] Vital Signs: Deficiencies in environmental control identified in outbreaks of Legionnaires disease North America, 2000-2014. […] Clinicians should also test patients with healthcare-associated pneumonia for Legionnaires disease.

• #33 Evaluation of the national surveillance of Legionnaires’ disease in Norway, 2008-2017 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7981-9

  In Norway, Legionnaires disease is reportable upon clinical suspicion to public health authorities and mandatorily notifiable through the Norwegian surveillance system for communicable diseases (MSIS) for both clinicians and laboratories. […] We evaluated MSIS to assess if it meets its objectives of detecting cases and trends in incidence of Legionnaires disease. […] Our results suggest that the surveillance in MSIS can detect incidence changes for Legionnaires disease over time, by place and person, but likely does not detect every case diagnosed in Norway. […] We recommend wider investigation of diagnostic procedures in order to improve representativeness and awareness of MSIS notification criteria among clinicians in order to improve acceptability of the surveillance. […] The overall objective of infectious disease surveillance through MSIS, which is common to all 72 notifiable diseases, is to contribute to the surveillance of communicable diseases in people in Norway through continuous and systematic collection, analysis, interpretation, and reporting of data on incidence of communicable diseases.

• #34 Evaluation of the national surveillance of Legionnaires’ disease in Norway, 2008-2017 | BMC Public Health | Full Text

  https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-019-7981-9

  For the external validity, the positive predictive value of MSIS was 83% (95% CI 7986%). […] The survey results suggested differences in representativeness and acceptability of the system, which supports that MSIS does not capture all cases of LD. […] The estimated external completeness reflects that not all cases are notified to MSIS and smaller outbreaks may not be reported. […] The internal completeness and internal validity were high for key variables, meaning the data quality was high for cases that were notified to MSIS.

• #35

  https://link.springer.com/article/10.1007/s10654-006-0009-7

  In Italy, although the number of cases of legionellosis notified to the health authorities has significantly increased in recent years, the incidence is still believed to be underestimated. […] To verify the true frequency and identify the sources of infection, an active clinical-environmental surveillance program was instituted in three hospital facilities in Southern Italy. […] Comparison of our data with those of the routine surveillance system for the same area (only 7 cases during the period 1997-2000), showed that the frequency of legionellosis is grossly underestimated in Southern Italy. […] It is therefore necessary to set up more rigorous controls in both hospital and community facilities, so that timely preventive measures can be taken to avoid any further spread of the disease.

• #36 The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

  https://www.mdpi.com/2076-0817/13/10/857

  Diagnostic testing for Legionella is rarely performed in mild CAP in community or hospitalized individuals and is only undertaken in severely ill hospitalized patients once other avenues have been exhausted. […] The CDC and the National Collaborating Centre for Infectious Disease (NCCID) recommend diagnostic testing for Legionella in outpatients failing antibiotic therapy, individuals requiring intensive care admission, immunocompromised individuals, individuals with recent travel history, or in the setting of a known Legionellosis outbreak. […] A recent review indicated a 42% increase in LD in the 3 weeks following storms. […] The prevalence of Legionella, especially non-pneumophila and non-serogroup 1 pneumophila, is likely underreported due to infrequent sampling, the unavailability of diagnostic tools in medical facilities, difficulty collecting sputum, long turnaround times, and the fact that it is only studied in severe clinical presentations or an outbreak context.

• #37 The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

  https://www.mdpi.com/2076-0817/13/10/857

  Our review found that most LD cases are caused by an unidentified species or serogroup of L. pneumophila. The emphasis on using a UAT that strictly detects LpSG1 as an initial test likely results in a significant number of missed cases. […] We found that almost 50% of LD cases are still caused by an unspecified species or a serogroup not detected by the standard UAT. […] The continued belief that LD is almost exclusively caused by L. pneumophila SG1 and the accompanying diagnostic practices leads to further missed diagnoses and increasingly discordant epidemiological data. […] While it has been widely recognized that diagnosis of Legionella pneumonia is poor, Table 6 highlights the need for diagnostics to be more comprehensive. […] Identifying an outbreak of Legionella is crucial, as typical outbreak strategies such as isolation of cases will not reduce cases, and the medium by which Legionella is contracted (water) makes outbreaks very likely.

• #38 Methods for Legionnaires’ Disease Surveillance | LD Investigations | CDC

  https://www.cdc.gov/investigate-legionella/php/data-research/index.html

  However, CDC is uniquely positioned to establish connections between cases that occur among residents of different jurisdictions. […] Most cases of Legionnaires’ disease aren’t associated with a known outbreak. However, outbreak detection is limited by availability of exposure information. Improved ascertainment and reporting of exposure information helps identify possible sources of exposure and can increase detection of outbreaks. […] Public health officials should report all cases of legionellosis to NNDSS. […] Public health officials should also report all cases of legionellosis to SLDSS. […] Case classifications and exposure categories are important for surveillance purposes. […] Epidemiology, environmental health, laboratory science, and health communication all play critical roles in Legionnaires’ disease investigations.

• #39 Legionellosis (Legionnaires’ Disease and Pontiac Fever) – Background | Occupational Safety and Health Administration

  https://www.osha.gov/legionnaires-disease/background

  Legionella species grow in a variety of places, including soil and both natural and manmade water sources. In nature, Legionella grow in the thin fresh-water biofilm layer (i.e., slime) on the surface of rivers, lakes, and streams, and rarely causes illness. In manmade settings, Legionella are commonly found in building water systems (e.g., heating, ventilation, and air conditioning; domestic and industrial potable water), hot tubs, and decorative fountains, and are not eliminated by normal chlorination processes.

• #40 Department of Health | Communicable Disease Service | Legionellosis (Legionnaires’ Disease and Pontiac Fever)

  https://www.nj.gov/health/cd/topics/legion.shtml

  Legionnaires’ disease and Pontiac fever are collectively known as legionellosis, a disease caused by Legionella bacteria. […] People can get Legionnaires disease or Pontiac fever when they breathe in small droplets of water in the air that contain the bacteria. […] Less commonly, people can get sick by aspiration of drinking water containing Legionella. […] Maintaining Building Water Systems Prevents Legionnaires Disease. […] CDC Vital Signs (2016): Legionnaires Disease Outbreaks. […] CMS Memo (June 2017): Requirement to Reduce Legionella Risk in Healthcare Facility Water Systems to Prevent Cases and Outbreaks of Legionnaires Disease.

• #41 Legionellosis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/legionellosis

  Legionellosis is a serious lung infection caused by the bacteria Legionella. This infection is also known as Legionnaires Disease. […] People can get sick when small drops of water with the bacteria get into the air. People then breathe them in and the bacteria gets in their lungs. The bacteria cannot spread from one person to another. […] Routine home maintenance can prevent growth of the bacteria. […] Legionellosis Surveillance Reports 2010 | 2011 | 2012 | 2013 | 2014 | 2015 | 2018 (PDF)

• #42 Legionellosis (Legionnaires’ Disease and Pontiac Fever) | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/legionellosis.htm

  Legionnaires’ disease is not normally spread from person to person. […] Outbreaks of Legionnaires disease are most commonly associated with large or complex water systems (e.g., hospitals, long-term care facilities, hotels, cruise ships). […] Legionnaires disease is on the rise in Wisconsin and nationally. The rising trend may be related to a combination of factors, such as increased awareness and testing, more people at risk (e.g., aging population, use of immune-suppressing medication), and increased Legionella in the environment. […] Because Legionnaires disease is likely underdiagnosed, the number of cases may be underestimated. […] Legionnaires’ disease is a Wisconsin Disease Surveillance Category II Disease. […] Report to the patient’s local public health department electronically, through the Wisconsin Electronic Disease Surveillance System (WEDSS), by mail or fax using an Acute and Communicable Disease case report, F-44151 (Word) or by other means within 72 hours upon recognition of a case. […] Investigations of clusters of Legionnaires disease depend on aggressive follow-up of the case-patients history and possible exposures to Legionella.

• #43 Health: Infectious Disease Epidemiology & Prevention Division: Legionellosis

  https://www.in.gov/health/idepd/diseases-and-conditions-resource-page/legionellosis/

  Lab testing is needed to confirm diagnosis. See your healthcare provider as they may take a sample of lung tissue, urine, or fluid from the lungs to test. Legionnaires’ disease is treated with antibiotics (drugs that kill bacteria in the body). Most people who become ill need care in a hospital but make a full recovery. However, about 1 out of 10 people who get Legionnaires’ disease will die from the infection. […] The key to preventing Legionnaires’ disease is to reduce the risk of Legionella growth and spread. […] Patients with risk factors who have prolonged exposure to healthcare settings are at increased risk for developing Legionnaires’ disease. Healthcare-associated cases of Legionnaires’ disease is a serve pneumonia associated with a 25% fatality rate. […] Healthcare facilities have complex building water systems and often experience construction that impacts systems. Keep Reading: Developing a water management program to reduce Legionella growth and spread in buildings.

• #44 Legionellosis (Legionnaires’ Disease) Task Force Recommendations | Texas DSHS

  https://www.dshs.texas.gov/legionellosis-legionnaires-disease/legionellosis-legionnaires-disease-task-force-recommendations

  Legionellosis (Legionnaires’ Disease) became a reportable condition in Texas in July 1984: Both physicians and laboratories are required by law to report confirmed cases of legionellosis to their local health departments. […] The CDC estimates that between 8,000 and 18,000 cases of Legionellosis occur each year in the United States; from 1995 through 2000, 400 to 600 of these were reported to public health authorities. Nosocomial cases have a higher mortality rate than community-acquired cases (40% compared to 20%). […] In a national survey of 192 randomly selected hospitals, 29% reported having at least a single case of nosocomial Legionellosis and 16% reported greater than five cases. […] The Texas Department of State Health Services has investigated three legionellosis outbreaks since 1989, involving from 3 to 20 patients each. However, state and local health departments have been asked to address numerous pseudo-outbreaks each year around suspected or feared but unconfirmed cases.

• #45 Legionella Infection: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/965492-overview

  Legionnaires disease (LD) was recognized in 1976 after an outbreak of pneumonia at an American Legion convention in Philadelphia. Soon after, the etiologic agent was identified as a fastidious gram-negative bacillus and named Legionella pneumophila. […] An estimated 8000-18,000 cases of Legionnaires disease are reported in the United States each year. Most cases are not reported. More than 80% of cases are sporadic throughout the year, and the rest occur in outbreaks during the summer and early fall. […] The Centers for Disease Control and Prevention (CDC) reported 2809 cases of Legionnaires disease in 2015, of which 3% were confirmed to be associated with a healthcare facility and 17% were possibly associated. […] According to the CDC, passive surveillance for legionellosis in the United States showed a 249% increase in crude incidence during 2000-2011.

• #46 Clinical Surveillance Essential to Checking Legionnaires’ Disease | Respiratory Therapy

  https://respiratory-therapy.com/miscellaneous/clinical-surveillance-essential-to-checking-legionnaires-disease/

  A study at the University of Pittsburgh led by Victor L. Yu, MD, PhD, found that the water supply is a major culprit in hospital-acquired Legionnaires diseases, reports Infection Control and Hospital Epidemiology. Of the 20 hospitals that were surveyed, 14, or 80%, tested positive for Legionella pneumophila and L. anisa, the two strains that cause the oftentimes-fatal form of pneumonia known as legionnaires disease. […] The researchers concluded that environmental monitoring followed by clinical surveillance was successful in uncovering previously unrecognized cases of hospital-acquired Legionella pneumonia. […] In a separate study, also conducted at University of Pittsburgh and published in a subsequent issue of ICHE, the introduction of chlorine dioxide into the water system of a 364-bed hospital testing positive for pneumophila significantly lowered colonization rates. Zero cases of hospital-acquired Legionnaires disease were reported.

• #47 Legionnaires’ Disease Surveillance and Public Health Policies in Italy: A Mathematical Model for Assessing Prevention Strategies

  https://www.mdpi.com/2073-4441/16/15/2167

  It is well established that building-level Water Safety Plans that reduce the risk of exposure to aerosolized Legionella lower Legionnaires’ disease risk. The U.S. Centers for Disease Control and Prevention (CDC) found that 9 out of 10 outbreaks could have been prevented with effective Water Management (Safety) Plans in a study in which 44% of the outbreaks were at hotels or resorts. […] Given the perennial challenges of competing priorities and pressures on finite public health funding, a tool that enables an objective analysis of the direct, economic, and total costs of a targeted L. pneumophila control strategy relative to a broader Legionella spp. control strategy could provide valuable insights for the policymakers responsible for setting those requirements.

• #48 About Legionnaires’ Disease – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/basics.html

  A chest x-ray and a Legionella test, most commonly a urinary antigen test, are the most common way Legionnaires disease is diagnosed. […] The key to preventing Legionnaires disease is to reduce the risk of Legionella growth and spread in building water systems and devices through good maintenance strategies.

• #49 Legionellosis (Legionnaires’ Disease) Task Force Recommendations | Texas DSHS

  https://www.dshs.texas.gov/legionellosis-legionnaires-disease/legionellosis-legionnaires-disease-task-force-recommendations

  The Task Force recognizes that no single template can serve the needs of all types of facilities and strongly supports an approach that allows institutions to individualize their legionellosis control plans based on the history of their institution; the matrix of environmental factors, engineering issues, and patient populations served by the institution; and the resources the institution has available to address these concerns. […] Each hospital should form a team of representatives from various departments such as infection control, engineering and maintenance, risk management, employee health, administration, and housekeeping to prevent and control legionellosis. The team should develop and write a legionellosis control plan. […] The guidelines developed for control of Legionellosis by the State of Maryland resemble those of the CDC in that they recommend hospital personnel conduct active surveillance and case finding, have ready access to appropriate tests for diagnosis, and investigate all nosocomial cases.

• #50 Legionellosis | Utah Epidemiology

  https://epi.utah.gov/legionellosis/

  Legionnaires’ disease is caused by a type of bacteria called Legionella. […] The bacteria grow best in warm water. […] It typically lasts 2–10 days. […] Information for public health departments includes epidemiologic investigation tools. […] Legionella investigation guidelines.

• #51 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  Many studies have found that increased precipitation, temperature, and relative humidity are positively associated with the occurrence of LD, particularly a sequence of elevated temperatures followed by a period of increased precipitation, high relative humidity, and low wind. […] The intensification of extreme meteorological events due to climate change (for instance, high temperature variations and heavy rainfall), may create conditions for the development of Legionella and increase the incidence of LD. […] The detection of Legionella DNA by PCR from respiratory tract samples has been increasingly used over the last 10 years. […] This method has the potential to detect all known Legionella species and all sgs (116) of Lp. […] A recent study highlighted the role of WGS in LD surveillance tool as it allows to identify endemic lineages, new clones and to perform phylogenetic analyses for epidemiological purposes.

• #52 Legionnaires’ disease in the time of COVID-19 | Pneumonia | Full Text

  https://pneumonia.biomedcentral.com/articles/10.1186/s41479-020-00080-5

  Due to similarities in initial disease presentation, clinicians may be inclined to repeatedly test community-acquired pneumonia cases for COVID-19 before recognizing the need to test for Legionnaires disease. […] The majority of Legionnaires disease cases occurring each year are not diagnosed, and some experts recommend that all patients hospitalized with community-acquired pneumonia without a known etiology be tested for Legionella infection. […] Over the past two decades, U.S. incidence of Legionnaires disease has increased over five-fold to more than 3.0 cases per 100,000 population in 2018, with most cases occurring in the summer and early autumn. […] Yet, Legionnaires disease remains vastly underdiagnosed with the true number of cases estimated to be more than 50,000 per year. […] As states relax lockdowns and physical distancing measures in response to COVID-19, the reopening of commercial buildings and more importantly, the taps of their dormant plumbing systems has the potential to expose large numbers of people to stagnant water containing Legionella spp.

• #53 Legionnaires’ disease in the time of COVID-19 | Pneumonia | Full Text

  https://pneumonia.biomedcentral.com/articles/10.1186/s41479-020-00080-5

  Additionally, these reopenings coincide with the annual seasonal peak of Legionnaires disease cases in the Northern hemisphere. […] The incubation period for Legionnaires disease is about 5 to 6 days but may range from 2 to 14 days, similar to COVID-19. […] Travel with overnight stays and healthcare exposure (e.g. hospitals, long-term care facilities) are known major risk factors for Legionnaires disease. […] The Centers for Disease Control and Prevention in Atlanta closed multiple buildings in August due to presence of Legionella in the buildings water systems, potentially linked to the long term building closure during the pandemic. […] Some experts recommend that all patients hospitalized with pneumonia and without a known etiology be tested with UAT, however, IDSA/ITS guidelines recommend only severe CAP be tested with the UAT. […] Because empiric treatment of Legionnaires disease is not always effective, early testing including UAT could improve the clinical and public health response.

• #54 The Adequacy of Current Legionnaires’ Disease Diagnostic Practices in Capturing the Epidemiology of Clinically Relevant Legionella: A Scoping Review

  https://www.mdpi.com/2076-0817/13/10/857

  Our findings show that the subgroups that warrant more deliberate monitoring are L. pneumophila regardless of serogroup, L. longbeachae, L. micdadei, and L. bozemanae. […] In conclusion, the real epidemiology of Legionella infections is unclear due to the lack of an adequate diagnostic test that identifies other non-pneumophila serogroup 1 Legionella and different criteria on who, when, and how to diagnose Legionella.

• #55 Legionnaires’ disease – Wikipedia

  https://en.wikipedia.org/wiki/Legionnaires%27_disease

  Between 1995 and 2005, over 32,000 cases of Legionnaires’ disease and more than 600 outbreaks were reported to the European Working Group for Legionella Infections. The data on Legionella are limited in developing countries, and Legionella-related illnesses likely are underdiagnosed worldwide. Improvements in diagnosis and surveillance in developing countries would be expected to reveal far higher levels of morbidity and mortality than are currently recognised. Similarly, improved diagnosis of human illness related to Legionella species and serogroups other than Legionella pneumophila would improve knowledge about their incidence and spread. […] A 2011 study successfully used modeling to predict the likely number of cases during Legionnaires’ outbreaks based on symptom onset dates from past outbreaks. In this way, the eventual likely size of an outbreak can be predicted, enabling efficient and effective use of public-health resources in managing an outbreak.

• #56 Legionellosis – Allegheny County, PA

  https://www.alleghenycounty.us/Services/Health-Department/Community-Indicators-and-Health-Data/Infectious-Disease-Epidemiology/Disease-Surveillance/Legionellosis

  Legionnaires disease is a type of pneumonia, diagnosed either by symptoms or by chest X-ray. Symptoms of Legionnaires disease may include fever, muscle aches, and shortness of breath that begin two days to 14 days after exposure to Legionella. […] In the United States, legionellosis has been on the rise since 2000. Case reports peaked in 2018 with health departments reporting almost 10,000 cases of Legionnaires disease that year, but it is thought this disease is vastly underreported. […] Patients being treated at healthcare facilities, such as hospitals or long-term care facilities, are at higher risk for Legionella infection, given they often have weak immune systems and stay in facilities with complex water systems. […] Clinicians and other professional staff at healthcare facilities should maintain a high level of suspicion for legionellosis and should immediately test patients for Legionella if they develop pneumonia while in the hospital. Healthcare providers must report legionellosis within 24 hours of identifying a case.

• #57 Legionellosis | Washington State Department of Health

  https://doh.wa.gov/public-health-provider-resources/notifiable-conditions/legionellosis

  There are two clinically and epidemiologically distinct illnesses: Legionnaires’ disease with fever, muscle aches, cough, pneumonia; and Pontiac fever, a milder illness without pneumonia. […] Nationwide as well as in Washington legionellosis incidence is on a generally upward trend, though reasons for the increase are unclear; increased awareness and testing may be a factor. […] To identify outbreaks and educate potentially exposed persons about signs and symptoms of disease, thereby facilitating early diagnosis and treatment. […] Health care providers and health care facilities: notifiable to local health jurisdiction within 24 hours. […] Local health jurisdictions: notifiable to the Washington State Department of Health (DOH) Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.

• #58

  https://www.who.int/emergencies/disease-outbreak-news/item/2023-DON487

  Mortality from Legionnaires disease depends on the severity of the disease, the use of antibiotic treatment, the setting where Legionella was acquired, and whether the patient has underlying conditions, including immunosuppression. […] Sporadic outbreaks of Legionnaires’ disease have been reported previously in Poland. […] Robust surveillance and response activities are being implemented during the current outbreak, and case numbers have been reduced. […] Legionnaires disease is a notifiable disease in the EU, and the events are closely followed up through ECDC and European Legionnaires Disease Surveillance Network (ELDSNet).

• #59 Legionnaires’ Disease Outbreak in Grand Rapids, 2023-2024 – MN Dept. of Health

  https://www.health.state.mn.us/diseases/legionellosis/outbreak.html

  Since April 2023, an outbreak of Legionnaires’ disease has been identified and tracked in Grand Rapids, Minnesota. […] There have been 34 cases of Legionnaires disease associated with this outbreak. […] After months of investigation, the Minnesota Department of Health (MDH) confirmed, through epidemiologic and laboratory data, that the municipal water system was the only common exposure reported by people who got sick. […] There have been no cases of Legionnaires disease since June 2024. […] Heightened Surveillance for Legionnaire’s Disease (PDF)MLS Laboratory Update: July 20, 2023. […] Health officials investigating Legionnaires disease cluster in Grand RapidsMDH news release, July 19, 2023.

• #60 Legionnaires’ Disease

  https://dph.illinois.gov/topics-services/diseases-and-conditions/legionellosis.html

  It is estimated that between 8,000 and 18,000 people are hospitalized with Legionellosis in the United States each year. An additional unknown number are infected with the Legionella bacterium but have mild symptoms or no illness at all. The disease can occur at any time of the year, but is more common in the summer and early autumn. […] Legionellosis is a reportable disease in the state of Illinois, and cases must be reported to the local health department within seven days. Timely reporting allows identification of additional cases and control of possible contaminated sources. […] IDPH and Illinois Department of Veterans Affairs continue to collaborate with the Centers for Disease Control and Prevention (CDC) to help ensure the safety and well-being of residents and staff at the Illinois Veterans Home in Quincy after outbreaks of Legionnaires disease since 2015. IDPH requested epidemiological assistance from the CDC, who sent a team of environmental and infectious disease specialists to Quincy. The CDC released three reports on the outbreaks.

• #61 Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States

  https://pmc.ncbi.nlm.nih.gov/articles/PMC10540183/

  Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is no clear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired in community settings where the environmental source is never identified. […] Reporting to the Centers for Disease Control and Prevention (CDC) National Notifiable Diseases Surveillance Systems (NNDSS) since 2002 shows that age-standardised legionellosis incidence has been increasing at an average annual rate of 9.3%. The annual increase in reported legionellosis cases is highest in the Middle Atlantic and Midwest regions. […] There is a lack of epidemiological data on the underlying drivers of increasing legionellosis incidence in the USA. Numerous clinical and environmental factors have been hypothesised for the year-on-year increase.

• #62 Severe Legionnaires’ disease | Annals of Intensive Care | Full Text

  https://annalsofintensivecare.springeropen.com/articles/10.1186/s13613-024-01252-y

  Legionnaires disease (LD) is a common but under-diagnosed cause of community-acquired pneumonia (CAP), although rapid detection of urine antigen testing (UAT) and advances in molecular testing have improved the diagnosis. […] The overall incidence of LD has increased worldwide in recent years due to the higher number of patients with risk factors, especially immunosuppression, and to improvements in diagnostic methods. […] The proportion of Lp among the causative agents of community-acquired pneumonia (CAP) was estimated to be 4.6% in a recent meta-analysis, and nearly twice this figure in patients admitted to the ICU. […] A general increase in incidence has been observed in Europe, the US, Canada and Australia in recent years. […] The reasons for this worldwide increase are not totally elucidated, but it is most pronounced in older age groups (60 years) and with a general accentuation of seasonal trends, without any systematic changes in the methods used for its diagnosis in Europe.

• #63 Legionellosis – Allegheny County, PA

  https://www.alleghenycounty.us/Services/Health-Department/Community-Indicators-and-Health-Data/Infectious-Disease-Epidemiology/Disease-Surveillance/Legionellosis

  An average of 72 confirmed Legionnaires disease cases per year were reported among Allegheny County residents from 2013 to 2023. […] In 2022-2023, there were 73 cases of Legionnaires disease reported in Allegheny County. Among these cases, 99% were hospitalized and 4% died. […] Cases in 2022-2023 occurred most frequently among males (73%) and occurred most often in white individuals (75%). Adults 50 years of age and older were at highest risk for disease.

• #64 Legionellosis (Legionnaires’ Disease) | Mass.gov

  https://www.mass.gov/info-details/legionellosis-legionnaires-disease

  Legionnaires’ disease is a pneumonia caused by Legionella bacteria. An outbreak of this disease among persons attending a state convention of the American Legion in Philadelphia in 1976 led to its name. However, it was not a new disease; the earliest documented case was in 1947. Although cases occur all year long, both single cases and outbreaks occur more frequently in the summer and fall. […] Anyone can get Legionnaires’ disease but it is more common among the elderly and those with impaired immune systems or underlying diseases. […] Studies have shown that 5-30% of people diagnosed with Legionnaires’ disease die. […] Measures can be taken to reduce the likelihood of exposure. For example, large air conditioning systems with cooling towers and evaporative condensers should be operated and maintained according to manufacturers’ recommendations.

Zobacz więcej