Legionellosis epidemiology and demographics: Difference between revisions

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{{Legionellosis}}
{{Legionellosis}}
 
{{CMG}} {{AE}} {{YD}}; {{SSK}}
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==Overview==
==Overview==
Legionellosis is [[ubiquitous]] worldwide, is generally caused by [[Legionella pneumophila]], tends to affect people over the age of 65 who are smokers with lung disease, and occurs after exposure to aquatic settings that promote bacterial growth where three conditions are met:
The majority of cases of legionellosis are reported between the Summer and early Fall (between June and October). Approximately 8,000-18,000 individuals are hospitalized annually in the USA for Legionnaires' disease with a case fatality rate ranging between 10% to 35%. The median case-patient age is 61 years, and the male to female ratio is 1.8 to 1.
#The aquatic environment is somewhat stagnant (e.g. water towers)
#The water is warm (77°F–108°F [25°C–42°C]) (e.g. hot tubs), and
#The water must be aerosolized so that the bacteria can be inhaled into the lungs.  


These 3 conditions are met almost exclusively in developed or industrialized settings. Legionellosis does not occur in association with natural settings such as waterfalls, lakes, or streams.
==Epidemiology and Demographics==
===Incidence===
*In USA, the [[incidence]] of legionellosis ranges between 1-3 cases per 100,000 individuals.
*Approximately 8,000-18,000 individuals are hospitalized annually in the USA for legionellosis.
*The [[incidence]] of legionellosis is believed to be increasing over the last 10-15 years.


==Seasonal Variation==
===Case Fatality Rate===
Legionellosis tends to occur in the summer and early fall, but it can happen any time of year.
*The [[case fatality rate]] of legionellosis ranges between 10% to 35%.
*Hospital-acquired legionellosis is associated with a higher case fatality rate compared with community-acquired legionellosis.


==Geographic Considerations==
===Age===
===Infection in the U.S.:===
*The median case-patient age is 61 years.
*Patients of all ages may acquire legionellosis, but elderly patients older than 65 years of age are at higher risk.


Each year, between 8,000 and 18,000 people are hospitalized with Legionnaires' disease in the U.S. '''Legionellosis is a reportable condition in most states''' but because of under-diagnosis and under reporting, only 2%-10% of estimated cases are reported. Thus, the number of cases may be much higher than reported.
===Gender===
*Males are slightly more likely to develop legionellosis.
*The male to female ratio is 1.8 to 1.


===Worldwide Infection:===
===Race===
Below is a list of Legionnaires' disease outbreaks:
*There is no racial predilection to the development of legionellosis.


{| class="wikitable"
===Seasonal Variation===
! Suspected Source !!  Cases  !!  Deaths  !! Date !! Location
*The majority of cases of legionellosis are reported between the Summer and early Fall (between June and October).
|-
|Cooling Tower||align=right|18||align=right|2||July - August 2007||Benalmadena, Spain
|-
|Institute of Animal Health||align=right|1+||align=right|0||2007||Pirbright, Surrey, UK
|-
|Water supply ||align=right|167||align=right|5||July - August 2007||Verkhnyaya Pyshma, Sverdlovsk oblast, Russia <ref>[http://gzt.ru/incident/2007/07/30/105145.html The cause of the pneumonia outbreak in Sverdlovskaya oblast is Legionella bacterium (in Russian)]</ref>
|-
|Cooling tower ||align=right|7||align=right|0||31st Dec 2006 - 1st Jan 2007||Australia, Sydney <ref>[http://www.hcinfo.com/outbreaks-news.htm#0701Sydney  HC INFO- Recent Outbreaks of Legionnaires' Disease, Sydney,6 Cases, Jan. 2007]</ref>
|-
|Spa Pool ||align=right|115||align=right|0||August 2006||Sunderland, UK
|-
|Cooling tower ||align=right|26||align=right|2||July - Sept 2006||Paris, France
|-
|Cooling tower ||align=right|30||align=right|2||July 2006||Amsterdam, Netherlands
|-
|Cooling towers||align=right|149||align=right|0||June 2006||Pamplona, Spain
|-
|Cooling tower||align=right|10||align=right|1||February 2006||Sydney, Australia
|-
|Cooling tower||align=right|20||align=right|0||December 2005||Torrevieja, Spain
|-
|Cooling tower||align=right|127||align=right|21||October 2005||Toronto, Canada
|-
|Cooling tower||align=right|21||align=right|0||June 2005||New Rochelle, NY, USA
|-
|Indoor ornamental fountain||align=right|17||align=right|1||Summer  2005||Rapid City, South Dakota|Rapid City, SD, USA
|-
|Air scrubber||align=right|52||align=right|10||May 2005||Fredrikstad, Norway
|-
|Cooling tower||align=right|86||align=right|21||2004||Pas-de-Calais, France
|-
|Cooling tower||align=right|172||align=right|7||2002||Barrow-in-Furness, UK
|-
|Cooling tower||align=right|28||align=right|7||2001||Stavanger, Norway
|-
|Cooling tower||align=right|449||align=right|6||July 2001||Murcia, Spain
|-
|Whirlpool and humidifier||align=right|200||align=right|32||1999||Bovenkarspel, Netherlands
|-
|Hospital||align=right|101||align=right|28||1985||Stafford, UK
|-
|Cooling Tower (widely accepted)||align=right|221||align=right|34||1976||Philadelphia, PA, USA


|}
===Infection in the U.S.===
*Although approximately 8,000 - 18,000 individuals are hospitalized with legionellosis in the U.S. each year, the disease is thought to be significantly under-reported with estimated of 2%-10% of cases being reported.
*'''In USA, legionellosis is a reportable condition in most states'''


==Sources==
* CDC Legionellosis [http://wwwnc.cdc.gov/travel/yellowbook/2012/chapter-3-infectious-diseases-related-to-travel/legionellosis-legionnaires-disease-and-pontiac-fever.htm]
==References==
==References==
{{reflist|2}}
{{reflist|2}}
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Latest revision as of 18:09, 18 September 2017

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Yazan Daaboul, M.D.; Serge Korjian M.D.

Overview

The majority of cases of legionellosis are reported between the Summer and early Fall (between June and October). Approximately 8,000-18,000 individuals are hospitalized annually in the USA for Legionnaires' disease with a case fatality rate ranging between 10% to 35%. The median case-patient age is 61 years, and the male to female ratio is 1.8 to 1.

Epidemiology and Demographics

Incidence

  • In USA, the incidence of legionellosis ranges between 1-3 cases per 100,000 individuals.
  • Approximately 8,000-18,000 individuals are hospitalized annually in the USA for legionellosis.
  • The incidence of legionellosis is believed to be increasing over the last 10-15 years.

Case Fatality Rate

  • The case fatality rate of legionellosis ranges between 10% to 35%.
  • Hospital-acquired legionellosis is associated with a higher case fatality rate compared with community-acquired legionellosis.

Age

  • The median case-patient age is 61 years.
  • Patients of all ages may acquire legionellosis, but elderly patients older than 65 years of age are at higher risk.

Gender

  • Males are slightly more likely to develop legionellosis.
  • The male to female ratio is 1.8 to 1.

Race

  • There is no racial predilection to the development of legionellosis.

Seasonal Variation

  • The majority of cases of legionellosis are reported between the Summer and early Fall (between June and October).

Infection in the U.S.

  • Although approximately 8,000 - 18,000 individuals are hospitalized with legionellosis in the U.S. each year, the disease is thought to be significantly under-reported with estimated of 2%-10% of cases being reported.
  • In USA, legionellosis is a reportable condition in most states

References


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