Legionellosis epidemiology and demographics
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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 Legionnaires' disease 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 of Legionnaires' disease ranges 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 Legionnaires' disease ranges between 1-3 cases per 100,000 individuals.
- Approximately 8,000-18,000 individuals are hospitalized annually in the USA for Legionnaires' disease.
- The incidence of Legionnaires' disease is believed to be increasing over the last 10-15 years.
Case Fatality Rate
- The case fatality rate of Legionnaires' disease ranges between 10% to 35%.
- Hospital-acquired Legionnaires' disease is associated with a higher case fatality rate compared with community-acquired Legionnaires' disease.
Age
- The median case-patient age is 61 years.
- Patients of all ages may acquire Legionnaires' disease, but elderly patients older than 65 years of age are at higher risk.
Gender
- Males are slightly more likely to develop Legionnaires' disease.
The male to female ratio is 1.8 to 1.
Race
There is no racial predilection to the development of Legionnaires' disease.
Seasonal Variation
- The majority of cases of Legionnaires' disease 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 Legionnaires' disease 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
Worldwide Infection
Below is a list of Legionnaires' disease outbreaks:
| Suspected Source | Cases | Deaths | Date | Location |
|---|---|---|---|---|
| Cooling Tower | 18 | 2 | July - August 2007 | Benalmadena, Spain |
| Institute of Animal Health | 1+ | 0 | 2007 | Pirbright, Surrey, UK |
| Water supply | 167 | 5 | July - August 2007 | Verkhnyaya Pyshma, Sverdlovsk oblast, Russia [1] |
| Cooling tower | 7 | 0 | 31st Dec 2006 - 1st Jan 2007 | Australia, Sydney [2] |
| Spa Pool | 115 | 0 | August 2006 | Sunderland, UK |
| Cooling tower | 26 | 2 | July - Sept 2006 | Paris, France |
| Cooling tower | 30 | 2 | July 2006 | Amsterdam, Netherlands |
| Cooling towers | 149 | 0 | June 2006 | Pamplona, Spain |
| Cooling tower | 10 | 1 | February 2006 | Sydney, Australia |
| Cooling tower | 20 | 0 | December 2005 | Torrevieja, Spain |
| Cooling tower | 127 | 21 | October 2005 | Toronto, Canada |
| Cooling tower | 21 | 0 | June 2005 | New Rochelle, NY, USA |
| Indoor ornamental fountain | 17 | 1 | Summer 2005 | Rapid City, SD, USA |
| Air scrubber | 52 | 10 | May 2005 | Fredrikstad, Norway |
| Cooling tower | 86 | 21 | 2004 | Pas-de-Calais, France |
| Cooling tower | 172 | 7 | 2002 | Barrow-in-Furness, UK |
| Cooling tower | 28 | 7 | 2001 | Stavanger, Norway |
| Cooling tower | 449 | 6 | July 2001 | Murcia, Spain |
| Whirlpool and humidifier | 200 | 32 | 1999 | Bovenkarspel, Netherlands |
| Hospital | 101 | 28 | 1985 | Stafford, UK |
| Cooling Tower (widely accepted) | 221 | 34 | 1976 | Philadelphia, PA, USA |
CDC Legionellosis [2]