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 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 legionellosis with a case fatality rate of legionellosis 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 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
Worldwide Infection
Below is a list of legionellosis 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]