Large community-acquired Legionnaires’ disease outbreak caused by Legionella pneumophila serogroup 1, Italy, July to August 2018

Published on 05/29/2020 | by Waterline Admin

Legionella pneumophila (Lp) is a Gram-negative bacterium responsible for a severe pneumonia named Legionnaires’ disease (LD). This infection represents 1.9% of all community‐acquired pneumonia cases, 4.0% of hospitalised cases and 7.9% of cases requiring admission to intensive care units [1]. The case fatality rate of LD ranges from 5% to 30% during outbreaks but can reach up to 50% in nosocomial cases or if antibiotic treatment is delayed [2]. The European Legionnaires’ disease Surveillance Network (ELDSNet) has reported an increase in age-standardised LD notification rates in the period 2011 to 2017 [3]. The same trend has been observed in Italy, with incidence rates increasing from 1.56 per 100,000 in 2011 to 4.9 per 100,000 in 2018 [4]. LD occurs predominantly in the elderly with chronic lung disease; immunosuppression and smoking as the most important risk factors. The incubation period ranges between 2 and 10 days from the, often nonspecific, initial symptoms. Infection occurs through inhalation of aerosols produced by contaminated water systems [3]. Outbreaks have been linked to a variety of aerosol‐producing devices, such as cooling towers, evaporative condensers and spa pools [5,6].

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