Legionnaires′ Disease ‐ Results of a Multicenter Canadian Study

Marrie, Thomas J.; Carolis, Emidio De; Yu, Victor L.; Stout, Janet E.

doi:10.1155/2003/951567

Cited by 8 publications

(6 citation statements)

References 30 publications

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“…We observed a seasonal distribution in our study. Such an observation has already been reported in other Canadian studies [7, 28]. The reason for this pattern is currently unknown.…”

Section: Discussionsupporting

confidence: 75%

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Sporadic Legionnaires' disease: the role of domestic electric hot-water tanks

et al. 2011

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Sporadic community-acquired legionellosis (SCAL) can be acquired through contaminated aerosols from residential potable water. Electricity-dependent hot-water tanks are widely used in the province of Quebec (Canada) and have been shown to be frequently contaminated with Legionella spp. We prospectively investigated the homes of culture-proven SCAL patients from Quebec in order to establish the proportion of patients whose domestic potable hot-water system was contaminated with the same Legionella isolate that caused their pneumonia. Water samples were collected in each patient's home. Environmental and clinical isolates were compared using pulsed-field gel electrophoresis. Thirty-six patients were enrolled into the study. Legionella was recovered in 12/36 (33%) homes. The residential and clinical isolates were found to be microbiologically related in 5/36 (14%) patients. Contaminated electricity-heated domestic hot-water systems contribute to the acquisition of SCAL. The proportion is similar to previous reports, but may be underestimated.

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“…We observed a seasonal distribution in our study. Such an observation has already been reported in other Canadian studies [7, 28]. The reason for this pattern is currently unknown.…”

Section: Discussionsupporting

confidence: 75%

“…There are conflicting data regarding its incidence, but most studies have found Legionella spp. to be responsible for 2-5 % of acute sporadic community-acquired pneumonia [3][4][5][6][7]. These cases are believed to be acquired by inhalation of aerosolized bacteria or by microaspiration [8].…”

Section: Introductionmentioning

confidence: 99%

Sporadic Legionnaires' disease: the role of domestic electric hot-water tanks

et al. 2011

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“…Nonetheless we do not believe that such reporting effects would explain the magnitude in observed difference in disease burden between Toronto and the Ottawa region (itself a major site of tertiary care beds in the province). Furthermore, we believe that the wide geographic base, prolonged interval of data collection, detailed information on testing practices, and performance of all testing by a single laboratory distinguish this study from those of shorter duration conducted in Europe and the U.S. [ 11 , 26 ], and from previous Canadian sentinel surveillance efforts [ 13 ], and also provide new insights into the distinctive epidemiology of this disease in Canada's most populous province.…”

Section: Discussionmentioning

confidence: 99%

“…Both sporadic legionellosis, and large legionellosis outbreaks are known to occur in the Canadian province of Ontario [ 8 , 13 ], with over 1400 cases recorded between 1978 and 2006. However, the epidemiology of legionellosis in this region has not been reviewed previously in the biomedical literature.…”

Section: Introductionmentioning

confidence: 99%

Laboratory-based evaluation of legionellosis epidemiology in Ontario, Canada, 1978 to 2006

Tang²,

Jamieson

et al. 2009

BMC Infect Dis

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BackgroundLegionellosis is a common cause of severe community acquired pneumonia and respiratory disease outbreaks. The Ontario Public Health Laboratory (OPHL) has conducted most testing for Legionella species in the Canadian province of Ontario since 1978, and represents a multi-decade repository of population-based data on legionellosis epidemiology. We sought to provide a laboratory-based review of the epidemiology of legionellosis in Ontario over the past 3 decades, with a focus on changing rates of disease and species associated with legionellosis during that time period.MethodsWe analyzed cases that were submitted and tested positive for legionellosis from 1978 to 2006 using Poisson regression models incorporating temporal, spatial, and demographic covariates. Predictors of infection with culture-confirmed L. pneumophila serogroup 1 (LP1) were evaluated with logistic regression models.Results1,401 cases of legionellosis tested positive from 1978 to 2006. As in other studies, we found a late summer to early autumn seasonality in disease occurrence with disease risk increasing with age and in males. In contrast to other studies, we found a decreasing trend in cases in the recent decade (IRR 0.93, 95% CI 0.91 to 0.95, P-value = 0.001); only 66% of culture-confirmed isolates were found to be LP1.ConclusionDespite similarities with disease epidemiology in other regions, legionellosis appears to have declined in the past decade in Ontario, in contrast to trends observed in the United States and parts of Europe. Furthermore, a different range of Legionella species is responsible for illness, suggesting a distinctive legionellosis epidemiology in this North American region.

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“…While it is estimated that 97% of clinical diagnoses are obtained using a UAT [7], these tests only recognize Legionella pneumophila serogroup 1 antigens, which accounts for 50%-80% of LD cases [5]. Furthermore, the sensitivity of the test ranges from approximately 60%-100% [5,8]. Thus, it is likely that there were more cases of LD in our community in the summer of 2018 than we report here.…”

Section: Discussionmentioning

confidence: 76%

Legionnaires’ Disease Cases at a Large Community Hospital—Common and Underdiagnosed

Spiegelman

Pedutem

Francisco

2020

IJERPH

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Legionnaires’ disease (LD) is a severe pneumonia with a mortality rate of about 10%. The illness remains largely underdiagnosed with outbreaks occurring with alarming incidence. In this study, we assessed the frequency of Legionnaires’ disease among pneumonia cases treated at a large community hospital over a summer season. We invited all admitted patients diagnosed with pneumonia, able to provide a urine sample for an antigen test, presenting from May to October 2018, to enroll in our study; 35 patients were tested for the presence of Legionella. Out of 33 patients tested, 9 (28%) were positive for Legionella. Three sets of the 9 Legionella cases exhibited spatiotemporal clustering indicative of LD outbreaks. Only one of the 9 Legionella UAT-positive patients presented a sporadic case of LD. The number of pneumonia cases in our community confirmed to be LD was strikingly high (28%), compared to other survey studies that report between 3.7% and 14%. These results are consistent with previous knowledge that LD is underdiagnosed and support that routine testing should be considered for all possible LD cases, particularly in the summer months. Such testing is likely to prevent further cases of community acquired LD.

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Legionnaires′ Disease ‐ Results of a Multicenter Canadian Study

Cited by 8 publications

References 30 publications

Sporadic Legionnaires' disease: the role of domestic electric hot-water tanks

Sporadic Legionnaires' disease: the role of domestic electric hot-water tanks

Laboratory-based evaluation of legionellosis epidemiology in Ontario, Canada, 1978 to 2006

Legionnaires’ Disease Cases at a Large Community Hospital—Common and Underdiagnosed

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