Legionnaires’ Disease Incidence and Risk Factors, New York, New York, USA, 2002–2011

Farnham, Andrea; Alleyne, Lisa; Cimini, Daniel; Balter, Sharon

doi:10.3201/eid2011.131872

Cited by 84 publications

(125 citation statements)

References 16 publications

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“…In patients with risk factors (smoking, chronic cardiovascular or respiratory disease, diabetes, alcohol abuse, and immunosuppression), LD is sometimes complicated by more severe disease (cavitation and pleural effusions) [25][26][27]. Jacobson et al [28], in a study of Legionella pneumonia in cancer patients, reported the presence of multilobar pneumonia in 82 % of the patients, bilateral involvement in 80 %, and pleural effusion in 56 % of the patients.…”

Section: Legionella Pneumophilamentioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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Community-acquired pneumonia (CAP) is associated with high rates of morbidity and mortality worldwide; the annual incidence of CAP among adults in Europe has ranged from 1.5 to 1.7 per 1000 population. Intracellular bacteria are common causes of CAP. However, there is considerable variation in the reported incidence between countries and change over time. The intracellular pathogens that are well established as causes of pneumonia are Legionella pneumophila, Mycoplasma pneumoniae, Chlamydophila pneumoniae, Chlamydophila psittaci, and Coxiella burnetii. Since it is known that antibiotic treatment for severe CAP is empiric and includes coverage of typical and atypical pathogens, microbiological diagnosis bears an important relationship to prognosis of pneumonia. Factors such as adequacy of initial antibiotic or early de-escalation of therapy are important variables associated with outcomes, especially in severe cases. Intracellular pathogens sometimes appear to cause more severe disease with respiratory failure and multisystem dysfunction associated with fatal outcomes. The clinical relevance of intracellular pathogens in severe CAP has not been specifically investigated. We review the prevalence, general characteristics, and outcomes of severe CAP cases caused by intracellular pathogens.

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Section: Legionella Pneumophilamentioning

confidence: 99%

Community-acquired pneumonia related to intracellular pathogens

Cillóniz¹,

Niederman

Eerden

et al. 2016

Intensive Care Med

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“…Multiple state public health agencies in the United States have shown people of African descent to represent a disproportionately high number of legionellosis cases. 58, 59 In a nationwide examination of public health data by the Centers for Disease Control (CDC), incidence among this group was substantially higher than for whites. 23 Additionally, residents of low-income neighborhoods in the state of New York have also been shown to have increased odds of contracting legionellosis.…”

Section: Introductionmentioning

confidence: 99%

“…23 Additionally, residents of low-income neighborhoods in the state of New York have also been shown to have increased odds of contracting legionellosis. 59 Further studies will be necessary to determine if these two risk groups are due to medical (comorbidities, limited health care), environmental (low-quality drinking water, premise plumbing deficiencies), or social (smoking rates, high-risk jobs) reasons.…”

Section: Introductionmentioning

confidence: 99%

Ten questions concerning the aerosolization and transmission of Legionella in the built environment

Prussin

Schwake

Marr

2017

Building and Environment

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Legionella is a genus of pathogenic Gram-negative bacteria responsible for a serious disease known as legionellosis, which is transmitted via inhalation of this pathogen in aerosol form. There are two forms of legionellosis: Legionnaires' disease, which causes pneumonia-like symptoms, and Pontiac fever, which causes influenza-like symptoms. Legionella can be aerosolized from various water sources in the built environment including showers, faucets, hot tubs/swimming pools, cooling towers, and fountains. Incidence of the disease is higher in the summertime, possibly because of increased use of cooling towers for air conditioning systems and differences in water chemistry when outdoor temperatures are higher. Although there have been decades of research related to Legionella transmission, many knowledge gaps remain. While conventional wisdom suggests that showering is an important source of exposure in buildings, existing measurements do not provide strong support for this idea. There has been limited research on the potential for Legionella transmission through heating, ventilation, and air conditioning (HVAC) systems. Epidemiological data suggest a large proportion of legionellosis cases go unreported, as most people who are infected do not seek medical attention. Additionally, controlled laboratory studies examining water-to-air transfer and source tracking are still needed. Herein, we discuss ten questions that spotlight current knowledge about Legionella transmission in the built environment, engineering controls that might prevent future disease outbreaks, and future research that is needed to advance understanding of transmission and control of legionellosis.

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“…In the USA 8000-18,000 persons are hospitalized for legionellosis each year. In the 2000s, a substantial increase in the number of reported cases was observed (Farnham et al 2014). The average case-fatality rate is 10 % in Europe and 8 % in the USA.…”

Section: Introductionmentioning

confidence: 98%

“…Recognized host risk factors for LD include smoking, diabetes, older age (>50 years), having a chronic underlying disease with or without an associated immunodeficiency, and receipt of a transplant or chemotherapy. Environmental risk factors associated with legionellosis outbreaks are travel, proximity to cooling towers, whirpool spas, decorative fountains, residence in a health care facility (Farnham et al 2014). In Europe, about 6000 Legionnaires' disease cases are noted annually (Beaute et al 2013).…”

Section: Introductionmentioning

confidence: 98%

PCR method for the rapid detection and discrimination of Legionella spp. based on the amplification of pcs, pmtA, and 16S rRNA genes

Janczarek

Palusińska-Szysz

2015

J Appl Genetics

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Legionella bacteria are organisms of public health interest due to their ability to cause pneumonia (Legionnaires' disease) in susceptible humans and their ubiquitous presence in water supply systems. Rapid diagnosis of Legionnaires' disease allows the use of therapy specific for the disease. L. pneumophila serogroup 1 is the most common cause of infection acquired in community and hospital environments. The non-L. pneumophila infections are likely under-detected because of a lack of effective diagnosis. In this work, simplex and duplex PCR assays with the use of new molecular markers pcs and pmtA involved in phosphatidylcholine synthesis were specified for rapid and cost-efficient identification and distinguishing Legionella species. The sets of primers developed were found to be sensitive and specific for reliable detection of Legionella belonging to the eight most clinically relevant species. Among these, four primer sets I, II, VI, and VII used for duplex-PCRs proved to have the highest identification power and reliability in the detection of the bacteria. Application of this PCR-based method should improve detection of Legionella spp. in both clinical and environmental settings and facilitate molecular typing of these organisms.

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Legionnaires’ Disease Incidence and Risk Factors, New York, New York, USA, 2002–2011

Abstract: Living in low-income areas and working in certain occupations may increase risk.

Cited by 84 publications

References 16 publications

Community-acquired pneumonia related to intracellular pathogens

Community-acquired pneumonia related to intracellular pathogens

Ten questions concerning the aerosolization and transmission of Legionella in the built environment

PCR method for the rapid detection and discrimination of Legionella spp. based on the amplification of pcs, pmtA, and 16S rRNA genes

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