Identifier to cite or link to this item: http://hdl.handle.net/20.500.13003/17000
Travel-associated Legionnaires' disease: would changing cluster definition lead to the prevention of a larger number of cases?
StatisticsItem usage statistics
MetadataShow Dublin Core item record
Document typeresearch article
CitationRota MC, Bella A, Caporalil MG, Nicolau A, Drasar V, Ricci ML, et al. Travel-associated Legionnaires' disease: would changing cluster definition lead to the prevention of a larger number of cases?. Epidemiol Infect. 2019;147:e62. Epub 2018 Dec 3.
According to European Guidelines for Legionnaires' Disease prevention and control, travel-associated Legionnaires' disease (TALD) cases are managed differently if classified as sporadic or as part of a cluster and more stringent control measures are deployed after clusters are identified. In this study, we propose to modify the current cluster definition: 'two or more cases of Legionnaires' disease (LD) who stayed at, or visited, the same commercial accommodation site 2-10 days before onset of illness and whose onset is within the same 2-year period' with a new cluster definition, i.e. accommodation sites associated with multiple cases regardless of the time elapsed between them. TALD cases occurred in Italy and in the Balearic Islands between 2005 and 2015 were analysed applying the current European Legionnaires' Disease Surveillance Network (ELDSNet) cluster definition. In a sample of selected accommodation sites with multiple cases, a microbiological study was also conducted. Using the new definition, 63 additional sites (16.4% increase) and 225 additional linked cases (19.5% increase) were identified. Legionella pneumophila sg1 was isolated from 90.7% of the selected accommodation sites. The use of the here proposed TALD cluster definition would warrant a full investigation for each new identified case. This approach should therefore increase the number of sites that will require a risk assessment and, in the presence of an increased risk, the adoption of LD control measures to hopefully prevent additional cases.