Abstract
According to the Italian Surveillance System for Legionnaires' disease (LD), physicians must fill in a form for every case and send it through the Local Health Units to the National Institute of Health (Istituto Superiore di Sanità, ISS). Forms reported in the period from 2000 to 2011 were analysed and discussed. A total of 9,803 cases of LD were reported to ISS during the study period. The median age of cases was 63 years, with a ratio male/female of 2.6 and a case fatality rate of 11.8%. The number of cases has been steadily increasing from 192 cases in 2000 to 1,235 in 2010 and 1,008 cases in 2011. The reported cases showed a geographical gradient, with the highest number notified in the north and the lowest in the south. The majority of cases (73.0%) were community-acquired, followed by travel-associated (13.5%) and healthcare-associated cases (9.3%), cases acquired in long-term care facilities (2.1%), and other types of exposure (2.1%). Even though the increasing trend of LD in Italy indicates an improvement in the ability to detect and report cases, the geographical gradient highlights the existence of low reporting areas where the epidemiological surveillance of LD should be further strengthened.
Highlights
Legionella spp. is a ubiquitous intracellular microorganism colonising natural and artificial aquatic environments, which grows at temperatures of 25 to 42°C [1,2]
The objective of this paper is to present the results of the Italian surveillance programme during the period from 2000 to 2011
According to the National Surveillance of Legionnaires’ disease (LD), for each case of LD diagnosed in Italy, physicians must fill in a surveillance form and send it to the Local Health Units (LHU)
Summary
Legionella spp. is a ubiquitous intracellular microorganism colonising natural and artificial aquatic environments, which grows at temperatures of 25 to 42°C [1,2]. Legionnaires’ disease (LD) is a form of interstitial pneumonia that is normally transmitted via aerosol, i.e. inhalation of mist droplets containing the bacteria. The aerosol containing Legionella bacteria can be produced by contaminated water sources such as cooling towers, domestic hot-water systems, swimming and spa pools, fountains, respiratory therapy equipment, and other devices that tap into a public water supply. No inter-human transmission has been documented, it can be presumed that natural and artificial aquatic environment is the only source of the infection. Individual risk factors such as long-term medical conditions, heavy smoking or alcohol abuse, and environmental risk factors may influence the likelihood to develop the infection. Medical equipment, if not adequately treated, can be a potential source of infection in hospitals (endoscopes, food or nasogastric tubes, devices for artificial respiration and oxygen therapy, dental tools, etc.) [10]
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