Abstract

Legionnaires' disease (LD) is caused by the inhalation of aerosols containing Legionella, a Gram-negative bacteria. Previous national- or regional-level studies have suggested an impact of climate on LD incidence. The objective of this study was to investigate the effect of temperature, rainfall, and atmospheric pressure on short-term variations in LD notification rate. EU/EEA Member States report their LD surveillance data to the European Centre for Disease Prevention and Control. Community-acquired LD cases reported by Denmark, Germany, Italy, and The Netherlands with onset date in 2007-2012 were aggregated by onset week and region of residence. Weather variables were extracted from the European Climate Assessment & Dataset project. We fitted Poisson regression models to estimate the association between meteorological variables and the weekly number of community-acquired LD cases. Temperature, rainfall and atmospheric pressure were all associated with LD risk with higher risk associated with simultaneous increase in temperature and rainfall. Temperatures >20 °C were not associated with a higher risk for LD. LD cases occurring during wintertime may be associated with sources less influenced by meteorological conditions.

Highlights

  • Known risk factors for LD include increasing age, Legionnaires’ disease (LD) is a severe pneumonia caused by Legionella spp

  • Across 77 NUTS2 regions with a total population of 164 million inhabitants, 8708 community-acquired LD cases were registered over 5–6 years, of which 8088 (93%) had available information on place of residence and date of onset

  • Using data from 77 regions across four countries we found an association between weekly cumulative rainfall, mean temperature, and atmospheric pressure and notification rate of community-acquired LD

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Summary

Introduction

Known risk factors for LD include increasing age, Legionnaires’ disease (LD) is a severe pneumonia caused by Legionella spp. These Gram-negative bacteria found in freshwater environments tend to contaminate water systems [1]. The disease is not transmitted person-to-person, but people are infected by inhalation of aerosols containing Legionella [1]. In Europe, most LD cases are sporadic and community-acquired [5]. Previous findings have suggested an impact of climate on the number of LD cases reported [6,7,8,9]. Any weather condition favouring the growth of Legionella or its presence in aerosols could potentially

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