Short-term effects of atmospheric pressure, temperature, and rainfall on notification rate of community-acquired Legionnaires' disease in four European countries.

J Beauté,P Sparén,J Giesecke,M C Rota,P Brandsema,S A Uldum,S Sandin

doi:10.1017/s0950268816001874

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

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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