Abstract
Twenty countries reported 921 cases of travel-associated Legionnaires' disease to EWGLINET (the European Surveillance Scheme for Travel-Associated Legionnaires' Disease) with onset during 2006; 875 confirmed and 46 presumptive. Thirty three cases died, giving a case fatality rate of 3.6%. Of the 124 new clusters detected in 2006, 43 would not have been identified without the EWGLINET scheme. A total of 146 investigations were conducted at cluster sites according to the standards of the EWGLINET investigation guidelines; 111 of these investigations were associated with the new clusters while 35 investigations were associated with re-offending sites (where additional cases had onset after a report was received to say that investigations and control measures had been satisfactorily conducted). The names of four accommodation sites were published on the EWGLI website. Overall, there has been an upwards trend in case numbers since the scheme was founded, which has implications for the work load of public health authorities across Europe and for the tour industry. Despite this increasing pressure on public health authorities, environmental investigations are being conducted in a timely manner.
Highlights
In 1986, the European Working Group for Legionella Infections (EWGLI) was formed to facilitate the exchange of information and to collaborate in the management of Legionnaires’ disease across Europe
This paper provides results and commentary on cases of travelassociated Legionnaires’ disease reported to EWGLINET with onset in 2006
Four cases were reported by the United States and one by Australia, two countries that do not form part of the official network. This brought the total number of cases reported to the EWGLINET scheme with onset in 2006 to 921, which is a major increase on 2005 when 755 cases were reported and continues the annual upward trend (Figure 1)
Summary
In 1986, the European Working Group for Legionella Infections (EWGLI) was formed to facilitate the exchange of information and to collaborate in the management of Legionnaires’ disease across Europe. A year later EWGLI members established the European Surveillance Scheme for Travel-Associated Legionnaires’ Disease (EWGLINET), which aims to identify clusters of Legionnaires’ disease cases in Europe that may not be detected by national surveillance systems alone, and to initiate investigation and control measures at the sites implicated. These measures are standardised in the European Guidelines for Control and Prevention of Travel Associated Legionnaires’ Disease, which were endorsed by the European Commission in 2003 [1]. The database is searched each time a new case report is received in order to determine whether it is a single case or part of a cluster
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