Abstract
A total of 818 cases of Legionnaires' disease with onset of illness in 2009 were reported from 22 European and two non-European countries to the European Surveillance Scheme for Travel-Associated Legionnaires' Disease (EWGLINET). This is a decrease of 52 cases compared with 2008 and 129 fewer than in 2007 - the peak year of reporting to date. A total of 794 (97.1%) cases were reported as confirmed and 24 as presumptive cases. Outcome of illness was reported for 561 (68.6%) cases. Of these cases 28 (5%) were reported to have died. More than half, of the cases in 2009 (n=469, 57.3%) were reported within 20 days of symptom onset. Cases visited 53 countries and were infected in all months of the year, with a peak in September (n=146). By country of residence of the cases, the United Kingdom (UK) reported the highest number of cases (n=173). Italy reported the second highest number of cases (n=169) and was also the country associated with the most cases by country of infection (n=209). A total of 88 new clusters (75 in Europe and 13 outside Europe) were detected in 2009 and were associated with 196 cases. The largest cluster occurred in Italy and involved seven cases. Without the scheme's international database, thirty three (37.5%) of the newly detected clusters would not have been identified. In 49 of the accommodation sites with clusters of cases, environmental samples were found to be positive for Legionella spp. Details of 10 sites were published on the European Working Group for Legionella Infections (EWGLI) website for failure to return information on the status of environmental investigations.
Highlights
The European Surveillance Scheme for Travel Associated Legionnaires’ Disease (EWGLINET) was established in 1987 by the European Working Group for Legionella Infections (EWGLI), one year after EWGLI itself was formed
From 1993 to March 2010 the scheme was run as a European Union (EU) funded disease specific network through a coordinating centre in London, United Kingdom (UK), with the common aim among collaborating countries of detection, response, control and prevention of cases and clusters of Legionnaires’ disease associated with public accommodation sites used by travellers
In April 2010 the scheme was transferred to the European Centre for Disease Prevention and Control (ECDC) and renamed ELDSNet, retaining the original aims and objectives of the network [2]
Summary
The European Surveillance Scheme for Travel Associated Legionnaires’ Disease (EWGLINET) was established in 1987 by the European Working Group for Legionella Infections (EWGLI), one year after EWGLI itself was formed. From 1993 to March 2010 the scheme was run as a European Union (EU) funded disease specific network through a coordinating centre in London, United Kingdom (UK), with the common aim among collaborating countries of detection, response, control and prevention of cases and clusters of Legionnaires’ disease associated with public accommodation sites used by travellers. European guidelines for the control and prevention of travel-associated Legionnaires’ disease were introduced by EWGLI in 2002, and endorsed by the European Commission in 2003 [1]. They were produced to ensure consistency of approach and a common high standard for investigation of cases and clusters in order to improve protection for travellers throughout Europe. This paper documents and comments on cases of travel-associated Legionnaires’ disease reported to EWGLINET with an onset of illness in 2009
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