Legionnaires’ disease: ECDC warns of increased cases in Europe

The number of cases of Legionnaires’ disease (legionella infection) in Europe has reached the highest level recorded to date, according to a report from the European Center for Disease Control and Prevention (ECDC).

Legionella bacteria that multiply in standing water and air conditioners, and spread by airborne dropletshave caused 10,720 known cases of pneumonia in the European Economic Area, which includes EUas well as Norway, Liechtenstein and Iceland. Of these cases, 704 were fatal.

Four countries (Italy, France, Spain and Germany) account for 75% of cases in 2021, while Greece reported 25 cases, up from 29 cases in 2020 and 45 in 2019.

At the European level, men aged 65 and over were the most affected group with 8.9 cases per 100,000 population. The reasons for the increase in 2021 remain unknown, according to ECDC, although the change is likely to be due to increased surveillance, an aging population, changes in water supply infrastructure, and changes in weather patterns.

There were also 895 travel-related cases of Legionnaires’ disease in 2021, up 38% from 2020. This is likely due to the lifting of travel restrictions due to the Covid-19 pandemic.

For to prevent disease transmission, disinfection and proper maintenance of air conditioners are recommendedwater networks and water tanks.

Key Facts

• The bacterium L. pneumophila was first identified in 1977. It caused an outbreak of severe pneumonia in a US convention center in 1976.
• The most common route of transmission of Legionella is through inhalation of contaminated aerosols, which are produced by water spraying, jets or mist from water in which the bacterium is present. Infection can also occur through aspiration of contaminated water and ice, especially by susceptible patients in hospital settings.
• The incubation period for Legionnaires’ disease is 2–10 days (however, in some outbreaks it has been reported to be up to 16 days).
• There are drugs for the disease, but there is no vaccine yet.
• Death from the disease occurs as a result of progressive pneumonia with disorder and / or respiratory arrest and multiple organ failure.
• If left untreated, Legionnaires’ disease usually worsens within the first week.
• In the total mass of registered cases of the disease, 75–80% of the patients were over the age of 50 years and 60–70% were male patients.

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