Surveillance of Legionnaires' Disease in Europe

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Abstract
Identification of the organism responsible for Legionnaires' disease was first associated with an outbreak in 1976 in Philadelphia, Pa., where 189 cases and 29 deaths occurred among American Legion veterans who had attended a hotel-based convention. European Working Group for Legionella Infections (EWGLI) provides expert epidemiological, microbiological, and environmental health advice to clinical and public health officials, tour operators, national and international government departments, and other relevant groups such as hoteliers and members of the public. This chapter mainly presents data from 1999, which was provided by 28 of the 31 countries that currently participate in the European scheme. It also compares trends and incidence of cases in Europe from 1993. Since 1993, the overall rate of infection per million residents has ranged from 3.35 to 4.46. In 1999, 32% of the overall cases were reported as community acquired, 9% were hospital acquired, and 21% were associated with travel either in their own country or abroad. The objectives of the December 1999 meeting of experts convened by the European Commission to review the Belgium and The Netherlands whirlpool spa outbreaks, were to advise the Commission on the need for European recommendations and guidelines for the control and prevention of future whirlpool spa outbreaks and to produce specific recommendations that could be addressed by the Commission. EWGLI is assisting data contribution for effective surveillance at the international level through its sharing of information on cases, outbreaks, sources of infection, and continued developments in epidemiological, microbiological, and environmental aspects of legionella infection.