Legionellosis --- United States, 2000-2009

Abstract

Legionnaires disease (LD), a serious, sometimes lethal pneumonia, and Pontiac fever (PF), an influenza-like, self-limited illness, are the two most common forms of legionellosis, which is caused by Legionella bacteria. Legionellosis cases are reported to CDC through the National Notifiable Disease Surveillance System (NNDSS) and a Supplemental Legionnaires Disease Surveillance System (SLDSS) designed to manage surveillance data on travel-related cases and enhance outbreak detection. For this report, cases reported to NNDSS during 2000-2009 from the 50 states and the District of Columbia (DC) were assessed, and crude and age-adjusted incidence rates per 100,000 persons were calculated. U.S. legionellosis cases reported annually increased 217%, from 1,110 in 2000 to 3,522 in 2009, and the crude national incidence rate increased 192%, from 0.39 per 100,000 persons in 2000 to 1.15 in 2009. Because NNDSS is a passive surveillance system dependent on health-care providers and laboratories reporting cases, the actual incidence of legionellosis in the United States likely is higher. Although NNDSS does not record legionellosis cases by type, 99.5% of the legionellosis cases reported to SLDSS during 2005-2009 were classified as LD and 0.5% as PF. Legionellosis surveillance was added to the population-based Active Bacterial Core surveillance (ABCs) system in January 2011 to assess reasons for these increases in numbers of reported cases. The rise in reported cases reinforces the need for health-care providers in all parts of the United States to test and treat adults with severe community-acquired pneumonia for LD, to be vigilant for health-care--associated LD, and to report legionellosis cases to public health authorities.