Legionellosis risk-an overview of Legionella spp. habitats in Europe

Abstract

An increase in the number of reports of legionellosis in the European Union and the European Economic Area have been recorded in recent years. The increase in cases is significant: from 6947 reports in 2015 to 11,298 in 2019. This is alarming as genus Legionella, which comprises a large group of bacteria inhabiting various aquatic systems, poses a serious threat to human health and life, since more than 20 species can cause legionellosis, with L. pneumophila being responsible for the majority of cases. The ability to colonize diverse ecosystems makes the eradication of these microorganisms difficult. A detailed understanding of the Legionella habitat may be helpful in the effective control of this pathogen. This paper provides an overview of Legionella environments in Europe: natural (lakes, groundwater, rivers, compost, soil) and anthropogenic (fountains, air humidifiers, water supply systems), and the role of Legionella spp. in nosocomial infections, which are potentially fatal for children, the elderly and immunocompromised patients.

Keywords: Aquatic pathogens; Disease control; Environmental microbiology; Legionella; Legionellosis.

Fig. 1

Distribution of Legionnaires’ disease cases and rates per 100 000 population by country in 2019, EU/EEA, 2021.

Fig. 2

Diverse adaptation strategies of Legionella spp. rods (images from the Centers for Disease Control and Prevention (2022) resources, public domain).