legionnaires' diseaseEUROPE: After a significant drop in 2011, reported cases of legionnaires’ disease rose by nearly 20% in 2012, according to figures from the European Centre for Disease Prevention and Control.

In 2012, 5,852 cases of legionnaires’ disease were reported in the EU/EEA, a 19.5% increase on the 4,897 cases reported in 2011. Most cases in 2012 were community-acquired (69%), while 20% were travel-associated and 8% were linked to healthcare facilities.

Although not matching the drop in 2011, the 2012 figures are 7% down on 2010 and highlight the fluctuations that have been observed in the past years.

The compilers of the report maintain that these fluctuations have been mainly driven by the number of community-acquired cases reported by six countries – France, Italy, Spain, Germany, UK and the Netherlands. These countries have continuously reported the majority of LD cases, accounting for four-fifths of all cases, while only representing two-thirds of the EU/EEA population.

Legionnaires’ disease is notifiable in all EU and EEA countries but is thought to be underreported because patients are not specifically tested for legionella or because some cases are not notified to health authorities.

The ECDC warns that legionnaires’ disease remains an important cause of both morbidity and mortality in Europe. Of 4,149 cases in 2012 with a known outcome, 419 were reported to have died.

“Even though sporadic community-acquired cases represent the majority of notified cases, large outbreaks continue to occur, placing temporary pressure on local healthcare services,” it states.

The report also warns of the unpredictable nature of large outbreaks, such as the one in Edinburgh in 2012, which the report says “served as a reminder that such events are unpredictable and not necessarily restricted to countries with warm climates.”

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