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Legionella

Why the syndrome was created:

The purpose of the CDC Legionella v1 ESSENCE query is to capture potential visits related to Legionella. It is useful to identify potential cases for follow-up, conduct situation awareness and monitoring of outbreaks, and perform retrospective trend monitoring across geographic regions to identify possible disease hotspots, etc.

Data sources the syndrome was used on (e.g., emergency room, EMS, air quality):

Emergency room

Submitted by hmccall on
Description

To evaluate the added value of a syndromic surveillance system in detecting a large severe respiratory disease outbreak with a point-source we used the Legionnaires' disease (LD) outbreak of 1999 in the Netherlands as a case-study. We retrospectively simulated a prospective syndromic surveillance for space-time clusters of patients with pneumonia in hospital records to detect the LD outbreak.

Submitted by elamb on
Description

In Michigan, both presentations of legionellosis, Pontiac Fever (PF) and Legionnaires’ Disease (LD), are reportable through the Michigan Disease Surveillance System (MDSS), a web-based electronic database. Legionella pneumophila serogroup 1 is responsible for 5090% of cases.1,2 Several diagnostic tests are available with varying sensitivities and specificities. Urinary Antigen testing (UAg) is the most commonly used test but only reliably detects L. pneumophila-1. Culturing is the gold standard test but is limited by antibiotic interference, technical expertise, and time.3 The purpose of this study was to evaluate Michigan’s legionellosis surveillance system and to determine if diagnostic methods influenced case distribution.

Objective

To describe the strengths and weaknesses of Michigan’s legionellosis surveillance system and the influence of diagnostic methods on the temporal and geographic distribution of legionellosis cases in Michigan.

Submitted by Magou on
Description

The Bureau of Communicable Disease (BCD) at the NYC Department of Health and Mental Hygiene performs daily automated analyses using SaTScan to detect spatio-temporal clusters for 37 reportable diseases. Initially, we analyzed one address per patient, prioritizing home address if available. On September 25, 2015, a BCD investigator noticed two legionellosis cases with similar work addresses. A third case was identified in a nearby residential facility, and an investigation was initiated to identify a common exposure source. Four days later, after additional cases living nearby were reported, the SaTScan analysis detected a corresponding cluster.  In response to this signaling delay, we implemented a multiple address (MA) analysis to improve upon single address (SA) analyses by using all location data available on possible exposure sites.

Objective

To improve timeliness and sensitivity of legionellosis cluster detection in New York City (NYC) by using all addresses available for each patient in one analysis.

Submitted by Magou on

We will present an overview of: (1) the epidemiology of Legionnaires’ disease (LD), (2) techniques applied by the New York City (NYC) Department of Health and Mental Hygiene for routine LD surveillance and outbreak investigation, (3) detection and investigation of the second largest community-acquired LD outbreak in the U.S (South Bronx, July 2015), and (4) recent legislation enforcing regular maintenance, testing, and mediation of NYC cooling towers.