ABCs Report: Legionellosis, 2012

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Active Bacterial Core Surveillance (ABCs): Emerging Infections Program Network

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ABCs Areas

California (3 county San Francisco Bay area); Colorado (5 county Denver area); Connecticut; Georgia (8 county Atlanta area); Maryland; Minnesota; New Mexico; New York (15 county Rochester and Albany areas); Oregon; Tennessee (20 urban counties)

ABCs Population

The surveillance areas represent 36,704,650 persons.

Source: National Center for Health Statistics bridged-race vintage 2012 postcensal file

ABCs Case Definition

Confirmed legionellosis case: A positive culture of any Legionella organism from a body site, detection of L. pneumophila serogroup 1 antigen in urine, or fourfold or greater rise in specific serum antibody titer to L. pneumophila serogroup 1 between acute and convalescent sera in a resident of a surveillance area in 2012.

ABCs Methodology

ABCs personnel actively contacted all laboratories serving persons in the surveillance area to identify cases. Standardized case report forms that include information on demographic characteristics, clinical syndrome, and outcome of illness were completed for each identified case. Regular laboratory audits assessed completeness of active surveillance and detected additional cases.

All rates of legionellosis were calculated using population estimates for 2012 from the bridged-race vintage 2012 postcensal file. For national estimates of cases, race- and age-specific rates of disease were applied from the aggregate surveillance area to the age and racial distribution of the 2012 U.S. population. Cases with unknown race were distributed by site based on reported race distribution for known cases within the nine age categories.^¶

Reported ABCs Profiles

Sex	No.	(Rate^*)
Male	256	(1.4)
Female	136	(0.7)

^* Cases per 100,000 population for ABCs areas

Race	No.	(Rate^*)
White	292	(1.0)
Black	92	(1.5)
Other	10	(0.3)

^* Cases per 100,000 population for ABCs areas

Age (years)	Cases No. (Rate^*)	Deaths No. (Rate^*)
< 10	0 (0.00)	0 (0.00)
10-19	2 (0.04)	0 (0.00)
20-29	3 (0.06)	0 (0.00)
30-39	17 (0.35)	0 (0.00)
40-49	46 (0.89)	9 (0.17)
50-59	111 (2.14)	4 (0.08)
60-69	88 (2.38)	5 (0.14)
70-79	72 (3.80)	7 (0.37)
≥ 80	55 (4.21)	16 (1.23)
Total	394 (1.07)	39 (0.11)

^*Cases or deaths per 100,000 population for ABCs areas

Site	Cases No. (Rate^*)	Deaths No. (Rate^*)
California**	10 (0.29)	1 (0.03)
Colorado**	16 (0.63)	3 (0.12)
Connecticut	58 (1.62)	8 (0.22)
Georgia**	20 (0.52)	1 (0.03)
Maryland	117 (1.99)	12 (0.20)
Minnesota	51 (0.95)	3 (0.06)
New Mexico	9 (0.43)	0 (0.00)
New York**	65 (2.98)	7 (0.32)
Oregon	21 (0.54)	2 (0.05)
Tennessee**	27 (0.70)	4 (0.10)
Total	394 (1.07)	41 (0.11)

^* Cases or deaths per 100,000 population for ABCs areas
** Data from select counties

Testing Methodology	No.	(%)
Urine Antigen	373	(94.7)
Culture	43	(10.9)
Serology	0	(0.0)

Note: Some cases had more than one testing method

Illness Severity	No.	(%)
Hospitalization	382	(97.0)
ICU admission	161	(40.9)
Mechanical ventilation	86	(21.8)
Death	41	(10.4)

National Estimates for Invasive Disease

Cases: 3,362 (1.1/100,000)
Deaths: 335 (0.11/100,000)

Citation

Centers for Disease Control and Prevention. 2014. Active Bacterial Core Surveillance Report, Emerging Infections Program Network, Legionellosis, 2012.