军团病2023年度流行病学报告

Legionnaires’ disease Annual Epidemiological Report for 2023 Key facts •In 2023, the notification rate of Legionnaires’ disease increased to 3.2 cases per 100 000 population, upfrom the 2.6 cases per 100 000 population reported in 2022.•Notification rates remained heterogenous across the European Union/European Economic Area(EU/EEA), varying from less than 0.5 per 100 000 population to 6.9 cases per 100 000 population (age-standardised rate) reported by Slovenia. Four countries (France, Germany, Italy, and Spain) accounted Introduction Legionnaires’ disease is a multi-system disease that causes pneumonia due to an infection withtheLegionella bacteria, most commonly of the speciesLegionella pneumophila. The bacteria are found in thenatural environment, soil, and water. They can be a health risk when they become aerosolised into inhalable finemists, usually through engineered water systems. Cooling towers, evaporative condensers, humidifiers, decorativefountains, hot tubs, and showers are examples of water systems with identifiedLegionella risks. Conditions that Methods This report is based on data for 2023 retrieved from The European Surveillance System (TESSy) on 31 March 2025for annual data and on 12 May 2025 for travel-associated Legionnaires’ disease and the outbreak reportingscheme. TESSy is a surveillance system for the collection, analysis and dissemination of data on communicable The methods used to produce this report are published online by ECDC [1] together with an overview of thenational surveillance systems [2]. A subset of the data used for this report is available through ECDC’sonlineSurveillance atlas of infectious diseases [3]. The surveillance data were collected through three different schemes: •annual retrospective data collection of all Legionnaires’ disease (LD) cases reported in EU/EEA countries,Iceland, Liechtenstein and Norway; time periods in results presented are based on reported date for statistics.•annual retrospective data collection of outbreak events detected and reported in EU/EEAcountries, Iceland and Norway. The following thresholds for reporting outbreaks are used:i.≥ five cases, if these are not exposed in same building, nor evidence of exposure to same aerosol-producing installation/device, nor microbiological evidence of linked cases;ii.≥ three cases, if these are exposed in the same building, or if evidence for exposure to same Legionnaires’ disease cases should be reported to these surveillance schemes in accordance with the2018 EU/EEA surveillance case definition for confirmed cases or probable cases, that includes at least one positivelaboratory test and a clinical diagnosis of pneumonia. Epidemiology In 2023, 28 countries reported 14 537 cases (Table 1), of which 13 493 (93%) were classified as confirmed. Thenumber of notifications per 100 000 population increased to 3.2, being the highest observed rate for the EU/EEAsince surveillance was coordinated at ECDC. Four countries, France, Germany, Italy and Spain, continue to account Of 10 797 cases with known outcome, 973 (9%) were reported to have a fatal outcome. Age-adjusted notification rates ranged from fewer than 1.0 cases per 100 000 population in six countries (Bulgaria,Cyprus, Finland, Greece, Ireland, and Romania) to 4.0 cases per 100 000 population or more in six countries(Denmark, Italy, Liechtenstein, the Netherlands, Slovenia, and Spain); see Table 1 and Figure 1. Source: Country reports from Austria, Belgium, Bulgaria, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Greece,Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia,Spain, and Sweden. The distribution of cases per month (Figure 2) shows a seasonal trend, with most cases in the EU/EEA reportedduring the summer. The majority (8 621, 59%) of cases occurred between June and October, as in previous years(Figure 3). Except for the month of July, the distribution of cases per month under 2023 was consistently abovethe range and the peaks observed in the previous 4 years (Figure 3). The peak of 2 308 cases seen in August Source: Country reports from Austria, Belgium, Bulgaria, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Greece,Hungary, Ireland, Italy, Latvia, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal, Romania, Slovakia, Slovenia,Spain, and Sweden. In 2023, people aged 45 years and older accounted for 13 356 of 14 524 cases with known age (92%). Thenotification rate increased with age, from≤0.1 cases per 100 000 population in those under 25 years of age to 8.5cases per 100 000 population in persons aged 65 years and above (12.7 cases per 100 000 population in males Source: Country reports from Austria, Belgium, Bulgaria, Cyprus, Czechia, Denmark, Estonia, Finland, France, Germany, Greece,Hungary, Ireland, Italy, Latvia, Liechtenstein, Lithuania, Luxembourg, Malta, the Netherlands, Norway, Poland, Portugal,Romania, Sl