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Community acquired legionnaires’ disease: lessons for surveillance from recent outbreaks
  1. M Regan1,
  2. B Olowokure2
  1. 1Health Protection Agency, North West Regional Epidemiology Service, Liverpool, UK
  2. 2Health Protection Agency, West Midlands Regional Surveillance Unit, Birmingham Heartlands Hospital, Birmingham, UK
  1. Correspondence to:
 Professor M Regan
 Health Protection Agency (North West), DBH House 105 Boundary Street Liverpool L5 9YJ, UK; martyn.regan{at}

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Sharing of multi-agency intelligence on cooling towers is needed for better prevention and control of outbreaks

Ever since the recognition of the clinical syndrome of epidemic atypical pneumonia and the identification of the causative role of legionella organisms, legionnaires’ disease has posed considerable logistical problems for public health services. Outbreaks continue to occur and may be explosive, high profile, and difficult to control despite appropriate tactical mobilisation and cooperation between the statutory organisations charged with surveillance and response.1,2

Hospital water systems initially featured as important preventable sources of legionella and a risk to susceptible groups, but nosocomial cases are now uncommon in the United Kingdom because of the successful implementation of proactive control measures directed towards reducing the risk from hot water and cooling systems.3

More recently surveillance for legionnaires’ disease has focused particularly on the rapid identification and alerting of travel associated cases supported by an extensive European surveillance network that has resulted in a number of notable successes in identifying linked cases associated with travel or specific high risk premises, particularly hotels.4 This network has enabled rapid communication of intelligence on suspected clusters and timely alerting of the travel industry and national control and enforcement agencies so that …

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  • Funding: none.

  • Competing interests: none declared.

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