3.+Epidemiology+(Nafie)

=__**Epidemiology of Legionnaire's disease by Nafisatu Tunkara:**__=

**__Epidemiology of legionnaire’s pneumonia __** Legionnaire’s disease is caused by bacteria and it’s a form of pneumonia. The name Legionnaire’s disease came from people who attended the American legion’s convection in Philadelphia in 1976 where they got affected by the disease. Ref? Legionella are mostly found in cooling waters, humidifiers and potable water distribution systems. Ref, why? explain This disease can be spread by erosolisation or aspiration of water contaminated with legionella organism. ??

The epidemic of this disease is the consequence of the rapid growth of bacteria, and leads to the rose of artificial sources from the failure of controlling and prevention measures. not only In England and Wales about 40% of cases were reported and it due to foreign travel. //(Edwards, M et al 2008)//

According to the “Bureau of Communicable Disease Control” it been reported that in the USA there were 8,000 to 18,000 cases of the disease reported each year. when??? ( //McNabb // //SJ. Et al 2005) // . In 1995 – 2005 more than 32,000 of Legionnaires’ disease were reported and over 600 outbreaks were also reported to the European Working Group for legionella infections. Why did you chose this 2 examples? both old

This disease is more likely to be increased as the population becomes more elderly, and there will be a shortage of data in relation to legionella in developing countries, most legionella disease is misdiagnosed worldwide, however diagnosis and surveillance can be improved in developing countries and a better result would be expected in order to reveal far higher level of morbidity and mortality than are currently recognised, this will also improve the awareness about the incidence and how it is spread. Some interesting facts reported here, but poorly presented and not discussed

I n the south of Wales, //(September 2010)// there is a new outbreak of legionnaire’s disease which killed about three people. Some people who have been ill never knew they got the disease till an investigation took place in certain area of South Wales, which identify a total of 19 people who suffer from the disease//. (bbc news one Wales)//

In Europe, 5,960 cases were reported in 2008 from 34 European countries, but the highest incidence was from France (1,244), Spain (1,219) and Italy (1,107). However, the rates per million population were highest in Switzerland (28.6), Slovenia (23.7), Denmark (23.3) and the Netherlands (20.5). On the other hand, in 2009, 808 cases of travel-associated Legionnaires’ disease were reported from European countries.

In Australia, especially Melbourne in year 2000 there were an outbreak of the disease were 125 cases were verified cases of legionnaires pneumonophia, but only 95 was hospitalised, and about 4 died from the outbreak. The cause was due to infection to the cooling tower at their newly open aquarium, but in 2001 the government introduced a controlling system for the infection.

In December 2011, the Hong Kong’s headquarters were contaminated with the bacterial that caused Legionnaires’ disease. A minister was hospitalised with the potentially fatal disease. There were traces of the bacteria which are 14 times above the acceptable level. The building has been disinfected by authorities, and the Hong Kong’s health centre protection has been gathering samples from various sites. Why did you chose these examples? Are they linked what point are you trying to make?

[[image:group-b-omed0074/Legionnaires_disease_cases_1988_-_2007.png]]

 * This graph is a statistics that showed reported cases over the past 20 years, an average of 200-300 cases every year. ( **//nemco-utilities.co.uk)//


 * References: **

[] New Legionnaires' rule call after south Wales outbreak Posted on Thursday 16th September 2010

Edwards, M. T., Fry, N. K., Harrison, T. G. (2008). Clonal population structure of Legionella pneumophila inferred from allelic profiling. Microbiology 154: 852-864

jo[|urnal of Infection][|Volume 56, Issue 1], January 2008, Pages 1-12 [|Volume 118, Issue 4] (April 1, 2008) J Clin Invest. 2008;118(4):1291–1300. [|Diagnostic Microbiology and Infectious Disease][|Volume 56, Issue 1], September 2006, Pages 7-11

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Legionellosis. World Health Organization. http://www.who.int/mediacentre/factsheets/fs285/en/index.html. Accessed Oct. 19, 2010.

<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">McNabb SJ, Jajosky RA, Hall-Baker PA, et alSummary of notifiable diseases United States, 2005. MMWR Morb Mortal Wkly Rep 2007;54:1-92.

<span style="font-family: 'Times New Roman',serif;">Sensitivity of three serum antibody tests in a large outbreak of Legionnaires' disease in the Netherlands.J Med Microbiol (2006) 55(Pt 5): 561-566

=**<span style="font-family: 'Times New Roman',serif; font-size: 12pt;">Conclusion: **= Legionella disease is a leading cause of pneumonia, the disease does not spread from one to other but widely spread in nature as it lives in ponds and water. The outbreak takes place from a purpose built system in which a temperature is warm, and can encourage the growth of bacteria, this occurs mainly in cooling water, evaporative condenser and spas. Most of the outbreak in the community that took place in the UK is linked to installation instance cooling water. In other to prevent the spreading of the disease places or organisation should manage these systems and conform to the regulations in maintain and treating water system properly, as the incidence of the disease is depending on the quantity of water reservoir contamination, and also the intensity of the patient exposure to that water and the susceptibility of the host.

Poor effort, often unclear, not discussed in depth or at all and very poor use of referencing protocol.