A 37-year-old man under treatment for manic-depressive illness developed pneumonia identified as Legionnaires' disease accompanied by a severe neurological disorder with profound dysarthria, ataxia, gaze paralysis, and downbeat nystagmus. At review six months later, he has made only a partial recovery with persisting limb and gait ataxia. Difficulties in diagnosing neurological complications of...

States is increasing. We reviewed case records to determine the the epidemiology of and risk factors for the 1,449 cases reported to the New York City Department of Health and Mental Hygiene, New York, New York, USA, during 2002–2011. The highest incidence (2.74 cases/100,000 population) occurred in 2009; this incidence was higher than national incidence for that year (1.15 cases/100,000 popula...

We studied the timing of occurrence of 1676 sporadic, community-acquired cases of Legionnaires' disease in England and Wales between 1993 and 2008, in relation to temperature, relative humidity, rainfall, windspeed and ultraviolet light using a fixed-stratum case-crossover approach. The analysis was conducted using conditional logistic regression, with consideration of appropriate lag periods. ...

During the winter of 1995, a space-time cluster of seven suspected cases of legionnaires’ disease occurred on Merseyside, involving three neighbouring health districts. A multidisciplinary investigation team was established but failed to obtain convincing evidence of an outbreak. Investigation of the seven cases confirmed two as sporadic cases; other infections were found to explain the remaini...

Legionnaires' disease is underreported in Europe; notification rates differ substantially among countries. Approximately 20% of reported cases are travel-associated. To assess the risk for travel-associated Legionnaires' disease (TALD) associated with travel patterns in European countries, we retrieved TALD surveillance data for 2009 from the European Surveillance System, and tourism denominato...

Legionella longbeachae, found in soil and compost-derived products, is a globally underdiagnosed cause of Legionnaires' disease. We conducted a case-control study of L. longbeachae Legionnaires' disease in Canterbury, New Zealand. Case-patients were persons hospitalized with L. longbeachae pneumonia, and controls were persons randomly sampled from the electoral roll for the area served by the p...

The incidence of Legionnaires' disease in the United States has been increasing since 2000. Outbreaks and clusters are associated with decorative, recreational, domestic, and industrial water systems, with the largest outbreaks being caused by cooling towers. Since 2006, 6 community-associated Legionnaires' disease outbreaks have occurred in New York City, resulting in 213 cases and 18 deaths. ...

COMMUNICATIONS TO THE EDITOR 713 Saravolatz and co-workers2 documented the lower levels of erythromycin while treating patients with Legionnaires’ disease with oral erythromycin and one of their patients developed Legionnaires’ disease ( LD) while receiving oral erythromycin. Among the antibiotics, rifampin has been shown in vitro to be more active than erythromycin against the LD bacterium. On...

Given the nonspecific clinical manifestations of Legionnaires' disease and the high mortality of untreated Legionnaires' disease, we recommend routine use of Legionella testing, especially the Legionella urinary antigen test, for all patients with community-acquired pneumonia. This includes patients with ambulatory pneumonia and hospitalized children. Legionella cultures should be more widely a...