Research and analysis

HPR volume 12 issue 12: news (6 April)

Updated 21 December 2018

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1. Legionnaires’ disease in England and Wales: annual report for 2016

The 2016 annual report on Legionnaires’ disease (LD) in England and Wales residents has been published by Public Health England, describing the epidemiological features of microbiologically-confirmed cases (who experienced onset of symptoms during that year) [1].

A total of 355 confirmed cases of LD were reported to the national surveillance scheme for cases with onset of symptoms in 2016, more than half of which were considered to have encountered the source of infection from within the community (which includes UK travel-related cases). This is in line with 2015, when approximately half of cases had been “community infections”). A smaller proportion of all 2016 cases (41.4%, 147 cases) were associated with travel abroad (compared with 46.1%, 177 cases, in 2015). Only 1.7% (six cases) in 2016 were healthcare-associated. There were 25 LD-related deaths, significantly below the median of 32 per year over the last decade.

The fall in the number of foreign travel-associated cases (and clusters) reflects year-on-year variation in LD cases among England and Wales residents. Spain remained the most-frequent travel destination among LD cases in 2016, with 28 cases having travelled there during their incubation period. However, the destination with the highest rate of infection in 2016 was United Arab Emirates, for which the rate of infection for England and Wales residents was equivalent to 26 cases per million visits, compared with 1.9 cases per million visits for Spain.

The report presents data on all microbiological methods of testing including both traditional urinary antigen testing and nucleic acid detection by polymerase chain reaction (PCR) techniques which, along with culture, are carried out by the PHE reference laboratory. Use of molecular techniques, such as PCR, play a significant role in determining the source of LD infection. Data on sequence types (STs) according to main categories of exposure, for example, are presented in the new report, indicating that although foreign-travel related cases were associated with greatest diversity of sequence type, some STs were uniquely associated with travel to a single country.

Updated guidance and documentation relating to the national enhanced surveillance scheme for England and Wales have also been published [2,3].

1.1 References

  1. PHE (5 April 2018). Legionnaires’ disease in England and Wales: 2016.
  2. PHE (5 April 2018). Guidance on investigating cases, clusters and outreaks of legionnaires disease.
  3. PHE (5 April 2018). National enhanced legionella surveillance in England and Wales: reporting form.

2. Infection reports in this issue of HPR

‘Laboratory reports of respiratory infections made to PHE Colindale from PHE and NHS laboratories in England and Wales: weeks 9 to 13, 2018’ is published in this issue of HPR.

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