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Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States

Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is noclear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired...

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Autores principales: Moffa, Michelle A., Rock, Clare, Galiatsatos, Panagis, Gamage, Shantini D., Schwab, Kellogg J., Exum, Natalie G.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cambridge University Press 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540183/
https://www.ncbi.nlm.nih.gov/pubmed/37503568
http://dx.doi.org/10.1017/S0950268823001206
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author Moffa, Michelle A.
Rock, Clare
Galiatsatos, Panagis
Gamage, Shantini D.
Schwab, Kellogg J.
Exum, Natalie G.
author_facet Moffa, Michelle A.
Rock, Clare
Galiatsatos, Panagis
Gamage, Shantini D.
Schwab, Kellogg J.
Exum, Natalie G.
author_sort Moffa, Michelle A.
collection PubMed
description Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is noclear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired in community settings where the environmental source is never identified. This scoping review aimed to summarise the drivers of infections in the USA and determine the magnitude of impact each potential driver may have. A total of 1,738 titles were screened, and 18 articles were identified that met the inclusion criteria. Strong evidence was found for precipitation as a major driver, and both temperature and relative humidity were found to be moderate drivers of incidence. Increased testing and improved diagnostic methods were classified as moderate drivers, and the ageing U.S. population was a minor driver of increasing incidence. Racial and socioeconomic inequities and water and housing infrastructure were found to be potential factors explaining the increasing incidence though they were largely understudied in the context of non-outbreak cases. Understanding the complex relationships between environmental, infrastructure, and population factors driving legionellosis incidence is important to optimise mitigation strategies and public policy.
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spelling pubmed-105401832023-09-30 Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States Moffa, Michelle A. Rock, Clare Galiatsatos, Panagis Gamage, Shantini D. Schwab, Kellogg J. Exum, Natalie G. Epidemiol Infect Original Paper Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is noclear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired in community settings where the environmental source is never identified. This scoping review aimed to summarise the drivers of infections in the USA and determine the magnitude of impact each potential driver may have. A total of 1,738 titles were screened, and 18 articles were identified that met the inclusion criteria. Strong evidence was found for precipitation as a major driver, and both temperature and relative humidity were found to be moderate drivers of incidence. Increased testing and improved diagnostic methods were classified as moderate drivers, and the ageing U.S. population was a minor driver of increasing incidence. Racial and socioeconomic inequities and water and housing infrastructure were found to be potential factors explaining the increasing incidence though they were largely understudied in the context of non-outbreak cases. Understanding the complex relationships between environmental, infrastructure, and population factors driving legionellosis incidence is important to optimise mitigation strategies and public policy. Cambridge University Press 2023-07-28 /pmc/articles/PMC10540183/ /pubmed/37503568 http://dx.doi.org/10.1017/S0950268823001206 Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.
spellingShingle Original Paper
Moffa, Michelle A.
Rock, Clare
Galiatsatos, Panagis
Gamage, Shantini D.
Schwab, Kellogg J.
Exum, Natalie G.
Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title_full Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title_fullStr Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title_full_unstemmed Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title_short Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States
title_sort legionellosis on the rise: a scoping review of sporadic, community-acquired incidence in the united states
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10540183/
https://www.ncbi.nlm.nih.gov/pubmed/37503568
http://dx.doi.org/10.1017/S0950268823001206
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