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Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016

The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification System for Infectious Diseases,...

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Autores principales: Fischer, Fabienne B., Schmutz, Claudia, Gaia, Valeria, Mäusezahl, Daniel
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579383/
https://www.ncbi.nlm.nih.gov/pubmed/33050023
http://dx.doi.org/10.3390/ijerph17197343
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author Fischer, Fabienne B.
Schmutz, Claudia
Gaia, Valeria
Mäusezahl, Daniel
author_facet Fischer, Fabienne B.
Schmutz, Claudia
Gaia, Valeria
Mäusezahl, Daniel
author_sort Fischer, Fabienne B.
collection PubMed
description The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification System for Infectious Diseases, has more than doubled since 2008. This study aims to investigate this increase, contextualizing disease surveillance data with denominator data, which is not routinely available, i.e., the number of tests performed for Legionella spp. We collected the testing data for Legionella spp. of 14 Swiss diagnostic laboratories and calculated the positivity, defined as the proportion of the number of positive tests to the number of tests performed. The number of positive tests increased proportionally to the number of tests performed; hence, the positivity remained stable. However, the cause of the increase in test volume is unclear and has a large impact on the interpretation of the positivity curve. Further, the test outcome was found to be dependent on regional determinants, and the diagnostic method applied. The lack of understanding if and at which stage LD is considered in current case management of pneumonia patients limits the interpretation of observed heterogeneities in incidence or underestimation of LD in Switzerland. The absence of (or non-adherence to) existing guidelines and the heterogeneity in diagnostic testing hampers the comparison of data in the Swiss public health context. Therefore, diagnostic procedures should be harmonised across Switzerland and adherence to national LD management guidelines supported.
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spelling pubmed-75793832020-10-29 Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016 Fischer, Fabienne B. Schmutz, Claudia Gaia, Valeria Mäusezahl, Daniel Int J Environ Res Public Health Article The risk of falling ill with Legionnaires’ disease (LD) is suggested to increase, but the global burden of disease is unknown due to a lack of appropriate diagnosis and surveillance systems. In Switzerland, the number of LD cases, captured by the National Notification System for Infectious Diseases, has more than doubled since 2008. This study aims to investigate this increase, contextualizing disease surveillance data with denominator data, which is not routinely available, i.e., the number of tests performed for Legionella spp. We collected the testing data for Legionella spp. of 14 Swiss diagnostic laboratories and calculated the positivity, defined as the proportion of the number of positive tests to the number of tests performed. The number of positive tests increased proportionally to the number of tests performed; hence, the positivity remained stable. However, the cause of the increase in test volume is unclear and has a large impact on the interpretation of the positivity curve. Further, the test outcome was found to be dependent on regional determinants, and the diagnostic method applied. The lack of understanding if and at which stage LD is considered in current case management of pneumonia patients limits the interpretation of observed heterogeneities in incidence or underestimation of LD in Switzerland. The absence of (or non-adherence to) existing guidelines and the heterogeneity in diagnostic testing hampers the comparison of data in the Swiss public health context. Therefore, diagnostic procedures should be harmonised across Switzerland and adherence to national LD management guidelines supported. MDPI 2020-10-08 2020-10 /pmc/articles/PMC7579383/ /pubmed/33050023 http://dx.doi.org/10.3390/ijerph17197343 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Fischer, Fabienne B.
Schmutz, Claudia
Gaia, Valeria
Mäusezahl, Daniel
Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title_full Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title_fullStr Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title_full_unstemmed Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title_short Legionnaires’ Disease on the Rise in Switzerland: A Denominator-Based Analysis of National Diagnostic Data, 2007–2016
title_sort legionnaires’ disease on the rise in switzerland: a denominator-based analysis of national diagnostic data, 2007–2016
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7579383/
https://www.ncbi.nlm.nih.gov/pubmed/33050023
http://dx.doi.org/10.3390/ijerph17197343
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