LEGIONELLOSIS

Wisconsin Division of Public Health Disease Surveillance Manual (EpiNet, February 2005)

I. IDENTIFICATION

A. CLINICAL DESCRIPTION: An illness with acute onset that can take two distinct forms:

1) Legionnaire disease, which is characterized by fever, cough, myalgia, and pneumonia.

2) Pontiac fever , a similar but milder illness without pneumonia.

B. REPORTING CRITERIA: Laboratory confirmation.

C. LABORATORY CRITERIA FOR CONFIRMATION:

• Isolation of Legionella species from a clinical specimen, OR
• Positive Direct Fluorescence Antibody (DFA) test of lower respiratory secretion, pleural fluid or tissue specimen for Legionella species, OR
• Fourfold or greater change of serum antibody titer to ³ 128 against Legionella species, OR
• Demonstration of L. pneumophila serogroup 1 antigens in urine by radioimmunoassay (RIA) or enzyme-linked immunosorbent assay (ELISA).

D. WISCONSIN CASE DEFINITION: A case that is laboratory confirmed.

II. ACTIONS REQUIRED / PREVENTION MEASURES

A. WISCONSIN DISEASE SURVEILLANCE CATEGORY II: Report to the patient's local health officer on an Acute and Communicable Disease Case Report (DPH 4151) or other means within 72 hours of the identification of a case or suspected case.

B. EPIDEMIOLOGY REPORTS REQUESTED:

1. Acute and Communicable Diseases Case Report (DPH 4151).

2. Legionellosis Case Report (DPH 9069).

C. PUBLIC HEALTH INTERVENTIONS:

• Attempts to culture the organism from clinical specimens prior to the initiation of antibiotic therapy are strongly encouraged.
• Source investigation by LHD. The completion of the Legionellosis Case Report Form (DPH 9069) usually fulfills this requirement for sporadic cases.
• Outbreaks require a search for potential exposures common to multiple case-patients. Contact the BPH / CDES as soon as possible.
  

III. CONTACTS FOR CONSULTATION

A. REGIONAL STAFF: See Epinet Introduction: “REGIONAL OFFICE CONTACTS”.

B. BCDP / COMMUNICABLE DISEASE EPIDEMIOLOGY SECTION: (608) 266-5326.

C. WSLH / 1. Legionella SEROLOGY: (608) 262-3217 2. DFA STAIN OR CULTURE: (608) 263-3421

IV. RELATED REFERENCES

1. “Legionellosis” DPH Disease Fact Sheet Series: View a list of all current Communicable Disease Fact Sheets

2. Heyman, DL. ed. LEGIONELLOSIS. In: Control of Communicable Diseases Manual. 18 th ed. Washington , DC : American Public Health Association, 2004: 292-295.

 

 

DPH Legionellosis Case Report Form here