Legionnaires' disease in Europe 2000-2002.

Each year, countries that participate in the European Surveillance Scheme for Travel Associated Legionnaires' Disease (EWGLINET) are requested to complete a set of standardized reporting forms that provide epidemiological and microbiological information on the total number of cases (non-travel as well as travel-related cases) detected in their country. Trends at the national and aggregated European level have been analysed for 2000-2002. For this period, 10,322 cases of Legionnaires' disease were reported and national infection rates ranged from 0 to 34.1 cases per million population. A total of 189 outbreaks were associated with nosocomial infection, community exposure or travel. The upward trend in diagnosis through the urinary antigen detection test has resulted in a higher ascertainment of cases in many countries. However, the decline in diagnosis by culture of the organism is likely to severely hamper outbreak investigations in the future if fewer clinical isolates are available for matching with environmental isolates. This important data-set has been used for studying the effectiveness of surveillance and legionella control and prevention programmes within Europe.