Legionnaires’ disease in Europe, 2014

Surveillance report
12 Jan 2016
Publication series: Legionnaires’ disease in Europe

European Centre for Disease Prevention and Control. Legionnaires’ disease in Europe, 2014. Stockholm: ECDC; 2016.

​This surveillance report is based on the 2014 disease surveillance data collected by the European Legionnaires’ Disease Surveillance Network.

The Network collects standard surveillance data on Legionnaires’ disease from EU Member States plus Iceland and Norway, but also operates a second system which covers travel-associated cases of Legionnaires’ disease, including cases recorded outside the EU/EEA.

Executive summary

​With 6 941 cases reported, the notification rate of Legionnaires’ disease in the EU/EEA in 2014 was 13.5 cases per million population, the highest ever observed. This is in line with the increasing trend observed over the 2009–2014 period, notwithstanding the large community outbreak that occurred in Vila Franca de Xira near Lisbon, Portugal, in 2014, which contributed substantially to the high number of reported cases. Further investigations, such as an analysis of meteorological conditions favourable to Legionnaires’ disease, may explain the other reasons for this increase.

France, Germany, Italy, Portugal, and Spain accounted for 74% of all cases. Many countries had a notification rate below five cases per million population (with several below one per million), a situation unchanged over the past five years and which is unlikely to reflect the true incidence of the disease in these countries.
The main characteristics of the cases reported in 2014 were very similar to those reported in previous years: most cases were sporadic and community acquired, and the disease affected mostly older males.
In 2014, 953 travel-associated cases of Legionnaires’ disease (TALD) were reported, 21% more than in 2013. This is in line with the increased overall notification rate for Legionnaires’ disease. Further analyses may provide a better insight into the factors behind this year’s increase. A total of 132 new standard travel-associated clusters were identified, compared with 110 in 2013 and 99 in 2012. More than half of these TALD clusters would probably not have been detected without international collaboration. This reinforces the added value of the European Legionnaires' disease Surveillance Network’s (ELDSNet) daily TALD surveillance in protecting the health of travellers in the EU/EEA and other participating countries.