Meteorological conditions and Legionnaires' disease sporadic cases-a systematic review. 2022

Despina Pampaka, and Diana Gómez-Barroso, and Noemí López-Perea, and Rocio Carmona, and Rosa Cano Portero
National Centre of Epidemiology, Instituto de Salud Carlos III, Madrid, Spain; European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden. Electronic address: d.pampaka@gmail.com.

A number of studies suggest that meteorological conditions are related to the risk of Legionnaires' disease (LD) but the findings are not consistent. A systematic review was conducted to investigate the association of weather with sporadic LD and highlight the key meteorological conditions related to this outcome. PubMed, EMBASE, The Cochrane Library and OpenGrey were searched on 26-27 March 2020 without date, language or location restrictions. Key words included "legionellosis", "legionnaires' disease", combined with "meteorological conditions", "weather", "temperature", "humidity", "rain", "ultraviolet rays", "wind speed", etc. Studies were excluded if they did not examine the exposure of interest, the outcome of interest and their association or if they only reported LD outbreak cases. The study was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines and it was registered in PROSPERO (#CRD42020168869). There were 811 articles, of which 17 were included in the review. The studies investigated different meteorological variables and most of them examined the combined effect of several variables. The most commonly examined factors were precipitation and temperature, followed by relative humidity. The studies suggested that increased precipitation, temperature and relative humidity were positively associated with the incidence of LD. There was limited evidence that higher wind speed, pressure, visibility, UV radiation and longer sunshine duration were inversely linked with the occurrence of LD. A period of increased but not very high temperatures, followed by a period of increased precipitation, favour the occurrence of LD. Increased awareness of the association of temperature and precipitation and LD occurrence among clinicians and public health professionals can improve differential diagnosis for cases of sporadic community-acquired pneumonia and at the same time contribute to improving LD surveillance.

UI MeSH Term Description Entries
D007877 Legionnaires' Disease An acute, sometimes fatal, pneumonia-like bacterial infection characterized by high fever, malaise, muscle aches, respiratory disorders and headache. It is named for an outbreak at the 1976 Philadelphia convention of the American Legion. Legionella pneumophila Infections,Infections, Legionella pneumophila,Legionnaire Disease,Pontiac Fever,Disease, Legionnaire,Disease, Legionnaires',Fever, Pontiac,Infection, Legionella pneumophila,Legionella pneumophila Infection,Legionnaire's Disease,Legionnaires Disease
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D006813 Humidity A measure of the amount of WATER VAPOR in the air. Humidities
D013696 Temperature The property of objects that determines the direction of heat flow when they are placed in direct thermal contact. The temperature is the energy of microscopic motions (vibrational and translational) of the particles of atoms. Temperatures
D014887 Weather The state of the ATMOSPHERE over minutes to months. Fog,Fogs
D055904 Meteorology The science of studying the characteristics of the atmosphere such as its temperature, density, winds, clouds, precipitation, and other atmospheric phenomena and aiming to account for the weather in terms of external influences and the basic laws of physics. (From McGraw-Hill Dictionary of Scientific and Technical Terms, 6th ed) Biometeorology,Climatology

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