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Abstract

Background

Legionnaires’ disease (LD) incidence has been increasing in several European countries since 2011. Currently, Denmark is experiencing one of the highest annual incidences of LD despite its relatively cold climate and homogenous population, and the incidence differs notably across the country.

Aim

We sought to determine whether provincial differences in LD incidence are attributable to the age and sex distribution of the population, and to characterise the risk of LD by province and age group in Denmark.

Methods

Using national routine surveillance data for domestic LD cases collected between 2015 and 2018, we assessed the incidence of disease by province and year. Poisson regression models were fit to understand the risk of LD by year and province, as well as by 5-year age groups.

Results

Incidence of domestic LD increased 48% between 2015 and 2018 across Denmark. Some provinces continuously had a high incidence of disease, even after adjusting for yearly trends and the underlying population distribution. Variations in the proportion of the population aged 65 years and older were not responsible for the increase in disease in our analysis. Finally, incidence of disease increased with each 5-year age group in both men and women.

Conclusions

The relative differences in incidence between Danish provinces could not be explained by the age and sex distribution of the population, indicating that other factors must be responsible for the varying incidence across the country. These results may help inform trends in other countries in Europe also experiencing an unexplained high incidence of LD.

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2021-06-24
2024-04-26
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2021.26.25.2000036
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Provincial trends in Legionnaires’ disease are not explained by population structure in Denmark, 2015 to 2018
<p class="citation"> <span>Citation style for this article:</span> <span class="meta-value authors"> <a href="/search?value1=Kelsie+Cassell&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Cassell Kelsie</a>, <a href="/search?value1=Daniel+Thomas-Lopez&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Thomas-Lopez Daniel</a>, <a href="/search?value1=Charlotte+Kjels%C3%B8&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Kjelsø Charlotte</a>, <a href="/search?value1=S%C3%B8ren+Uldum&option1=author&noRedirect=true" class="nonDisambigAuthorLink">Uldum Søren</a></span>. Provincial trends in Legionnaires’ disease are not explained by population structure in Denmark, 2015 to 2018. <a href="/content/ecdc">Euro Surveill.</a> 2021;26(25):pii=2000036. <a href="https://doi.org/10.2807/1560-7917.ES.2021.26.25.2000036" title="doi link" target="_blank">https://doi.org/10.2807/1560-7917.ES.2021.26.25.2000036</a> <span class="ES_Article_citation"> <span class="generated">Received</span>: 16 Jan 2020;&nbsp;&nbsp; <span class="generated">Accepted</span>: 01 Jun 2021 </span> </p>
/content/10.2807/1560-7917.ES.2021.26.25.2000036
/content/10.2807/1560-7917.ES.2021.26.25.2000036
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