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The impact of diagnosis by legionella urinary antigen test on the epidemiology and outcomes of Legionnaires' disease

Published online by Cambridge University Press:  26 November 2001

N. FORMICA ,
M. YATES ,
M. BEERS ,
J. CARNIE ,
G. HOGG ,
N. RYAN  and
G. TALLIS
N. FORMICA
Affiliation:
Communicable Disease Section, Department of Human Services, Melbourne VIC, Australia Master of Applied Epidemiology Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra ACT, Australia
M. YATES
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Parkville, Melbourne VIC, Australia
M. BEERS
Affiliation:
Master of Applied Epidemiology Program, National Centre for Epidemiology and Population Health, Australian National University, Canberra ACT, Australia
J. CARNIE
Affiliation:
Communicable Disease Section, Department of Human Services, Melbourne VIC, Australia
G. HOGG
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Parkville, Melbourne VIC, Australia
N. RYAN
Affiliation:
Victorian Infectious Diseases Reference Laboratory, Parkville, Melbourne VIC, Australia
G. TALLIS
Affiliation:
Communicable Disease Section, Department of Human Services, Melbourne VIC, Australia
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Abstract

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Legionnaires' disease is an uncommon but important cause of life-threatening community-acquired or nosocomial pneumonia. The urinary antigen enzyme immunoassay test, used in Victoria since 1995, now accounts for the majority of initial laboratory notifications (81% in 1999). We review the impact of the test on the disease epidemiology and the public health investigative process. We focus on the major subgroup of cases due to Legionella pneumophila serogroup 1, comparing delays until notification and mortality for urinary antigen detected cases with culture detected cases. The urinary antigen test facilitates a 5-day reduction for the delay between onset of illness and notification. We observed that there was minimal clinical heterogeneity of urinary antigen detected cases whether they were subsequently culture confirmed or not. We encourage clinician use of the urinary antigen test in cases of community-acquired pneumonia where Legionnaires' disease is a possible diagnosis, in conjunction with culture of clinical specimens.

Type
Research Article
Information
Epidemiology & Infection , Volume 127 , Issue 2 , October 2001 , pp. 275 - 280
Copyright
2001 Cambridge University Press