National case definition: Legionnaires' disease and Pontiac fever (Legionellosis)

Legionellosis

Date of last revision/review: May 2008

National notification

Only confirmed cases of disease should be notified.

Type of surveillance

Routine case-by-case notification to the federal level.

Case classification

Laboratory comments

Jurisdictions should use a validated antigen detection test, and test interpretation must be in accordance with the manufacturer's instructions. The urinary antigen test (UAT) is widely used in Canada and internationally. UAT targets Legionella pneumophila serogroup 1 but is not validated to target other serogroups or species in the genus.

Few laboratories use culture with biochemical confirmation in conjunction with antigen detection. A limited number of laboratories currently participate in College of American Pathologists (CAP) and Clinical Microbiology Proficiency Testing (CMPT) proficiency testing programs.

Clinical evidence

Legionellosis comprises two distinct illnesses: Legionnaires' disease, characterized by fever, myalgia, cough and pneumonia, and Pontiac fever, a milder illness without pneumonia.

ICD code(s)

Type of international reporting

Under Article 6 of the International Health Regulations (IHR) (2005), each State Party shall notify the World Health Organization (WHO) by way of the IHR National Focal Point, and within 24 hours of assessment of public health information, of all events which may constitute a public health emergency of international concern within its territory in accordance with the decision instrument (Annex 2 of the IHR), as well as any health measure implemented in response to those events.

Comments

Probable case definitions are provided as guidelines to assist with case finding and public health management, and are not for national notification purposes.

References

World Health Organization. International Health Regulations (2005). 3rd ed. Geneva, 2016, from http://www.who.int/ihr/publications/9789241580496/en/

Previous case definitions

Canadian Communicable Disease Surveillance System: disease-specific case definitions and surveillance methods. Can Dis Wkly Rep 1991;17(S3).

Case definitions for diseases under national surveillance. CCDR 2000;26(S3).

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