[Epidemiology and surveillance of legionella infections]

Since 1987, in France, Legionella infection is a notifiable disease. Notification should be transmitted by the clinician to the referent public health physician in the Direction départementale des Affaires sanitaires et sociales. Criteria for certain and probable cases have been defined. From this level, nationwide information is centralised in the institut de veille sanitaire. The public health physician is responsible for the inquiry in the health care facility or community setting and for action taking as appropriate. After isolation, Legionella strains are further studied in the Centre national de référence in Lyon. This center is also responsible for typing of environmental strains. In 2002, the incidence of notified legionellosis was 1,7 per 100,000 inhabitants and the mortality rate of 13%. Median age was 61 years and the sex-ratio M/F of 2.9. Only 39 cases were nosocomial. Very few cases have been observed in children, almost all in immunocompromised patients. Legionellosis is of exceptional occurrence in neonates, but the lethality is high. Treatment guidelines have been published in France only for adult patients.