Sporadic community-acquired Legionnaires' disease in France: a 2-year national matched case-control study.
Legionnaires' disease (LD) is an aetiology of community-acquired bacterial pneumonia in adults, with a high case-fatality ratio (CFR). We conducted a matched case-control study to identify risk factors for sporadic, community-acquired LD. Cases of sporadic, community-acquired and biologically confirmed LD, in metropolitan France from 1 September 2002 to 31 September 2004, were matched with a control subject according to age, sex, underlying illness and location of residence within 5 km. We performed a conditional logistic regression on various host-related factors and exposures. Analysis was done on 546 matched pairs. The CFR was 3.5%. Age ranged from 18-93 years (mean 57 years), with a 3.6 male:female sex ratio. Cases were more likely to have smoked with the documentation of a dose-effect relation, to have travelled with a stay in a hotel (OR 6.1, 95% CI 2.6-14.2), or to have used a wash-hand basin for personal hygiene (OR 3.5, 95% CI 1.6-7.7) than controls. Tobacco and travel have been previously described as risk factors for LD, but this is the first time that such a dose-effect for tobacco has been documented among sporadic cases. These findings will provide helpful knowledge about LD and help practitioners in identifying patients at high risk.
Che
D
D
Institut de Veille Sanitaire, Saint Maurice, France. d.che@invs.sante.fr
Campese
C
C
Santa-Olalla
P
P
Jacquier
G
G
Bitar
D
D
Bernillon
P
P
Desenclos
J-C
JC
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D016022:Case-Control Studies; D017714:Community-Acquired Infections / Q000453:epidemiology; D004777:Environment; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D007877:Legionnaires' Disease / Q000453:epidemiology*; D007899:Leisure Activities; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D012907:Smoking; D014195:Travel; D055815:Young Adult