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Estimation of minimum infection rates with Legionella pneumophila in an exposed population

Published online by Cambridge University Press:  20 October 2005

H. C. BOSHUIZEN ,
N. J. D. NAGELKERKE ,
J. W. DEN BOER ,
H. DE MELKER ,
J. F. P. SCHELLEKENS ,
M. F. PEETERS ,
H. VAN VLIET  and
M. A. E. CONYN-VAN SPAENDONCK
H. C. BOSHUIZEN
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
N. J. D. NAGELKERKE
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
J. W. DEN BOER
Affiliation:
Municipal Health Service Kennemerland, Haarlem, The Netherlands
H. DE MELKER
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
J. F. P. SCHELLEKENS
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
M. F. PEETERS
Affiliation:
Regional Laboratory of Public Health Tilburg, Tilburg, The Netherlands
H. VAN VLIET
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
M. A. E. CONYN-VAN SPAENDONCK
Affiliation:
National Institute for Public Health and the Environment, Bilthoven, The Netherlands
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Abstract

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The distribution of antibody levels to Legionella (L.) pneumophila (serotypes 1–7) was compared between subjects who worked near the source of a large outbreak of Legionnaires' disease (n=668) and a population sample of comparable age (n=480). In a previous analysis of these data, it was estimated that 80% of those working near the source were infected with L. pneumophila. However, the estimation procedure implicitly assumes that the probability of infection does not depend on the antibody level of a person before exposure. This is questionable, as antibodies could protect against infection. We have now estimated the minimum value consistent with the data on the number of infected persons. We observed that a minimum of 40% [95% confidence interval (CI) 32–48] of those working near the source and 13% (95% CI 8–18) of those working further away were infected with L. pneumophila. Implications of these findings for design options in future research are discussed.

Type
Research Article
Information
Epidemiology & Infection , Volume 134 , Issue 3 , June 2006 , pp. 579 - 584
Copyright
2005 Cambridge University Press