Evidence map›Paper›PMID 37503568›Full record

ArticleEpidemiology and infection2023

Legionellosis on the rise: A scoping review of sporadic, community-acquired incidence in the United States.

Michelle A Moffa, Clare Rock, Panagis Galiatsatos, Shantini D Gamage, Kellogg J Schwab, Natalie G Exum

Abstract readScoping Review
In one paragraph

Article in Epidemiology and infection, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers.

0numbers the graph read from it
0cells of the map it votes in
21citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

21 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Global climate gradients structure soilbioRxiv : the preprint server for biology · 2026
    Article
  5. Seasonality and effects of climatic exposures on community-acquired Legionnaires' disease incidence, Italy, 2005 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2026
    Article
  6. Mucin stimulates the growth ofMicrobiology (Reading, England) · 2026
    Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Observational
  14. Review
  15. Article
  16. The Brief Case: A fatal case ofJournal of clinical microbiology · 2024
    Review
  17. Article
  18. Article
  19. Review
  20. Severe Legionnaires' disease.Annals of intensive care · 2024
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Michelle A MoffaDepartment of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0002-2830-946X
Clare RockDivision of Infectious Diseases, Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0001-6502-8096
Panagis GaliatsatosMedicine for the Greater Good, Johns Hopkins University School of Medicine, Baltimore, MD, USA.ORCID 0000-0001-8309-0985
Shantini D GamageU.S. Department of Veterans Affairs, National Infectious Diseases Service, Veterans Health Administration, Washington, DC, USA.ORCID 0000-0001-7541-7976
Kellogg J SchwabDepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID 0000-0002-4966-8517
Natalie G ExumDepartment of Environmental Health and Engineering, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.ORCID 0000-0002-8374-4034

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Over the past two decades, the incidence of legionellosis has been steadily increasing in the United States though there is noclear explanation for the main factors driving the increase. While legionellosis is the leading cause of waterborne outbreaks in the US, most cases are sporadic and acquired in community settings where the environmental source is never identified. This scoping review aimed to summarise the drivers of infections in the USA and determine the magnitude of impact each potential driver may have. A total of 1,738 titles were screened, and 18 articles were identified that met the inclusion criteria. Strong evidence was found for precipitation as a major driver, and both temperature and relative humidity were found to be moderate drivers of incidence. Increased testing and improved diagnostic methods were classified as moderate drivers, and the ageing U.S. population was a minor driver of increasing incidence. Racial and socioeconomic inequities and water and housing infrastructure were found to be potential factors explaining the increasing incidence though they were largely understudied in the context of non-outbreak cases. Understanding the complex relationships between environmental, infrastructure, and population factors driving legionellosis incidence is important to optimise mitigation strategies and public policy.

Indexed as

LegionellosisLegionnaires' DiseaseDisease OutbreaksHumansIncidenceTemperatureUnited Statesbuilt environmentclimatecommunity-acquired pneumoniadrinking waterLegionellaLegionellosis (Pontiac fever)Legionnaires’ Disease

Identifiers

PMID37503568
PMCPMC10540183

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.