Legionellosis / Legionnaires’ Disease or Pontiac Fever | CDC

NOTE: A surveillance case definition is a set of uniform criteria used to define a disease for public health surveillance. Surveillance case definitions enable public health officials to classify and count cases consistently across reporting jurisdictions. Surveillance case definitions are not intended to be used by healthcare providers for making a clinical diagnosis or determining how to meet an individual patient’s health needs.

Clinical Description

Legionellosis is associated with two clinically and epidemiologically distinct illnesses: Legionnaires’ disease, which is characterized by fever, myalgia, cough, pneumonia, and Pontiac fever, a milder illness without pneumonia.

Laboratory Criteria For Diagnosis

  • Isolation of Legionella from respiratory secretions, lung tissue, pleural fluid, or other normally sterile fluids, OR
  • Demonstration of a fourfold or greater rise in the reciprocal immunofluorescence antibody (IFA) titer to greater than or equal to 128 against Legionella pneumophila serogroup 1 between paired acute- and convalescent-phase serum specimens, OR
  • Detection of L. pneumophila serogroup 1 in respiratory secretions, lung tissue, or pleural fluid by direct fluorescent antibody testing, OR
  • Demonstration of L. pneumophila serogroup 1 antigens in urine by radioimmunoassay or enzyme-linked immunosorbent assay

Case Classification

Confirmed

A clinically compatible case that is laboratory confirmed

Comments

The previously used category of "probable case," which was based on a single IFA titer, lacks specificity for surveillance and is no longer used.

References(s)

1. CSTE. Strengthening surveillance for travel-associated legionellosis and revised case definitions for legionellosis. Position statement 05-ID-01 available at http://www.cste.org/resource/resmgr/PS/05-ID-01FINAL.pdf.

2. CDC. (1990). Case Definitions for Public Health Surveillance. MMWR, 39(RR-13), 1-43. https://www.cdc.gov/mmwr/preview/mmwrhtml/00025629.htm

3. CSTE. Public health reporting and national notification for legionellosis. Position statement 09-ID-45 available at http://www.cste.org/resource/resmgr/PS/09-ID-45.pdf.

Related Case Definition(s)

Page last reviewed: April 16, 2021