Most knowledge regarding Legionnaires’ disease comes from outbreak investigations; however, only 4% of cases are associated with known outbreaks and are thoroughly investigated. In the United States, the rate of reported cases of Legionnaires’ disease has grown by nearly nine times since 2000. Outbreaks of Legionnaires’ disease are associated with inhalation or aspiration of aerosolized water from a variety of sources. Major risk factors include older age, a history of smoking, chronic lung disease, and a compromised immune system. Closing research and policy gaps around Legionnaires’ disease is imperative to preventing further increases in disease. Because this disease is tied so closely with built water systems, successful efforts will require collaboration between partners in public health, microbiology, environmental health, and engineering, among others.
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