背景:报告的军团菌病病例在2001年至2012年间在美国增加了两倍多。该疾病主要是由于暴露于被军团菌污染的雾化水。
目的:确定并描述美国军团菌病一级预防的政策和指南。
方法:2012年3月至6月,在互联网上搜索了美国联邦和州一级的军团菌预防指南。还包括在最初搜索中确定的地方政府机构指南和专业组织的指南。
方法:联邦,state,以及地方管理机构和专业组织。
结果:军团菌病一级预防指南和法规(即,军团病和庞蒂亚克热)已由联邦的各种公共卫生和其他政府机构开发,state,和地方层面以及专业组织。这些准则在建议维护建筑物供水系统方面是相似的;联邦和其他准则在目标人口/机构方面有所不同,技术细节的程度,并支持监测水系统的军团菌污染水平。
结论:军团菌病应在研究和政策制定方面给予更高的公共卫生优先权。公共卫生机构对军团病一级预防的指导需要加强,因为这种疾病作为严重发病率和死亡率的原因的重要性不断升级。我们建议对预防军团菌病的国家公共卫生指南进行正式和全面的审查。
BACKGROUND: Reported cases of
legionellosis more than tripled between 2001 and 2012 in the United States. The disease results primarily from exposure to aerosolized water contaminated with Legionella.
OBJECTIVE: To identify and describe policies and guidelines for the primary prevention of
legionellosis in the US.
METHODS: An Internet search for Legionella prevention guidelines in the United States at the federal and state levels was conducted from March to June 2012. Local government agency
guidelines and
guidelines from professional organizations that were identified in the initial search were also included.
METHODS: Federal, state, and local governing bodies and professional organizations.
RESULTS: Guidelines and regulations for the primary prevention of
legionellosis (ie, Legionnaires\' disease and Pontiac fever) have been developed by various public health and other government agencies at the federal, state, and local levels as well as by professional organizations. These guidelines are similar in recommending maintenance of building water systems; federal and other guidelines differ in the population/institutions targeted, the extent of technical detail, and support of monitoring water systems for levels of Legionella contamination.
CONCLUSIONS: Legionellosis deserves a higher public health priority for research and policy development. Guidance across public health agencies for the primary prevention of legionellosis requires strengthening as this disease escalates in importance as a cause of severe morbidity and mortality. We recommend a formal and comprehensive review of national public health guidelines for prevention of
legionellosis.