Infection with Legionella is an important cause of community-acquired pneumonia and occasionally multi-systemic disease, occurring both sporadically and in outbreaks. Legionella infections can cause a spectrum of symptoms, including subclinical infection (infection with no disease).

Fits clinical description Tick Yes if the case fits the clinical description as follows:

For notification purposes Legionella infections can be classified into three categories:

• pneumonia (Legionnaires’ disease)
• non-pneumonic disease (e.g. Pontiac fever) – a self-limiting acute febrile illness which may be accompanied by cough
• extrapulmonary disease – involving skin, joints, pericardium or other organs

Although the most common clinical manifestation of legionellosis reported worldwide is Legionnaires’ disease, non-pneumonic disease is often clinically unrecognised and therefore likely to be under-reported.

Clinical features
Ideally, obtain information on all of the clinical features listed. If the feature was present, record by ticking the box. If the disease is extrapulmonary, specify the site.