In outbreaks with potential international implications
All travel-associated (TALD)
and all community-acquired outbreaks should be considered as having potential international
implications, i.e. involving cases of Legionnaires' disease in other countries. For
TALD, an established
procedure for sharing information within ELDSNet exists (see http://ecdc.europa.eu/en/activities/surveillance/ELDSNet/Pages/Index.aspx). For
community-acquired outbreaks, past experience has shown that additional cases with matching
outbreak strains can be found in international travellers living in other countries. Sharing
information on community outbreaks allows for active case finding and cases identified are to
be considered outliers with potential interesting information for source identification.
EPIS ELDSNet allows for sharing information on
community-acquired outbreaks with the network of relevant public health authorities.
Information sharing and collaboration:
- Consider using EPIS -
for sharing information on risk assessment and outbreak investigation.
- Consider issuing a EWRS
 message to Member States focussing on risk management and the control measures taken in the
country of origin and other countries.
IHR [WHO, 2005, http] are designed to provide security
against the international spread of infectious diseases. Although Legionellosis is not
incorporated into the lists of diseases in the IHR (WHO, 2005), any disease event that meets the criteria
described in the Regulations (serious public health impact, unexpected, likely to spread
internationally or likely to result in travel or trade restrictions) must be notified to
WHO following the inception
of the IHR (2005) in June
- Consider publishing a preliminary report (e.g. Eurosurveillance)
- Consider performing an analytical study
- Investigations might need to be managed from an incident room within a national public
 The Network for the Surveillance and Control of
Communicable Diseases has been established to promote cooperation and coordination between
the Member States, with the assistance of the European Commission, with a view to improving
the prevention and control, in the community, of communicable diseases. The Network includes
an Early Warning and Response
System (EWRS), which is
formed by bringing into permanent communication with one another, through appropriate means,
the Commission and the competent public health authorities in each Member State responsible
for determining the measures which may be required to protect public health.