Background

HISTORY
In 1986, the European Working Group for Legionella Infections (EWGLI) was set up to facilitate international collaboration across Europe with regards to Legionnaires' disease. In 1987, EWGLI introduced the European Surveillance Scheme for Travel Associated Legionnaires’ Disease that later came to be known as EWGLINET. The scheme was coordinated by the National Bacteriology Laboratory in Stockholm and funded by WHO until 1993 when the coordination was transferred to the Public Health Laboratory Service Communicable Disease Surveillance Centre in London and the European Commission became the main source of financial support. Between 2007 and 2010, EWGLINET was funded by ECDC. Since April 2010, it is also coordinated by ECDC, with the name of the scheme changing to European Legionnaires’ Disease Surveillance Network (ELDSNet).

RELEVANT SURVEILLANCE GOALS AND OBJECTIVES
(as approved by the ECDC Advisory Forum in October 2008)

General surveillance goals:

Monitor trends over time to assess the present situation and compare trends across Member States.
Detect and monitor any outbreaks with respect to source, time, person, population and place to provide a rationale for public health action.
Contribute to the evaluation and monitoring of prevention and control programmes to provide the evidence for recommendations to strengthen and improve these programmes at the national and European level.
Contribute to the assessment of the burden of communicable diseases on the population.
Generate hypotheses on (new) sources, modes of transmission and groups most at risk and identify needs for research.

General objectives for strengthening surveillance:

Collect and disseminate validated and comparable information on communicable diseases.
Improve and update methodologies and quality assurance.
Define surveillance outputs that will provide added value by informing public health decisions and actions at the EU and/or Member State level.
Consolidate outbreak detection and monitoring in EU Member States and at the EU level.
Strengthen the laboratory surveillance in EU Member States.
Strengthen national capacities for surveillance and contribute to the evaluation of prevention and control programmes.
Promote the wider use of surveillance data for a maximum of public health benefit, including research projects at a European level.
Ensure patient confidentiality and legal foundation for data collection in individual member states.

Objectives of Legionnaires’ disease surveillance:

Monitor the incidence of Legionnaires’ disease over time with respect to both community- acquired and travel-associated cases
Monitor the morbidity and mortality due to Legionnaires’ disease and attempt to identify particularly vulnerable populations.
Provide relevant epidemiological and microbiological data to contribute to the development of recommendations on the control of outbreaks.
Promote the development of a laboratory network for Legionnaires’ disease, including quality assurance and training.
Support training for environmental microbiologists and public health experts in Legionnaires’ disease surveillance methods.

LEGAL BASIS FOR SURVEILLANCE
In setting up a network for the epidemiological surveillance and control of communicable diseases in the Community, Decision No 2119/98/EC of 24 September 1998 lists water-borne diseases and diseases of environmental origin among the categories of diseases to be progressively covered.
Elaborating on Decision No 2119/98/EC, Decision No 2000/96/EC of 22 December 1999 lists Legionnaires’ disease under other airborne disease to be progressively covered by the Community network.
Decision No 2008/426/EC contains the latest version of the case definitions for reporting communicable diseases to the Community network, including a case definition for Legionnaires’ disease.
Regulation (EC) No 851/2004 establishes ECDC charging it, among other tasks, with the integrated operation of dedicated surveillance networks and with the identification of emerging health threats.