{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,26]],"date-time":"2026-10-26T12:31:36Z","timestamp":1793017896822,"version":"4.5.0"},"reference-count":32,"publisher":"Cambridge University Press (CUP)","issue":"5","license":[{"start":{"date-parts":[[2006,11,23]],"date-time":"2006-11-23T00:00:00Z","timestamp":1164240000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2007,5]]},"abstract":"<jats:title>SUMMARY<\/jats:title>\n                  <jats:p>\n                    Legionnaires' disease (LD) is caused by\n                    <jats:italic>Legionella<\/jats:italic>\n                    species, most of which live in water. The Mid-Atlantic region experienced a sharp rise in LD in 2003 coinciding with a period of record-breaking rainfall. To investigate a possible relationship, we analysed the association between monthly legionellosis incidence and monthly rainfall totals from January 1990 to December 2003 in five Mid-Atlantic states. Using negative binomial model a 1-cm increase in rainfall was associated with a 2\u00b76% (RR 1\u00b7026, 95% CI 1\u00b7012\u20131\u00b7040) increase in legionellosis incidence. The average monthly rainfall from May to September 1990\u20132002 was 10\u00b74\u00a0cm compared to 15\u00b77\u00a0cm from May to September 2003. This change in rainfall corresponds to an increased risk for legionellosis of approximately 14\u00b76% (RR 1\u00b7146, 95% CI 1\u00b7067\u20131\u00b7231). Legionellosis incidence increased during periods of increased rainfall; identification of mechanisms that increase exposure and transmission of\n                    <jats:italic>Legionella<\/jats:italic>\n                    during rainfall might lead to opportunities for prevention.\n                  <\/jats:p>","DOI":"10.1017\/s0950268806007552","type":"journal-article","created":{"date-parts":[[2006,11,23]],"date-time":"2006-11-23T07:54:31Z","timestamp":1164268471000},"page":"811-817","source":"Crossref","is-referenced-by-count":98,"title":["Increased rainfall is associated with increased risk for legionellosis"],"prefix":"10.1017","volume":"135","author":[{"given":"L.\u00a0A.","family":"HICKS","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"suffix":"Jr.","given":"C.\u00a0E.","family":"ROSE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.\u00a0S.","family":"FIELDS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M.\u00a0L.","family":"DREES","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J.\u00a0P.","family":"ENGEL","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P.\u00a0R.","family":"JENKINS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B.\u00a0S.","family":"ROUSE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"BLYTHE","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.\u00a0P.","family":"KHALIFAH","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.\u00a0R.","family":"FEIKIN","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.\u00a0G.","family":"WHITNEY","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2006,11,23]]},"reference":[{"key":"S0950268806007552_ref032","doi-asserted-by":"publisher","DOI":"10.1136\/jcp.33.12.1179"},{"key":"S0950268806007552_ref027","doi-asserted-by":"publisher","DOI":"10.1093\/ije\/23.5.1082"},{"key":"S0950268806007552_ref025","doi-asserted-by":"publisher","DOI":"10.1016\/S0001-706X(99)00059-5"},{"key":"S0950268806007552_ref016","doi-asserted-by":"publisher","DOI":"10.1086\/324211"},{"key":"S0950268806007552_ref012","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(96)91137-X"},{"key":"S0950268806007552_ref010","doi-asserted-by":"publisher","DOI":"10.1086\/338060"},{"key":"S0950268806007552_ref021","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/138.4.512"},{"key":"S0950268806007552_ref031","first-page":"1861","article-title":"The 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