{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T02:14:39Z","timestamp":1790734479314,"version":"4.1.0"},"reference-count":43,"publisher":"Cambridge University Press (CUP)","issue":"14","license":[{"start":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T00:00:00Z","timestamp":1534118400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"},{"start":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T00:00:00Z","timestamp":1534118400000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["www.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2018,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>According to the Centers for Disease Control and Prevention (CDC), from 2000 to 2014, reported cases of legionellosis per 100 000 population increased by 300% in the USA, although reports on disease seasonality are inconsistent. Using two national databases, we assessed seasonal patterns of legionellosis in the USA. We created a monthly time series from 1993 to 2015 of reported cases of legionellosis from the CDC, and from 1997 to 2006 of medical claims of legionellosis-related hospitalisation in older adults from the Centers for Medicaid and Medicare Services (CMS). We split the study time interval into two segments (before and after 2003), and applied a Poisson harmonic regression model to each dataset and each segment. The time series of monthly counts exhibited a significant shift of seasonal peaks from mid-September (9.676 \u00b1 0.164 months) before 2003 to mid-August (8.452 \u00b1 0.042 months) after 2003, along with an alarming increase in the amplitude of seasonal peaks in both CDC and CMS data. The lowest monthly reported cases of legionellosis in 2015 (281) exceed the maximum value reported before 2003 (206). We also observed a discrepancy between CDC and CMS data, suggesting that not all cases of legionellosis diagnosed by hospital-based laboratories were reported to the CDC. Improved reporting of legionellosis is required to better inform the public and organise disease prevention.<\/jats:p>","DOI":"10.1017\/s0950268818002182","type":"journal-article","created":{"date-parts":[[2018,8,13]],"date-time":"2018-08-13T07:19:02Z","timestamp":1534144742000},"page":"1824-1833","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":47,"title":["The shift in seasonality of legionellosis in the USA"],"prefix":"10.1017","volume":"146","author":[{"given":"T. M.","family":"Alarcon Falconi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. S.","family":"Cruz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9562-4734","authenticated-orcid":false,"given":"E. N.","family":"Naumova","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2018,8,13]]},"reference":[{"key":"S0950268818002182_ref33","first-page":"437","volume-title":"Advances in Statistical Methods for the Health Sciences","author":"Naumova","year":"2006"},{"key":"S0950268818002182_ref26","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2458-9-447"},{"key":"S0950268818002182_ref10","unstructured":"Centers for Disease Control and Prevention (CDC). Active Bacterial Core surveillance (ABCs). Background. Available at https:\/\/www.cdc.gov\/abcs\/overview\/background.html (Accessed 26 February 2018)."},{"key":"S0950268818002182_ref8","first-page":"1083","article-title":"Legionellosis \u2013 United States, 2000\u20132009","volume":"60","year":"2011","journal-title":"MMWR Morbidity and Mortality Weekly Report"},{"key":"S0950268818002182_ref43","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268817001170"},{"key":"S0950268818002182_ref42","doi-asserted-by":"publisher","DOI":"10.3201\/eid1704.100446"},{"key":"S0950268818002182_ref25","doi-asserted-by":"crossref","first-page":"461","DOI":"10.33321\/cdi.2002.26.45","article-title":"A review of national legionellosis surveillance in Australia, 1991 to 2000","volume":"26","author":"Li","year":"2002","journal-title":"Communicable Diseases Intelligence"},{"key":"S0950268818002182_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(14)70713-3"},{"key":"S0950268818002182_ref37","unstructured":"Naik FC and Phin N (2014) Legionnaires\u2019 disease in England and Wales 20133. 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Legionnaires\u2019 disease in Europe, 2014. 2016."},{"key":"S0950268818002182_ref9","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6442a2"},{"key":"S0950268818002182_ref18","doi-asserted-by":"publisher","DOI":"10.1186\/s13756-017-0213-0"},{"key":"S0950268818002182_ref32","doi-asserted-by":"crossref","first-page":"480","DOI":"10.1002\/sim.3886","article-title":"Measuring disease burden in the older population using the slope-intercept method for population log-linear estimation (SIMPLE)","volume":"30","author":"Cohen","year":"2011","journal-title":"Statistics in Medicine"},{"key":"S0950268818002182_ref40","doi-asserted-by":"publisher","DOI":"10.1021\/acs.est.6b04754"},{"key":"S0950268818002182_ref6","doi-asserted-by":"crossref","first-page":"E46","DOI":"10.33321\/cdi.2015.39.7","article-title":"Australia's notifiable disease status, 2012: annual report of the National Notifiable Diseases Surveillance System","volume":"39","year":"2015","journal-title":"Communicable Diseases Intelligence"},{"key":"S0950268818002182_ref38","doi-asserted-by":"publisher","DOI":"10.1086\/342903"},{"key":"S0950268818002182_ref19","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816001874"},{"key":"S0950268818002182_ref7","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6354a1"},{"key":"S0950268818002182_ref15","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.3.506-526.2002"},{"key":"S0950268818002182_ref36","doi-asserted-by":"publisher","DOI":"10.2807\/ese.18.23.20497-en"},{"key":"S0950268818002182_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268811000975"},{"key":"S0950268818002182_ref24","doi-asserted-by":"publisher","DOI":"10.3201\/eid2311.170137"},{"key":"S0950268818002182_ref27","doi-asserted-by":"publisher","DOI":"10.1086\/590557"},{"key":"S0950268818002182_ref35","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0092206"},{"key":"S0950268818002182_ref14","volume-title":"Legionella and the Prevention of Legionellosis","author":"Bartram","year":"2007"},{"key":"S0950268818002182_ref12","doi-asserted-by":"publisher","DOI":"10.3201\/eid2011.131872"},{"key":"S0950268818002182_ref34","unstructured":"United States Department of Health and Human Services (USDHHS), Centers for Disease Control and Prevention (CDC), National Center for Health Statistics (NCHS). Bridged-Race Population Estimates, United States July 1st resident population by state, county, age, sex, bridged-race, and Hispanic origin. Compiled from 1990\u20132015. Available on CDC WONDER Online Database."},{"key":"S0950268818002182_ref1","unstructured":"Michigan Department of Health and Human Services. Genesee County Public Health Department. Legionellosis Outbreak-Genesee County, June, 2014 \u2013 March, 2015 Summary Analysis. 2016."},{"key":"S0950268818002182_ref29","doi-asserted-by":"publisher","DOI":"10.1057\/s41271-016-0038-8"},{"key":"S0950268818002182_ref2","unstructured":"Michigan Department of Health and Human Services. Genesee County Public Health Department. Legionellosis Outbreak-Genesee County, May, 2015 \u2013 November, 2015 Summary Analysis. 2016."},{"key":"S0950268818002182_ref5","unstructured":"Ontario Agency for Health Protection and Promotion (Public Health Ontario). Epidemiology of legionellosis in Ontario, 2013. Surveillance period: January 1, 2013 to December 31, 2013. Toronto, ON, 2014."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268818002182","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,7,6]],"date-time":"2025-07-06T09:23:51Z","timestamp":1751793831000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268818002182\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,8,13]]},"references-count":43,"journal-issue":{"issue":"14","published-online":{"date-parts":[[2018,10]]}},"alternative-id":["S0950268818002182"],"URL":"https:\/\/doi.org\/10.1017\/s0950268818002182","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,8,13]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2018\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}