{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T18:12:09Z","timestamp":1787767929180,"version":"build-2784847793"},"reference-count":30,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T00:00:00Z","timestamp":1593388800000},"content-version":"unspecified","delay-in-days":180,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2020]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>From 2011 through 2018, there was a notable increase in sporadic Legionnaires' disease in the state of Minnesota. Sporadic cases are those not associated with a documented outbreak. Outbreak-related cases are typically associated with a common identified contaminated water system; sporadic cases typically do not have a common source that has been identified. Because of this, it is hypothesised that weather and environmental factors can be used as predictors of sporadic Legionnaires' disease. An ecological design was used with case report surveillance data from the state of Minnesota during 2011 through 2018. Over this 8-year period, there were 374 confirmed Legionnaires' disease cases included in the analysis. Precipitation, temperature and relative humidity (RH) data were collected from weather stations across the state. A Poisson regression analysis examined the risk of Legionnaires' disease associated with precipitation, temperature, RH, land-use and age. A lagged average 14-day precipitation had the strongest association with Legionnaires' disease (RR 2.5, CI 2.1\u20132.9), when accounting for temperature, RH, land-use and age. Temperature, RH and land-use also had statistically significant associations to Legionnaires' disease, but with smaller risk ratios. This study adds to the body of evidence that weather and environmental factors play an important role in the risk of sporadic Legionnaires' disease. This is an area that can be used to target additional research and prevention strategies.<\/jats:p>","DOI":"10.1017\/s0950268820001417","type":"journal-article","created":{"date-parts":[[2020,6,29]],"date-time":"2020-06-29T03:53:51Z","timestamp":1593402831000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":16,"title":["The association between sporadic Legionnaires' disease and weather and environmental factors, Minnesota, 2011\u20132018"],"prefix":"10.1017","volume":"148","author":[{"given":"J. K.","family":"Passer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R. N.","family":"Danila","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. S.","family":"Laine","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K. J.","family":"Como-Sabetti","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W.","family":"Tang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1316-9342","authenticated-orcid":false,"given":"K. M.","family":"Searle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2020,6,29]]},"reference":[{"key":"S0950268820001417_ref23","unstructured":"23. World Health Organization (2018) Legionellosis: 16 February 2018. Available at https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/legionellosis (Accessed 28 April 2019)."},{"key":"S0950268820001417_ref30","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268816001874"},{"key":"S0950268820001417_ref9","unstructured":"9. Centers for Disease Control and Prevention (2018) Prevention: 30 April 2018. Available at https:\/\/www.cdc.gov\/legionella\/about\/prevention.html (Accessed 25 February 2019)."},{"key":"S0950268820001417_ref10","unstructured":"10. Centers for Disease Control and Prevention (2018) Clinical features: 30 April 2018. Available at https:\/\/www.cdc.gov\/legionella\/clinicians\/clinical-features.html (Accessed 25 February 2019)."},{"key":"S0950268820001417_ref7","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197712012972201"},{"key":"S0950268820001417_ref12","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268806007552"},{"key":"S0950268820001417_ref16","unstructured":"16. Minnesota Department of Health (n.d.). Reporting Legionellosis: n.d.. Available at https:\/\/www.health.state.mn.us\/diseases\/legionellosis\/report.html (Accessed 28 April 2019)."},{"key":"S0950268820001417_ref6","doi-asserted-by":"publisher","DOI":"10.1097\/EDE.0b013e31820937c6"},{"key":"S0950268820001417_ref8","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMc1505356"},{"key":"S0950268820001417_ref27","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880800157X"},{"key":"S0950268820001417_ref5","doi-asserted-by":"crossref","first-page":"1006","DOI":"10.3201\/eid1406.080345","article-title":"Legionella and the prevention of legionellosis","volume":"14","author":"Bartram","year":"2008","journal-title":"Emerging Infectious Diseases"},{"key":"S0950268820001417_ref18","unstructured":"18. Centers for Disease Control and Prevention (2018) Outbreaks: 30 April 2018. Available at https:\/\/www.cdc.gov\/legionella\/outbreaks.html (Accessed 29 February 2019)."},{"key":"S0950268820001417_ref2","unstructured":"2. Centers for Disease Control and Prevention (2018) Preventing Legionnaires\u2019 disease: a training on Legionella water management programs: 14 December 2018. Available at https:\/\/www.cdc.gov\/nceh\/ehs\/elearn\/prevent-LD-training.html (Accessed 25 February 2019)."},{"key":"S0950268820001417_ref3","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.00029-14"},{"key":"S0950268820001417_ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s10393-009-0218-0"},{"key":"S0950268820001417_ref19","unstructured":"19. National Centers for Environmental Information. Available at https:\/\/www.ncdc.noaa.gov\/data-access\/land-based-station-data\/land-based-datasets\/cooperative-observer-network-coop (Accessed 28 April 2019)."},{"key":"S0950268820001417_ref1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.3.506-526.2002"},{"key":"S0950268820001417_ref4","unstructured":"4. Centers for Disease Control and Prevention (2018) What owners and managers of buildings and healthcare facilities need to know about the growth and spread of Legionella: 30 April 2018. Available at https:\/\/www.cdc.gov\/legionella\/wmp\/overview\/growth-and-spread.html (Accessed 25 February 2019)."},{"key":"S0950268820001417_ref21","unstructured":"21. National Centers for Environmental Information. Available at https:\/\/www.ncdc.noaa.gov\/IPS\/lcd\/lcd.html?_page=1&state=MN&stationID=14926&_target2=Next+%3E (Accessed 26 March 2019)."},{"key":"S0950268820001417_ref22","unstructured":"22. U.S. Geologic Survey. Available at https:\/\/www.usgs.gov\/gapanalysis\/land-cover-data-download?qt-science_center_objects=0#qt-science_center_objects (Accessed 28 April 2019)."},{"key":"S0950268820001417_ref28","doi-asserted-by":"publisher","DOI":"10.1086\/498248"},{"key":"S0950268820001417_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813003476"},{"key":"S0950268820001417_ref13","doi-asserted-by":"publisher","DOI":"10.3201\/eid2311.170137"},{"key":"S0950268820001417_ref25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0061036"},{"key":"S0950268820001417_ref14","doi-asserted-by":"publisher","DOI":"10.1017\/S095026880800099X"},{"key":"S0950268820001417_ref11","unstructured":"11. United States Environmental Protection Agency (2016) What climate change means for Minnesota: August 2016. Available at https:\/\/www.epa.gov\/sites\/production\/files\/2016-09\/documents\/climate-change-mn.pdf (Accessed 28 March 2019)."},{"key":"S0950268820001417_ref15","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813003294"},{"key":"S0950268820001417_ref24","unstructured":"24. U.S. Census Bureau QuickFacts: Minnesota. Available at https:\/\/www.census.gov\/quickfacts\/mn (Accessed 28 April 2019)."},{"key":"S0950268820001417_ref17","unstructured":"17. Centers for Disease Control and Prevention (2018) CDC surveillance classifications: 30 April 2018. Available at https:\/\/www.cdc.gov\/legionella\/health-depts\/surv-reporting\/surveillance-classifications.html. (Accessed 1 March 2019)."},{"key":"S0950268820001417_ref20","unstructured":"20. Minnesota Department of National Resources. Available at https:\/\/www.dnr.state.mn.us\/climate\/historical\/acis_stn_meta.html (Accessed 15 March 2019)."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268820001417","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2020,7,24]],"date-time":"2020-07-24T03:38:35Z","timestamp":1595561915000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268820001417\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020]]},"references-count":30,"alternative-id":["S0950268820001417"],"URL":"https:\/\/doi.org\/10.1017\/s0950268820001417","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020]]},"assertion":[{"value":"Copyright \u00a9 The Author(s), 2020. Published by Cambridge University Press","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}],"article-number":"e156"}}