{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T09:59:58Z","timestamp":1792403998364,"version":"4.4.0"},"reference-count":37,"publisher":"Cambridge University Press (CUP)","license":[{"start":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T00:00:00Z","timestamp":1729123200000},"content-version":"unspecified","delay-in-days":290,"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":[[2024]]},"abstract":"<jats:title>Abstract<\/jats:title>\n\t  <jats:p>Legionellosis is a respiratory infection caused by <jats:italic>Legionella<\/jats:italic> sp. that is found in water and soil. Infection may cause pneumonia (Legionnaires\u2019 Disease) and a milder form (Pontiac Fever). <jats:italic>Legionella<\/jats:italic> colonizes water systems and results in exposure by inhalation of aerosolized bacteria. The incubation period ranges from 2 to 14 days. Precipitation and humidity may be associated with increased risk. We used Medicare records from 1999 to 2020 to identify hospitalizations for legionellosis. Precipitation, temperature, and relative humidity were obtained from the PRISM Climate Group for the zip code of residence. We used a time-stratified bi-directional case-crossover design with lags of 20 days. Data were analyzed using conditional logistic regression and distributed lag non-linear models. A total of 37\u00a0883 hospitalizations were identified. Precipitation and relative humidity at lags 8 through 13 days were associated with an increased risk of legionellosis. The strongest association was precipitation at day 10 lag (OR = 1.08, 95% CI = 1.05\u20131.11 per 1 cm). Over 20 days, 3 cm of precipitation increased the odds of legionellosis over four times. The association was strongest in the Northeast and Midwest and during summer and fall. Precipitation and humidity were associated with hospitalization among Medicare recipients for legionellosis at lags consistent with the incubation period for infection.<\/jats:p>","DOI":"10.1017\/s0950268824000979","type":"journal-article","created":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T10:52:03Z","timestamp":1729162323000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":10,"title":["Weather conditions and legionellosis: a nationwide case-crossover study among Medicare recipients"],"prefix":"10.1017","volume":"152","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7843-0997","authenticated-orcid":false,"given":"Timothy J.","family":"Wade","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carly","family":"Herbert","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,10,17]]},"reference":[{"key":"S0950268824000979_r13","doi-asserted-by":"crossref","first-page":"687","DOI":"10.1017\/S095026881200101X","article-title":"Meteorological conditions and incidence of Legionnaires\u2019 disease in Glasgow, Scotland: Application of statistical modelling","volume":"141","author":"Dunn","year":"2013","journal-title":"Epidemiology and Infection"},{"key":"S0950268824000979_r37","unstructured":"[37] Barskey, A , Lee, S , Hannapel, E , Smith, J and Edens, C (2022) Legionnaires\u2019 Disease Surveillance Summary Report, United States. Centers for Disease Control and Prevention, Division of Bacterial Diseases, National Center for Immunication and Respiratory Diseases. https:\/\/www.cdc.gov\/legionella\/health-depts\/surv-reporting\/2018-19-surv-report-508.pdf."},{"key":"S0950268824000979_r30","doi-asserted-by":"publisher","DOI":"10.1175\/BAMS-86-2-225"},{"key":"S0950268824000979_r15","doi-asserted-by":"crossref","first-page":"e114337","DOI":"10.1371\/journal.pone.0114337","article-title":"Precipitation increases the occurrence of sporadic legionnaires\u2019 disease in Taiwan","volume":"9","author":"Chen","year":"2014","journal-title":"PLoS One"},{"key":"S0950268824000979_r6","volume-title":"Legionella and the Prevention of Legionellosis","author":"Bartram","year":"2007"},{"key":"S0950268824000979_r18","doi-asserted-by":"publisher","DOI":"10.1016\/j.envres.2023.116327"},{"key":"S0950268824000979_r21","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2021.05.018"},{"key":"S0950268824000979_r26","doi-asserted-by":"publisher","DOI":"10.1017\/S0950268813003476"},{"key":"S0950268824000979_r16","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0061036"},{"key":"S0950268824000979_r31","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a115853"},{"key":"S0950268824000979_r33","doi-asserted-by":"crossref","first-page":"689","DOI":"10.1002\/1099-095X(200011\/12)11:6<689::AID-ENV439>3.0.CO;2-N","article-title":"Bias in the case\u2013crossover design: Implications for studies of air pollution","volume":"11","author":"Lumley","year":"2000","journal-title":"Environmetrics: The Official Journal of the International Environmetrics 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Centers for Disease Control and Prevention (2023) Legionella (Legionnaires\u2019 Disease and Pontiac fever) Causes and Transmission. https:\/\/www.cdc.gov\/legionella\/about\/causes-transmission.html (accessed 24 July 2023)."},{"key":"S0950268824000979_r29","doi-asserted-by":"publisher","DOI":"10.32614\/RJ-2013-014"},{"key":"S0950268824000979_r1","doi-asserted-by":"publisher","DOI":"10.1128\/CMR.15.3.506-526.2002"}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0950268824000979","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,17]],"date-time":"2024-10-17T10:52:09Z","timestamp":1729162329000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0950268824000979\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024]]},"references-count":37,"alternative-id":["S0950268824000979"],"URL":"https:\/\/doi.org\/10.1017\/s0950268824000979","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024]]},"assertion":[{"value":"\u00a9 United States Environmental Protection Agency, 2024","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is a work of the US Government and is not subject to copyright protection within the United States. Published by Cambridge University Press","name":"license","label":"License","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, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e125"}}