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Chapter 66 : Legionellosis in Sweden
A voluntary, laboratory-based reporting system of legionellosis was initiated in Sweden in 1981 and became compulsory in January 1996. According to the Swedish Act for Communicable Diseases, clinicians have to report all diagnosed cases of legionellosis since 1 July 1989. The incidence rate for reported cases of legionellosis during 1995 to 1999 ranged from 0.57 to 1.15 per 100,000 inhabitants. An estimation of sources of infection indicates that about one-third of the cases had a domestic, community-acquired infection and another third contracted legionellosis during travel abroad. The first recognized indigenous outbreak of legionellosis in Sweden occurred as early as 1979, when 58 persons contracted legionellosis at an indoor shopping center in a medium-sized Swedish town. The information is reported to the European Working Group for Legionella Infections (EWGLI) database. Five persons received treatment against legionellosis at a hospital after a weekend trip to Paris in 1988. In 1990, several Nordic tourists including 13 Swedes were reported to have contracted legionellosis during a visit to Majorca. At least 20 Swedish tourists had shown symptoms of legionellosis. Several persons in a group of bridge players, who went to Kusadasi in Turkey in 1996, also contracted legionellosis.