Travel-associated Legionnaires disease in Europe: 2006.

Twenty countries reported 921 cases of travel-associated Legionnaires' disease to EWGLINET (the European Surveillance Scheme for Travel-Associated Legionnaires' Disease) with onset during 2006; 875 confirmed and 46 presumptive. Thirty three cases died, giving a case fatality rate of 3.6%. Of the 124 new clusters detected in 2006, 43 would not have been identified without the EWGLINET scheme. A total of 146 investigations were conducted at cluster sites according to the standards of the EWGLINET investigation guidelines; 111 of these investigations were associated with the new clusters while 35 investigations were associated with re-offending sites (where additional cases had onset after a report was received to say that investigations and control measures had been satisfactorily conducted). The names of four accommodation sites were published on the EWGLI website. Overall, there has been an upwards trend in case numbers since the scheme was founded, which has implications for the work load of public health authorities across Europe and for the tour industry. Despite this increasing pressure on public health authorities, environmental investigations are being conducted in a timely manner.