annual ld reporting protocol 2011

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© European Centre for Disease Prevention and Control, Stockholm, 2012

ELDSNet reporting protocol

Legionnaires’ disease 2011

March 2012



ELDSNet reporting protocol Legionnaires’ disease 2011

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ContentsCONTENTS ....................................................................................................................................................2 1 INTRODUCTION ....................................................................................................................................3 2 REPORTING TO TESSY ...........................................................................................................................3

2.1 WHO? ......................................................... ................................................................... ............................. 3

2.2 WHAT? .................................................................. .................................................................. ................... 3 2.3 WHEN? ............................................................................. .................................................................. ........ 3

2.4 HOW? ................................................................................................................. ........................................ 3 3 RECORD TYPES AND VARIABLES .............................................................................................................4

3.1 LEGI ........................................................................................................ ................................................... 4

3.1.1 Common TESSy variables .................................................................................................... .................. 4 3.1.1.1 Record Identifier (mandatory) ..................................................................................................................... 4 3.1.1.2 Record type (mandatory) ............................................................................................................................. 4 3.1.1.3 Record type version ..................................................................................................................................... 4 3.1.1.4 Subject (mandatory) .................................................................................................................................... 4 3.1.1.5 Data source (mandatory) ............................................................................................................................. 4 3.1.1.6 Reporting country (mandatory) ................................................................................................................... 5 3.1.1.7 Date used for statistics (mandatory) ........................................................................................................... 5

3.1.1.8 Status ........................................................................................................................................................... 5 3.1.2 Basic epidemiological variables ................................................................... ......................................... 5

3.1.2.1 Age (mandatory) ..................... ........................ ........................ ........................ ........................ ..................... 5 3.1.2.2 Gender (mandatory) .................................................................................................................................... 5 3.1.2.3 Date of onset (mandatory) .......................................................................................................................... 5 3.1.2.4 Date of diagnosis ......................................................................................................................................... 6 3.1.2.5 Date of notification ...................................................................................................................................... 6 3.1.2.6 Outcome (mandatory) ................................................................................................................................. 6 3.1.2.7 Classification (mandatory) ........................................................................................................................... 6 3.1.2.8 Clinical criteria met (mandatory) ................................................................................................................. 7

3.1.3 Disease-specific epidemiological variables .............................................................. ............................. 7 3.1.3.1 Epidemiological link (mandatory) ................................................................................................................ 7 3.1.3.2 Imported (mandatory) ................................................................................................................................. 7 3.1.3.3 Countries/regions visited ....................... ........................ ........................ ........................ ........................ ...... 7 3.1.3.4 Cluster (mandatory) ........................ ........................ ........................ ........................ ........................ ............. 8 3.1.3.5 Cluster identifier .......................................................................................................................................... 8 3.1.3.6 Laboratory method (mandatory) ................................................................................................................. 8 3.1.3.7 Pathogen (mandatory) ....................... ........................ ........................ ........................ ........................ .......... 8 3.1.3.8 Monoclonal subtype .................................................................................................................................... 9 3.1.3.9 Sequence type ............................................................................................................................................. 9 3.1.3.10 Setting (mandatory) .......................................................................................................................................... 9 3.1.3.11 Environmental investigation ........................................................................................................................... 10 3.1.3.12 Legionella found .............................................................................................................................................. 10 3.1.3.13 Matching isolates ............................................................................................................................................ 10 3.1.3.14 Positive sampling site ...................................................................................................................................... 11

3.2 LEGIDENOM ........................................................................................... ................................................. 11

3.2.1 Common TESSy variables (all mandatory) .............................................................. ............................ 11 3.2.1.1 Record type................................................................................................................................................ 11 3.2.1.2 Record type version ................................................................................................................................... 11 3.2.1.3 Subject ....................................................................................................................................................... 12 3.2.1.4 Data source ................................................................................................................................................ 12 3.2.1.5 Reporting country ...................................................................................................................................... 12 3.2.1.6 Date used for statistics .............................................................................................................................. 12 3.2.1.8 Status ......................................................................................................................................................... 12

3.2.2 Population denominator data (all mandatory) .................... .............................................................. 12 3.2.2.1 Denominator: Age 0-19 ............................................................................................................................. 12 3.2.2.2 Denominator: Age 20-29 ........................................................................................................................... 12 3.2.2.3 Denominator: Age 30-39 ........................................................................................................................... 13 3.2.2.4 Denominator: Age 40-49 ........................................................................................................................... 13 3.2.2.5 Denominator: Age 50-59 ........................................................................................................................... 13 3.2.2.6 Denominator: Age 60-69 ........................................................................................................................... 13 3.2.2.7 Denominator: Age 70-79 ........................................................................................................................... 13 3.2.2.8 Denominator: Age 80+ ............................................................................................................................... 13

3.2.2.9 Denominator: Total ................................................................................................................................... 13 3.2.2.10 Denominator: Age unknown ........................................................................................................................... 13 ANNEX ........................................................................................................................................................ 14

EU CASE DEFINITION............................................................... ................................................................... ................ 14




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1 Introduction The purpose of this protocol is to provide instructions for the reporting of annual national datasets of Legionnaires’disease cases to the European Legionnaires’ Disease Surveillance Network (ELDSNet). The protocol covers themode and contents of reporting these cases to the European Surveillance System (TESSy): the identity of the datareporters, the case definition and the time under surveillance, ways to access the system, the timing of reporting,

and most importantly, the variables to be transmitted. The protocol does not cover the daily reporting of travel-associated cases of Legionnaires’ disease, as this is dealt with in a separate document. The target users of thisprotocol are the persons preparing the annual datafiles of Legionnaires’ disease and transmitting them from thenational to the European level.

2 Reporting to TESSy

2.1 Who?Cases of Legionnaires’ disease can be reported to TESSy only by persons from the 27 EU Member States, Iceland,Liechtenstein and Norway who have been assigned TESSy upload and approval rights by their national contactpoints for surveillance. By default, the data reporters are the national experts nominated for European

Legionnaires’ disease surveillance, but depending on the country, this task may also be carried out by specificallydelegated TESSy users or the national contact points for surveillance themselves.

Establishing each country’s data source(s) for Legionnaires’ disease reporting in TESSy is an indispensableprerequisite for entering or uploading any surveillance data. The data source(s) can only be created and updatedby the national contact point for surveillance.

2.2 What?Member States are kindly requested to report their confirmed and probable cases of Legionnaires’ disease notifiedfrom 1 January until 31 December 2011, applying the EU case definition (see annex) and using TESSymetadataset version 24. This includes both imported and domestic cases notified to the national surveillancesystems. To avoid duplication, each ELDSNet Member State should only report cases in their own residents.

2.3 When?The data submission period starts with the sending of this protocol and will last until 30 April 2012. During thistime, one member of the TESSy helpdesk team will be exclusively assigned to assist in annual Legionnaires’ disease dataset upload. Data validation will take place until 15 May 2012 and may involve ELDSNet contactingnetwork members for clarifications or resubmission of corrected data. Legionnaires’ disease data files can of coursealso be uploaded to TESSy outside of the submission period. Data providers should be aware, however, that TESSyhelpdesk attention might not be quite as undivided. In addition, late submitters run the risk of their data not beingincluded in the presentation at the annual network meeting or in the annual report.

2.4 How?The annual datasets of Legionnaires’ disease are reported to TESSy by upload of CSV or XML files. The upload

functionality is accessible directly in TESSy (https://tessy.ecdc.europa.eu/TessyWeb) or via the ELDSNet workspace(https://extranet.ecdc.europa.eu/RTI/ELDSNet/default.aspx, “TESSy” link).

Some variables in the national datasets may have to be recoded to match the LEGI record type in TESSy. Themetadata and a description of some tools for data transformation in Access and Excel can be found in the TESSyhelp menu. For information regarding CSV and XML files for TESSy, the user is referred to the TESSy transportprotocols (http://ecdc.europa.eu/en/publications/Publications/1003_TER_TESSy_Transport_Protocol_CSV.pdf ; http://ecdc.europa.eu/en/publications/Publications/1003_TER_TESSy_transport_protocol_XTML.pdf )

Prior to proper upload, a file can be tested for meeting the TESSy validation requirements. Wrong entries causingerror messages ( ) must be corrected for file acceptance. Those causing warnings ( ) should be corrected for fileacceptance. As a final step, the uploaded file must be approved by the user, otherwise the data is not visible forECDC.

To enhance data analysis and interpretation, data incomplete at the time of initial reporting (for example,

laboratory results, outcome) should be updated once the missing information becomes available. Likewise, wrongdata should be corrected. For this purpose, an existing file in TESSy can be deleted, supplemented with previouslymissing data, or replaced with a completed or corrected file. For technical details, the user is referred to the TESSyUser Guide, accessible in TESSy (‘Help’ menu, ‘Guides and Training’ tab).

http://ecdc.europa.eu/en/publications/Publications/1003_TER_TESSy_Transport_Protocol_CSV.pdf



http://ecdc.europa.eu/en/publications/Publications/1003_TER_TESSy_transport_protocol_XTML.pdf







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3 Record types and variables

The variables contained in the record type LEGI were modelled to capture in disaggregate format what used to becollected through the EWGLINET annual aggregate dataset tables. The record type LEGIDENOM only addspopulation denominator data for the calculation of age-specific incidence rates. These variables are meant to beworking tools to monitor trends, to identify areas for action and increased surveillance efforts, and to generate

hypotheses for further research. The ELDSNet coordination group and annual network meetings offer opportunityto discuss, and if necessary, revise these variables.

3.1 LEGI

3.1.1 Common TESSy variables

3.1.1.1 Record Identifier (mandatory)

Field: RecordId

Coding: Text (max 80 characters)

The record identifier is provided by the Member State. It must be

unique within the national Legionnaires’ disease surveillance system

anonymous.

A LEGITRAVEL record with the identifier X is not overwritten by uploading the same record with the identifier X as

part of the annual LEGI dataset as long as the appropriate two different record types are indicated.

3.1.1.2 Record type (mandatory)

Field: RecordType

Coding: LEGI

The record type defines the structure and the format of the data reported. The record types are defined by ECDC

and are related to the subject. Only valid combinations of subject, record type and data source are accepted.

3.1.1.3 Record type version

Field: RecordTypeVersion

Coding: 3

The version of the record type defines the current structure of the data reported. If the dataset is changed, the

version changes to the next higher integer. The current version of the LEGI record type is 3. This version is

replacing the record type version 2 since April 2011.

This variable is not mandatory as TESSy concludes the record type version from the metadataset indicated. Thevariable RecordTypeVersion allows to override this default.

3.1.1.4 Subject (mandatory)

Field: Subject

Coding: LEGI

The subject describes the disease to be reported.

3.1.1.5 Data source (mandatory)

Field: DataSource

Coding: List of surveillance systems

The data source specifies the surveillance system from which the data originates and is generated and

revised/updated by the national contact point for surveillance in each Member State. The descriptions of




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the surveillance systems submitted to TESSy should be kept up to date and will be used to assist with data

interpretation.

3.1.1.6 Reporting country (mandatory)

Field: ReportingCountry

Coding: International organization for standardization (ISO) 3166-1-alpha-2, (two-letter code)

This variable identifies the country reporting the case.

3.1.1.7 Date used for statistics (mandatory)

Field: DateUsedForStatistics

Coding: yyyy-mm-dd (preferred) yyyy-Www yyyy-mm yyyy-Qq yyyy

This is the date used by the national surveillance institute/organisation in case reports and official statistics. The

date used for statistics can vary from country to country (for example, date of diagnosis, date of notification).

It is recommended to use the date of onset.

3.1.1.8 Status

Field: Status

Coding: NEW/UPDATEDELETE

The status is used for updating data; the default is New/Update. By choosing ‘Delete’, the selected record (orbatch of data) will be marked as inactive, but will remain in TESSy to reconstruct the data for a given date in thepast.

3.1.2 Basic epidemiological variables

3.1.2.1 Age (mandatory)

Field: Age

Coding: Numerical (0-120)UNK = Unknown

Age of the person in years as reported to the national surveillance system of each Member State.

3.1.2.2 Gender (mandatory)

Field: Gender

Coding: F = FemaleM = MaleO = Other (for example, transsexual)UNK = Not known

Gender of the person.

3.1.2.3 Date of onset (mandatory)

Field: DateOfOnset

Coding: yyyy-mm-dd (preferred) yyyy-mm yyyy-Qq

yyyy

Date of symptom onset. If not known precisely, the date of onset can be estimated.

Validation: Date of onset must be before date of diagnosis which again must be before date of notification.




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3.1.2.4 Date of diagnosis

Field: DateOfDiagnosis

Coding: yyyy-mm-dd (preferred) yyyy-Www yyyy-mm yyyy-Qq

yyyyUNK = Unknown

Date of laboratory confirmation.


3.1.2.5 Date of notification

Field: DateOfNotification

Coding: yyyy-mm-dd (preferred) yyyy-Www yyyy-mm yyyy-Qq

yyyyUNK = Unknown

Date of first notification to the national surveillance system.


3.1.2.6 Outcome (mandatory)

Field: Outcome

Coding: A = AliveD = DiedUNK = Unknown

Outcome refers to the patient’s vital status resulting from Legionnaires’ disease. Death should be directly orindirectly due to Legionnaires’ disease.

If the patient is still ill at the time of reporting, it is recommended to code the outcome as ‘Unknown’.

3.1.2.7 Classification (mandatory)

Field: Classification

Coding: CONF = ConfirmedPROB = Probable

This variable indicates the case classification according to the EU case definition (see Annex).

Validation:

Classification coded as ‘Confirmed’ AND laboratory method not coded as ‘Urinary antigen test’, ‘Culture’ or ‘Fourfold titre rise’ produces the following error message: “A confirmed case can only be reported whenlaboratory method is culture, urinary antigen test or fourfold titre rise.”

Classification coded as ‘Confirmed’ AND laboratory method coded as ‘Fourfold titre rise’ (but not inaddition as ‘Urinary antigen test’ or ‘Culture’) AND pathogen not coded as ‘L. pneumophila serogroup 1’ produces the following error message: “Only L. pneumophila serogroup 1 can be reported as a confirmedcase when laboratory method is fourfold titre rise. Other pathogens must be reported as probable.”

Classification not coded as ‘Confirmed’ AND laboratory method coded as ‘Culture’ produces the followingerror message: “If the laboratory method is culture, a case is always classified as confirmed.”

Classification not coded as ‘Confirmed’ AND laboratory method coded as ‘Urinary antigen test’ producesthe following error message: “If the laboratory method is urinary antigen detection, a case is alwaysclassified as confirmed.”




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Classification not coded as ‘Confirmed’ AND laboratory method coded as ‘Fourfold titre rise’ AND pathogencoded as ‘L. pneumophila serogroup 1’ produces the following error message: “If the laboratory method isfourfold titre rise and the pathogen is L. pneumophila serogroup 1, a case is always classified asconfirmed.”

Cases with unknown classification cannot be reported.

3.1.2.8 Clinical criteria met (mandatory)Field: ClinicalCriteria

Coding: Y = YesN = No

This variable answers the question of whether the patient’s clinical presentation included pneumonia, that is, fulfilsthe clinical criterion of the EU case definition.

Validation: ‘No’ produces the following error message: “The diagnosis of Legionnaires' disease requires apneumonia”.

3.1.3 Disease-specific epidemiological variables

3.1.3.1 Epidemiological link (mandatory)

Field: EpiLinked

Coding: Y = YesN = NoNA = Not applicableUNK = Unknown

This variable answers the question of whether the patient’s exposure fulfils any of the epidemiological criteria of the EU case definition:

Environmental exposure: this should be interpreted as exposure to an environment with recentlaboratory-confirmed presence of legionella.

Exposure to the same source as a confirmed case: this implies recent laboratory confirmation of thatcase.

According to the EU case definition, any pneumonia and an epidemiological link define a probable case of Legionnaires’ disease even if this diagnosis is not laboratory-confirmed.

3.1.3.2 Imported (mandatory)

Field: Imported

Coding: Y = YesN = NoUNK = Unknown

Has the patient been outside the reporting country during the incubation period of 2-10 days prior to date of

onset?

3.1.3.3 Countries/regions visited

Field: ProbableCountryOfInfection

Coding: List of countries

Country/ies the patient has been to during the incubation period of 2-10 days prior to date of onset. More than onecountry can be indicated. For technical details on how to report repeatable variables, the user is referred to theTESSy transport protocols (2.4).

Validation:

Reporting a case as imported, but not reporting any probable country of infection produces the followingremark: “Do you know in which country the imported case was infected? ProbableCountryOfInfection is

not reported.”

Reporting a case as not imported, but reporting a probable country of infection other than the country of reporting produces the following warning: “ProbableCountryOfInfection should not be reported, if the caseis not imported.”




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For domestic cases, it is recommended to leave this field blank. ‘Not applicable’ is no longer permitted.

3.1.3.4 Cluster (mandatory)

Field: Cluster


Does the case form part of a domestic or international cluster?

3.1.3.5 Cluster identifier

Field: ClusterId

Coding: TEXT

If the case is known to have formed part of a cluster, the cluster identifier should be indicated. Depending onwhether it is a domestic or international (=travel-associated) cluster, the identifier assigned in the nationalsurveillance system or the ELDSNet identifier should be used.

Validation: Reporting a case as forming part of a cluster, but not reporting any cluster Id produces the following

warning: “If the case is part of a cluster, a ClusterId is required.”

3.1.3.6 Laboratory method (mandatory)

Field: LabMethod

Coding: URIN = Urinary antigen testCULT = CultureFOUR = Fourfold titre riseSINGLE = Single high titreNUC = Nucleic acid amplification, e.g. PCR IMM = Direct immunofluorescence

Laboratory method(s) used to confirm the diagnosis. More than one method can be indicated. For technical detailson how tot report repeatable variables, the user is referred to the TESSy transport protocols (2.4).

Cases without any information on the laboratory method used for confirmation cannot be reported.

3.1.3.7 Pathogen (mandatory)

Field: Pathogen

Coding: SG1 = L . pneum oph i l a serogroup 1SG2 = L . pneum oph i l a serogroup 2SG3 = L . pneum oph i l a serogroup 3SG4 = L . pneum oph i l a serogroup 4SG5 = L . pneum oph i l a serogroup 5SG6 = L . pneum oph i l a serogroup 6SG7 = L . pneum oph i l a serogroup 7SG8 = L . pneum oph i l a serogroup 8SG9 = L . pneum oph i l a serogroup 9SG10 = L . pneum oph i l a serogroup 10SG11 = L . pneum oph i l a serogroup 11SG12 = L . pneum oph i l a serogroup 12SG13 = L . pneum oph i l a serogroup 13SG14 = L . pneum oph i l a serogroup 14SG15 = L . pneum oph i l a serogroup 15SG16 = L . pneum oph i l a serogroup 16SGMIX = L . pneum oph i l a serogroup mixedSGUNK = L . pneum oph i l a serogroup unknown ANISA = L. anisa BOZ = L . bozem an i i BRU = L . b runens i s

CIN = L . c inc innat i ens i s DUM = L . dumof f i i FEE = L. feele i i JOR = L . jo rdan i s LONG = L . l ongbeacha e




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MAC = L . ma caechern i i MIC = L . m icdade i WAD = L . wadswo r t h i i O = L. other speciesUNK = L. species unknown

Legionella species and serogroup confirmed by at least one of the previously indicated laboratory methods.

3.1.3.8 Monoclonal subtype

Field: MonoclonalSubtype

Coding: ALLN = Allentown (serogroup 1) ALLNFRAN = Allentown/France (serogroup 1)BELI = Bellingham (serogroup 1)BENI = Benidorm (serogroup 1)CAMB = Cambridge (serogroup 5)CAMP = Camperdown (serogroup 1)DALA = Dallas (serogroup 5)FRAN = France (serogroup 1)HEY = Heysham (serogroup 1)

KNOX = Knoxville (serogroup 1)LA = Los Angeles (serogroup 4)OLDA = OLDA (serogroup 1)OXF = Oxford (serogroup 1)OXFOLDA = Oxford/OLDA (serogroup 1)PHIL = Philadelphia (serogroup 1)PORT = Portland 4 (serogroup 4)O = OtherUNK = UnknownNA = Not applicable

Validation:

Reporting L. pneumophila serogroup 1 and any non-serogroup 1 monoclonal subtype produces the

following error message: “The value given for MonoclonalSubtype is not valid for serogroup 1.” The sameapplies to L. pneumophila serogroups 4 and 5.

Reporting L. pneumophila serogroup 1 and coding the monoclonal subtype as Not applicable produces thefollowing error message: “MonoclonalSubtype cannot be not applicable when serogroup 1 is selected.” The same applies to L. pneumophila serogroups 4 and 5.

Reporting a monoclonal subtype with any pathogen other than L. pneumophila serogroups 1, 4 and 5produces the following error message: “MonoclonalSubtype is only applicable for serogroups 1, 4 and 5.Please code MonoclonalSubtype as not applicable.”

3.1.3.9 Sequence type

Field: ResultSeqType

Coding: Numerical, 1-9999

Legionella pneumophila sequence type as obtained by using the internationally standardised seven-gene locisequence-based typing (SBT) scheme of the European Working Group for Legionella Infections (EWGLI). Availableat: http://www.hpa-bioinformatics.org.uk/legionella/legionella_sbt/php/sbt_homepage.php

3.1.3.10 Setting (mandatory)

Field: Setting

Coding: COMAS = Community (assumed)COMDE = Community (definite)NOS = Nosocomial (hospital)HOTH = Healthcare otherTRAABR = Travel abroad

TRADOM = Domestic travelO = OtherUnk = Unknown

Setting in which the case most likely acquired Legionnaires’ disease.

http://www.hpa-bioinformatics.org.uk/legionella/legionella_sbt/php/sbt_homepage.php







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As this annual retrospective surveillance does not serve the purpose of immediate detection and control of sources of Legionnaires’ disease posing a risk to public health, the criteria defining travel-associated cases do not need to be as strict as in the day-to-day surveillance of travel-associated Legionnaires’ disease. All imported cases should therefore be reported as associated with travel abroad (TRAABR), regardlless of whether the case stayed in commercial or privately owned accommodation. The same applies to cases associated with domestic travel (TRADOM). The only exception to this rule should be imported cases probably infected in a hospital abroad – they should be reported as nosocomial (NOS) as this is epidemiologically more relevant.

Regardless of where they were most likely exposed to Legionella, cases in persons not living in the reporting country should be notified to their countries of residence and reported to ELDSNet only by the latter to avoid duplicate reporting.

3.1.3.11 Environmental investigation

Field: EnvironInvest


Answers the question whether any environmental investigation was carried out. A missing value will be interpretedas ‘Unknown’.

3.1.3.12 Legionella found

Field: LegionellaFound

Coding: Y = YesN = NoUNK = UnknownNA = Not applicable

If an environmental investigation was carried out, was Legionella found?

Validation:

Reporting an environmental investigation with LegionellaFound coded as not applicable produces the

following warning: “If an environmental investigation has been performed, LegionellaFound cannot bereported as not applicable.”

Reporting no environmental investigation with LegionellaFound coded as Yes , No or Unknown produces

the following warning: “If no environmental investigation has been performed, LegionellaFound must be

reported as not applicable.”

Reporting that it was unknown if an environmental investigation was carried out, yet coding

LegionellaFound as Yes , No or Not applicable produces the following warning: “If is is not known if an

environmental investigation has been performed, LegionellaFound must also be reported as unknown.”

3.1.3.13 Matching isolates

Field: MatchingIsolates

Coding: Y = YesN = NoUNK = UnknownNA = Not applicable

If Legionella was found, were the environmental and clinical isolates matching?

Validation:

Reporting a culture-confirmed case and positive findings of an environmental investigation, yet coding the

Matching isolates variable as Not applicable produces the following warning: “If laboratory method is

culture and Legionella was found (LegionellaFound = Y), matching isolates cannot be reported as not

applicable.”

Reporting a case not confirmed by culture, yet not coding the Matching isolates variable as Not applicable

produces the following warning: “Matching isolates should be reported as not applicable when lab method

is not culture.”




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Reporting a case where no Legionella was found in the environmental investigation, yet not coding the

Matching isolates variable as Not applicable produces the following warning: “Matching isolates should be

reported as not applicable when Legionella is not known to have been found (LegionellaFound ≠ Y).

Reporting no environmental investigation with the Matching isolates variable coded as Yes , No or

Unknown produces the following warning: “If no environmental investigation has been performed,

MatchingIsolates must be reported as not applicable.”

3.1.3.14 Positive sampling site

Field: SamplingSite

Coding: CTOW = Cooling towerPOOL = Whirlpool / Spa poolWAT = Water systemWATCOLD = Cold water systemWATHOT = Hot water systemO = OtherUnk = UnknownNA = Not applicable

Site(s) from which samples were taken that tested positive for Legionella. More than one site can be indicated. Fortechnical details on how to report repeatable variables, the user is referred to the TESSy transport protocols (2.4).

Validation:

Reporting an environmental investigation, yet coding the Sampling site variable as Not applicable produces the following warning: ” If there was an environmental investigation done, the sampling sitecannot be reported as not applicable.”

Reporting no environmental investigation, yet not coding the Sampling site variable as Not applicable produces the following warning: ” If there was no environmental investigation done, the sampling sitemust be reported as not applicable.”

Reporting that it was unknown if an environmental investigation was carried out, yet not coding theSampling site variable as Unknown produces the following warning: ” If it is not known if an

environmental investigation was done, the sampling site must be reported as unknown.” Reporting that Legionella was found in an environmental investigation, yet coding the Sampling site

variable as Not applicable produces the following warning: ” If Legionella was found, the sampling sitecannot be reported as not applicable.”

3.2 LEGIDENOM

This record type provides age-specific population denominator data to calculate incidence rates. It is mandatoryfor countries where Legionnaires’ disease surveillance only covers regional subsets of the population,that is, where a country’s data source settings do not confirm national coverage. For countries withdata source settings indicating national coverage of Legionnaires’ disease surveillance, the reportingof LEGIDENOM is not required. Instead, ECDC will retrieve country and age-specific population denominatordata from the Statistical Office of the European Union (Eurostat).

3.2.1 Common TESSy variables (all mandatory)

3.2.1.1 Record type

Field: RecordType

Coding: LEGIDENOM

The record type defines the structure and the format of the data reported. The record types are defined by ECDC

and are related to the subject. Only valid combinations of subject, record type and data source are accepted.

3.2.1.2 Record type version

Field: RecordTypeVersion

Coding: 1




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The version of the record type defines the current structure of the data reported. If the dataset is changed, the

version changes to the next higher integer.

3.2.1.3 Subject

Field: Subject

Coding: LEGIDENOM

Describes the subject of the data to be reported.

3.2.1.4 Data source

Field: DataSource

Coding: List of surveillance systems

The data source specifies the surveillance system from which the data originates and is generated and

revised/updated by the national contact point for surveillance in each Member State. The descriptions of the

surveillance systems submitted to TESSy should be kept up to date and will be used to assist with data

interpretation.It is recommended to link the LEGIDENOM record type to the existing data source for LEGI reporting.

3.2.1.5 Reporting country

Field: ReportingCountry

Coding: International organization for standardization (ISO) 3166-1-alpha-2, (two-letter code)

This variable identifies the country reporting the case.

3.2.1.6 Date used for statistics

Field: DateUsedForStatistics

Coding: yyyy

Year of reporting.

3.2.1.8 Status

Field: Status

Coding: NEW/UPDATEDELETE

The status is used for updating data; the default is New/Update. By choosing ‘Delete’, the selected record (orbatch of data) will be marked as inactive, but will remain in TESSy to reconstruct the data for a given date in thepast.

3.2.2 Population denominator data (all mandatory)The following variables are age-specific aggregate numbers of the population under surveillance. They serve tocalculate incidence rates.

3.2.2.1 Denominator: Age 0-19

Field: Denominator00-19

Coding: NUMERICAL



Coding: NUMERICAL




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Coding: NUMERICAL



Coding: NUMERICAL



Coding: NUMERICAL



Coding: NUMERICAL



Coding: NUMERICAL

3.2.2.8 Denominator: Age 80+

Field: Denominator80+

Coding: NUMERICAL

3.2.2.9 Denominator: Total

Field: DenominatorTotal

Coding: NUMERICAL

3.2.2.10 Denominator: Age unknown

Field: DenominatorUnk

Coding: NUMERICAL




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Annex

EU case definition

Legionnaires’ disease is an uncommon form of pneumonia. The disease has no particular clinical features thatclearly distinguish it from other types of pneumonia, and laboratory investigations must therefore be carried out inorder to obtain a diagnosis. The following definitions have been agreed:

Clinical criteria: Any person with pneumonia

Laboratory criteria for case confirmation: At least one of the following three:

Isolation of Legionella spp. from respiratory secretions or any normally sterile site Detection of Legionella pneumophila antigen in urine Legionella pneumophila serogroup 1 specific antibody response

Laboratory criteria for a probable case: At least one of the following four:

Detection of Legionella pneumophila antigen in respiratory secretions or lung tissue e.g. by DFA stainingusing monoclonal-antibody derived reagents

Detection of Legionella spp. nucleic acid in a clinical specimen Legionella pneumophila non-serogroup 1 or other Legionella spp. specific antibody response L. pneumophila serogroup 1, other serogroups or other Legionella species: single high titre in specific

serum antibody

Epidemiological criteria: At least one of the following two epidemiological links:

Environmental exposure Exposure to the same common source

Case classification

1. Possible caseNA

2. Probable case Any person meeting the clinical criteria AND at least one positive laboratory test for a probable case OR an epidemiological link

3. Confirmed case Any person meeting the clinical and the laboratory criteria for case confirmation

The above definitions are taken from the Commission Decision of 28 April 2008 amending Decision 2002/253/EClaying down case definitions for reporting communicable diseases to the Community network under Decision No2119/98/EC of the European Parliament and of the Council

http://eur-lex.europa.eu/LexUriServ/LexUriServ.do?uri=OJ:L:2008:159:0046:01:EN:HTML







annual ld reporting protocol 2011

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