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In Brazil, Legionnaire’s Disease is a silent epidemic. We do not have
any official statistics about the impact of this disease on the health of the
population. However, it is estimated that from six to nine thousand people
die every year in Brazil1, a number by far higher than the official statistics
show for the whole of Europe and the United States. Based on the 2013
Annual Epidemiological Report published by ECDC (European Centre
for Disease Prevention and Control), there were 306
Legionella
death cases
notified in that year. One must bear inmind that European countries benefit
from heavy public and private investments for surveillance, prevention and
minimization of risks associated to
Legionella
.
Brazilian estimated death numbers by
Legionella
appear to be quite
high. However, it is important to note that these figures were estimated
based on the legionellosis/pneumonia proportion verified in countries that
adopt more accurate death notification policies and assuming that this
proportion is constant all over the world. However, we could easily think
about some circumstantial risks that Brazil presents as a tropical developing
country. We have issues such as constant water heat gain by insolation;
intermittent water supply for some extensive regions that affects millions
of people; water is privately stored more than weeks with no quality control
and in no proper conditions (especially in areas with water scarcity); scarce
information about basic water safety.
There are many different actions to be taken to revert or to mitigate
this situation in Brazil. It is the state’s responsibility, for example, to create
public health policies intending to prevent legionellosis throughout the
country. There are different arrangements that could be used for this task
based on the way Brazilian public health policies are organized: surveillance
with mandatory notifications of infections, field inspections, laws and
