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The Cost of Legionnaires' Disease

Posted by Chloe on May 24, 2021 10:08:20 AM


Legionnaires’ disease and Legionellosis has a significant financial impact on public health and productivity. Cases of Legionnaires’ have been on the rise across in the UK, the EU and the United States for years. 

Official statistics, concerning as they are, largely underestimate the real number of cases and the actual growth in cases. The ELDSNet suggests that cases in the EU could be as high as 50,500 cases a year, or about 100 per million of the population.

A detailed review of several years of pneumonia cases also concluded that 9% of all hospitalised pneumonia cases could actually be Legionnaires’ disease.

In the USA the CDC has estimated that the real number of Legionnaires’ disease cases could be as high as 18,000 cases per year. The National Academies of Sciences, Engineering and Medicine (NASEM) have stated that cases are higher still, estimating up to 70,000 cases per year.

How much is this crisis costing us?
The widespread increase in cases of Legionnaires’ disease has devastating consequences for human life. Around 10% of all people who contract the infection will die and the mortality rate is significantly higher in healthcare facilities or care homes.

Legionnaires’ disease also has an enormous financial burden on healthcare systems and the economy. In Europe the cost of healthcare and loss of productivity due to Legionnaires’ disease tallies up to about £1billion per annum.

Experts in the field have estimated that the cost of Legionnaires’ disease for health care and productivity losses in the UK is around £100 million a year.

The Edinburgh Outbreak
In 2012, an outbreak caused by Legionella pneumophila serogroup 1 (the most dangerous form of Legionella bacteria) infected 101 people and killed 3 in Edinburgh, UK.

A study estimated the immediate cost of the outbreak to the national health service.

Since no long-term data was available, the cost of long-term health impacts such as persistent neurological and physical impacts, disability, and PTSD is unknown.

Direct health-care costs were estimated at £884, 730 (see table below).

Screenshot 2021-05-20 at 10.26.47

Source: https://www.researchgate.net/publication/309771205_The_cost_of_Legionellosis_and_technical_ways_forward 

When care for those who were not hospitalised and the cost of drugs and diagnostic testing were factored in, the direct cost was estimated at around £1million.

The same study tried to estimate the cost the Edinburgh outbreak had on the economy. They did this assuming half of the survivors were fully employed and had to take 3 months off work on average.

They estimated productivity costs at around £900,000.

Overall, the estimated cost of the Edinburgh outbreak was £1.8million, excluding mortalities.

What about in the United States?
In the United States, another study estimated the cost of health care and productivity losses at around $835million per annum.

They estimated $21million in productivity losses caused by absenteeism and $412 million in losses caused by premature deaths.

The same paper concluded that the economic burden of Legionnaires’ disease more than doubled when loss of productivity and medical care was factored in.
Screenshot 2021-05-20 at 14.29.08

Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774564/

This research provides further support for investments into the prevention of Legionnaires’ disease and shows that more legislation is desperately needed in the United States and European countries where legislation is either non-existent or fragmented.

Scientists predict that cases of Legionnaires’ disease will continue to rise along with global heating and ageing populations. Failure to implement preventative measures could put hundreds of thousands of lives at risk and could lead to a staggering financial burden on our health care and economies.

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