Traveling may place a person at risk for exposure to Legionnaire’s disease.
Jespersen et al defined travel-associated as a person visiting a foreign country within 10 days of the onset of symptoms, but the definition should not be restricted for foreign travel.
Sites of exposure:
(1) hotel
(2) cruise ship
(3) country with increased incidence (for example, Italy and Greece in Europe)
Exposures may include:
(1) potable water supply
(2) spa, hot tub or thermal bath
(3) cooling tower
(4) following heavy rains during the warm season
An outbreak is easier to recognized but this can be difficult to detect in travelers who have left prior to onset of clinical symptoms.
Barriers to control:
(1) failure to monitor water supplies for Legionella species
(2) failure to recognize cases, especially sporadic cases
(3) failure to communicate and to report
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