Time to return to work or daily activities under an outbreak of Legionnaires´ disease in Portugal

Background: A large outbreak of Legionnaires9 disease with 334 confirmed cases was identified on November 2014 in Northern suburban Lisbon, Vila Franca de Xira. As part of the team working in the Hospitals that cared for these patients, the authors decided to assess the social and economic impact of this outbreak by evaluating time to return to work or daily activities (TRW). Objectives: To assess the TRW in patients admitted with confirmed or suspected Legionnaires9 disease. Methods: We applied a questionnaire to all 53 cases of confirmed or suspected Legionnaires9 disease. A confirmed case was defined as pneumonia with laboratory confirmation of Legionella pneumophila (serogroup 1) , symptom onset occurring after October 1 st and epidemiological link. Suspected cases were clinically similar to confirmed cases, had an epidemiological link but lacked laboratory confirmation. TRW was quantified from admission date to time to return to work in the active population or time to resume daily activities in the non-active population. Results: Of the 53 cases there were 41 confirmed cases and 12 suspected cases. The average age was 57.2 years; 31 (58.5%) were male and 33 (62.2%) were in full time work. 41.5% were smokers, 19.0% had chronic respiratory disease and 58.0% had cardiovascular disease. The average TRW for all patients was 21 days (21.8 in actives and 19.4 in non actives), 22 days in smokers, 24 days in those with cardiovascular disease and 30 days for those with chronic respiratory disease. Conclusion: In a predominately active population the average TRW was 21 days. TRW was higher in smokers, patients with cardiovascular disease and especially in those with chronic respiratory disease.