What is the probability of successive cases of Legionnaires' disease occurring in European hotels?

BACKGROUND: Public health officials will normally take action at accommodation sites following an association with a cluster of cases of Legionnaires' disease. This paper seeks to determine the likelihood of such a cluster occurring at a site once it has been associated with a single case of the disease, and therefore whether more should be done at sites following individual cases. METHODS: Information for UK residents reported to the EWGLINET system between 1993 and 2000 was included in a dataset. The size and country of hotel visited by the cases were divided into six country groups (France, Italy, Spain, Turkey, other Europe and other World), and eight size groups (30%; the probability of a subsequent case occurring within 2 years of the first reached over 50% in some instances. CONCLUSIONS: There may be support for early intervention at some accommodation sites following a first case of Legionnaires' disease, in specific country and size groups