Mysteriously rapid rise in Legionnaires’ disease incidence correlates with declining atmospheric sulfur dioxide
La maladie du Légionnaire est une forme sévère de pneumonie due à l’inhalation d’aérosols contaminés par Legionella pneumophila. Cette bactérie présente dans les systèmes de refroidissement d’eau. Récemment une augmentation importante et inexpliquée de l’incidence de la maladie du légionnaire a été observée globalement et en particulier aux Etats-Unis entre 2000 et 2018, notamment au sein des sous-groupes vulnérables socioéconomiquement. Cette étude met en évidence par une démonstration épidémiologique, en prenant le soin d’éliminer les facteurs classiquement décrits dans la littérature contribuant à l’augmentation de l’incidence des légionelloses, qu’un nouveau facteur impliqué dans l’occurrence de la maladie du légionnaire permet d’expliquer cette augmentation en lien avec l’exposition aux tours de refroidissement. En effet la diminution de la pollution de l’air par du dioxyde de soufre ([SO2]), qui pourtant est connue pour améliorer la santé humaine, résulte dans la diminution de l’acidité des aérosols émis par les tours aéroréfrigérantes, ce qui pourrait prolonger la durée de survie des légionnelles dans les microgouttes contaminées émanant des tours de refroidissement, contribuant par la même à l’augmentation de l’incidence de la maladie du légionnaire. Cet article permet d’améliorer la connaissance de la transmission de cette maladie, ainsi que la prédiction et management de futures risques.
Fig1. Evolution spatiale et temporelle de la maladie du Légionnaire (NYS : New York State ; NEUS : Northeast United States ; US : United States)
Fig2. Maladie du Légionnaire et Facteurs environnementaux influents (RH : humidité relative)
Fig 3A. Schéma du mécanisme proposé pour la réduction du [SO2] affectant le pH des microgouttes et des aérosols issues des tours de refroidissement, du taux de survie des Légionnelles, et les conséquences sur le risque d’occurrence de la maladie du Légionnaire
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