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Arthur L. Reingold, MD; Jeffrey D. Band, MD
Centers for Disease Control Atlanta

JAMA. 1981;245(7):702.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The recent article by Fay et al (1980;243:2311-2313), which determined the frequency of unrecognized Legionnaires' disease (LD) among patients coming to autopsy in their hospital, concluded that there may be as many as 71,370 unrecognized adult LD-associated deaths each year in the United States.

The accuracy of this estimate depends on whether findings of this study are applicable elsewhere. We believe that it is inappropriate to apply these results to the general population and that the resultant estimate substantially overstates the likely number of LD-associated deaths.

The applicability of these findings to hospital patients in general is questionable because of the following reasons:

1. The hospital under study has had a continuing problem with nosocomial LD. During the period examined, there was a well-documented cluster of cases that were most likely hospital acquired.¹
   
2. Serosurveys have shown substantial geographic variability in the frequency of exposure to Legionella
   

Footnotes
Edited by John D. Archer, MD, Senior Editor.

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