Arising from the first outbreak at the 1967 American Legion Convention, to re-occurring incidents across the nation, Legionnaires Disease (LD) is a dangerous strain of pneumonia. Derived from the Legionella pneumophila bacteria, LD has persistence and resistance built into its cellular code. Classified as an Opportunistic Premise Plumbing Pathogen (OPPP), Legionella’s ecological growth begins in plumbing, stagnation of water, drinking water treatment plants, and with exposure to contaminated aerosols. Analysis of LD requires study of the cyclic nature of Legionella pneumophila as well as the examination of environmental and other factors that may potentially increase risk of infection in susceptible populations. Previously unnoticed, distinguishable characteristics of LD have been identified from the rapid increase of reported outbreaks and their correlation to demographic factors. Particularly, analysis of LD cases from local, state, and national-level surveillance reports from 2000 to 2016 show not only an increased incidence of total cases of LD in the United States, but also a heightened incidence within socioeconomically, racially, and infrastructurally disadvantaged communities. The objective of this literature review is to explore the relevant social determinants of health, environmental and other associated factors to better understand and address disparities in the incidence of LD.
