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It is not known whether rainfall increases the risk of sporadic cases of  Legionella  pneumonia. We sought to test this hypothesis in a prospective observational cohort study of non-immunosuppressed adults hospitalized for community-acquired pneumonia (1995–2011). Cases with  Legionella  pneumonia were compared with those with non- Legionella  pneumonia. Using daily rainfall data obtained from the regional meteorological service we examined patterns of rainfall over the days prior to admission in each study group. Of 4168 patients, 231 (5.5%) had  Legionella  pneumonia. The diagnosis was based on one or more of the following: sputum (41 cases), antigenuria (206) and serology (98). Daily rainfall average was 0.556 liters/m 2  in the  Legionella  pneumonia group vs. 0.328 liters/m 2  for non- Legionella  pneumonia cases (p = 0.04). A ROC curve was plotted to compare the incidence of  Legionella  pneumonia and the weighted median rainfall. The cut-off point was 0.42 (AUC 0.54). Patients who were admitted to hospital with a prior weighted median rainfall higher than 0.42 were more likely to have  Legionella  pneumonia (OR 1.35; 95% CI 1.02–1.78; p = .03). Spearman Rho correlations revealed a relationship between  Legionella  pneumonia and rainfall average during each two-week reporting period (0.14; p = 0.003). No relationship was found between rainfall average and non- Legionella  pneumonia cases (−0.06; p = 0.24). As a conclusion, rainfall is a significant risk factor for sporadic  Legionella  pneumonia. Physicians should carefully consider  Legionella  pneumonia when selecting diagnostic tests and antimicrobial therapy for patients presenting with CAP after periods of rainfall.

Rainfall Is a Risk Factor for Sporadic Cases of Legionella pneumophila Pneumonia