Legionnaires' Disease Cases Rise Sharply

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Fri, Jul. 11, 2003

Legionnaires' Disease Cases Rise SharplyRANDALL CHASEAssociated Press

DOVER, Del. - The number of reported cases of Legionnaires disease has risen sharply this year, baffling federal and state health officials.

The number of cases of legionellosis reported to the federal Centers for Disease Control and Prevention this year totaled 624 as of last week, compared to 436 for the corresponding period last year.

In some regions of the country, the numbers are double or triple those reported at this time last year. Officials say the cases appear to be random, and that they have not identified any specific outbreak or source of the bacteria that causes the disease.

"There don't seem to be any explanations yet," said n Flannery, an epidemic intelligence officer with the CDC in Atlanta.

The 197 cases reported in the CDC's South Atlantic region was more than double last year's 95 cases. Health officials from Delaware, land, Pennsylvania, Virginia and North Carolina held a conference call Friday with CDC officials to discuss the situation.

"We're just trying to figure out what's going on, but nobody has any really good ideas," said Diane Woolard, director of surveillance and investigations for the Virginia Department of Health.

Among the questions officials are trying to answer is whether the apparent increase in the prevalence of the disease is real, whether there might be problems with the urine antigen test used to diagnose most cases, or whether reporting simply has improved.

"We've always assumed that Legionnaires' is pretty underreported," said McGarvey, a spokesman for the Pennsylvania Department of Health.

People contract Legionnaires' disease after inhaling mists from a water source contaminated with the legionella bacteria, which thrives in warm, stagnant water. Sources can include hot water tanks, cooling towers and evaporative condensers of large air conditioning systems, whirlpool spas and showers.

Symptoms of the disease include fever, chills, cough, body aches, headache, fatigue, loss of appetite, and, occasionally, diarrhea. The disease can be treated with antibiotics, but between 5 percent and 30 percent of cases are fatal.

While the disease can affect anyone, middle-aged and older persons are at highest risk, particularly smokers and those with chronic lung disease. Also at increased risk are those whose immune systems suppressed by medications or by diseases such as cancer, diabetes and AIDS.

The illness is called Legionnaires' disease because it was first reported at an American Legion convention in 1976 in Philadelphia, where it made 182 people ill.