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Legionnaire's Disease
Legionnaire's disease was first noticed in 1976 when an outbreak of the bacterial pneumonia occurred at a American Legion convention in Philadelphia [thought to be spread at the time by a ventilation system]. There were 200 confirmed cases of which 34 people died from the illness. Sporadic cases still appear, and occasionally, epidemics are reported. It has been estimated that 25,000 to 50,000 cases of legionella occur yearly in the United States. Males are at increased risk over females. Smokers are also at increased risk. Legionnaire's disease has been shown to be spread through contact (inhalation) with infected water vapor. Common symptoms include: fever, dry cough, muscle aches, and watery diarrhea (about 50% of cases). Evaluation includes: chest x-ray, special serologic (blood) tests for the offending bacteria, specimens for sputum culture, and immunofluorescent studies (special immunologic assay).
Hospitalization is required in all suspected cases. These patients will require antibiotic therapy to counteract the legionella bacterium. Erythromycin has been effective treatment. Some patients require assisted mechanical ventilation. This is a potentially fatal infection ALWAYS requires physician evaluation and treatment. The mortality rate is approximately 75% in untreated cases and about 5% with the application of aggressive medical treatment.
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