ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Friday, October 25, 1996 TAG: 9610250089
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
DATELINE: CHRISTIANSBURG
SOURCE: MARK CLOTHIER STAFF WRITER
Four New River Valley residents have been hospitalized with Legionnaires' disease, a form of pneumonia often linked to air-cooling systems.
Two victims are in critical condition in Salem hospitals - one at Lewis-Gale Medical Center and another at the Veterans Affairs Medical Center. The other two are at the VA Medical Center and Columbia Montgomery Regional Hospital near Blacksburg.
The patients live in different areas: Pearisburg, Blacksburg, Christiansburg and the Floyd County community of Willis.
The first two cases were confirmed Tuesday, the third Wednesday, and the fourth Thursday morning.
The four cases appear isolated, according to Dr. Jody Hershey, director of the New River Health District. Public health officials are investigating them, along with an increase in reported pneumonia cases in the New River Valley.
Between 0.5 percent and 5 percent of all pneumonia cases are caused by Legionella, the bacterium that causes Legionnaires' disease, Hershey said. The bacterium is found almost everywhere, including in moist soil, but it generally attacks only people with weakened immune systems.
"We're gathering information to try and determine whether this is an epidemic or whether there's any kind of connection between the cases," Hershey said. "As of now, there is no evidence of any connection and no reason for alarm."
The disease is not contagious.
The state's New River Health District is made up of Montgomery, Floyd, Giles and Pulaski counties and the city of Radford.
Hershey said there was one reported case in the district in 1995: a 25-year-old HIV-positive Montgomery County man who survived. This week's cases are the first this year in the New River District; the Roanoke-Alleghany health district has had five cases reported since 1993.
The state averages about 15 cases of the disease a year, although 18 have been reported so far this year, not counting the ones in the New River Valley, said Leslie Branch, surveillance coordinator.
In 1995, there were 28 cases reported; in 1994, there were 17 cases, Branch said.
Nationally, between 10,000 and 15,000 people get Legionnaires' disease each year. Most cases emerge individually throughout the year, but they are more common in summer and autumn.
The death rate has been as high as 39 percent in hospitalized cases and can be higher if there are other health problems, Hershey said.
Many people are infected with the bacterium but have mild symptoms or none at all, according to the federal Centers for Disease Control and Prevention in Atlanta.
Anyone can get the disease, but those most susceptible are middle-aged or older people, especially those who drink or smoke heavily. People with chronic illnesses, including lung and kidney diseases, cancer, diabetes and immune-system difficulties, also are at greater risk.
Emily McClure, a CDC epidemiologist, said isolated Legionnaires' cases are common enough that her office gets two or three calls daily about clusters of two or three cases.
"The bacterium that causes Legionnaires' is not exotic," she said. "It's always there. It just happens to find its way into a man-made environment optimal for its dispersal."
The bacterium appears to be spread when a spray of water is created by such things as whirlpool baths, water taps, water-based humidifiers, room humidifiers and air-conditioning cooling towers for large buildings.
It's also found in air-conditioning ducts, storage tanks, rivers, ponds, creeks and moist soil. In 1994, 14 people who had taken a cruise ship to Bermuda became ill with Legionnaires' disease.
The disease received its name 20 years ago when an outbreak among Pennsylvania American Legion conventioneers in a Philadelphia hotel killed 34 people.
Although outbreaks like the 1976 case garner the most attention, the disease usually appears in isolated instances. There is no evidence of it spreading from person to person.
The early symptoms are flu-like, including muscle aches, headaches, fatigue, loss of appetite, abdominal pain and, occasionally, diarrhea. Those symptoms describe many ailments, but what separates Legionnaires' from other forms of pneumonia is its potentially quick, 24-hour escalation, characterized by chills and fever as high as 104 degrees.
"But lots of times people have it and aren't even sick, never go to the doctor and have mild symptoms or none at all," Hershey said. "They recover in two to five days without treatment, thinking they had the flu or a cold."
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