ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Saturday, October 26, 1996 TAG: 9610280064
SECTION: VIRGINIA PAGE: A-1 EDITION: METRO
DATELINE: CHRISTIANSBURG
SOURCE: MARK CLOTHIER STAFF WRITER
State health officials confirmed four more cases of Legionnaires' disease Friday in the New River Valley.
Officials now call the total of eight cases an outbreak.
Health officials have stepped up their investigation to find more cases and common threads. The one indication there might be a connection is that the eight patients' Legionnaires' symptoms came at roughly the same time, about two weeks ago.
Of the eight, three are hospitalized, two in critical condition at Salem hospitals - one at Lewis-Gale Medical Center and one at the Veterans Affairs Medical Center. The third is in stable condition at Columbia Montgomery Regional Hospital.
The New River Valley outbreak is Virginia's first ever, according to Dr. Jody Hershey, director of the New River Health District.
The four new Legionnaires' patients live in Montgomery County, bringing the total of confirmed cases there to six. The other two patients live in Pearisburg and the Floyd County community of Willis. All but one are over 50.
Legionnaires' is a form of pneumonia often linked to air-cooling systems. It is not contagious. From 0.5 percent to 5 percent of all pneumonia cases are caused by Legionella, the bacterium that causes Legionnaires' disease. The bacterium, the third most common cause of pneumonia, is found almost everywhere but generally attacks people older than 60 and those with weakened immune systems. Both of the critical patients had prior medical conditions.
Hershey said that for every 100,000 reported cases of Legionella infection, about six require hospitalization. Once patients are hospitalized, the fatality rate has been as high as 39 percent.
Hershey said most of eight confirmed cases fit the profile of middle-aged to older men who smoke and have medical conditions such as diabetes, cancer, lung or kidney disease.
Investigators from the federal Centers for Disease Control and Prevention in Atlanta were expected Friday evening.
Hershey said the CDC offers experience, labor and superior lab facilities that can help match Legionella bacteria from patients with those found at a site if a common source is determined.
Officials from Carilion Radford Community and Columbia Montgomery Regional hospitals said the number of patients hospitalized with pneumonia skyrocketed more than 250 percent during the past two weeks. Carilion Giles Memorial Hospital reported about a 25 percent increase of pneumonia patients last week and a normal number this week.
"We came across this a week and a half ago," said Bob Brannigan, chief nursing officer at Columbia Montgomery. "It was so abnormal, it just stuck out."
Brannigan said the hospital normally has two to four pneumonia patients at any given time. Lately there have been 20 or more.
The expanded investigation has included testing of patients admitted with pneumonia and those who may already have been treated and released, Hershey said.
Virginia averages about 15 Legionnaires' cases a year. Last year, 28 cases were reported. There have been 18 this year, not counting the New River Valley cases.
Dr. Charles Schleupner, chief of medical services at the VA Medical Center, said the number of cases is relatively low considering the New River Valley's population of more than 155,000.
"There is no room for panic here," he said. "But if you feel ill with a fairly high fever - 102 degrees to 103 degrees - and have a dry cough, see your doctor. If we treat it early, we can do much better."
LENGTH: Medium: 72 lines ILLUSTRATION: GRAPHIC: Chart by staff: Legionnaires disease. KEYWORDS: MGRby CNB