ROANOKE TIMES
Copyright (c) 1996, Roanoke Times
DATE: Sunday, October 27, 1996 TAG: 9610280078
SECTION: VIRGINIA PAGE: B-1 EDITION: METRO
DATELINE: RADFORD
SOURCE: ALLISON BLAKE STAFF WRITER
It may be weeks before state and federal health officials find the source of an outbreak of Legionnaires' disease that has sickened eight New River Valley residents.
If they find out at all, that is.
"We will try to generate a hypothesis of where the individuals were exposed," said Dr. Jody Hershey, director of the New River Health District.
No new confirmed cases were reported Saturday. But, Hershey said, "in this proactive investigation, we may find some other cases."
An exhaustive investigation, begun by state and local health officials Oct. 17, was joined Saturday by two Atlanta-based investigators from the federal Centers for Disease Control and Prevention. Among the keys to their search: extensive testing of pneumonia patients at area hospitals. The idea is to confirm other cases, if they exist, Hershey said.
Legionnaires' is not contagious, and generally attacks older people with compromised immune systems.
The eight Legionnaires' patients fell ill about two weeks ago. The state's first outbreak of the pneumonia-like disease coincided with a local rise in reports of pneumonia. Six patients are Montgomery County residents. One lives in Pearisburg and one in Willis, in Floyd County. All but one are over age 50.
One of the patients, in critical condition at Salem's Veterans Affairs Medical Center, was "slightly improved" Saturday, although still in intensive care, said Dr. Charles Schleupner, chief of medical services at the center. Another patient is at Lewis-Gale Medical Center in Salem. Hershey said he also is slightly improved, but still in critical condition. A third is in stable condition at Columbia Montgomery Regional Hospital.
The five other patients have been discharged from area hospitals.
Most at risk for the disease are men middle-aged and older who smoke or drink heavily, and others with a chronic illness such as diabetes, lung or kidney disease, or who have compromised immune systems, Hershey said. Both patients in critical condition had prior medical conditions.
The hunt for the cause of the disease will unfold in stages. Health officials are testing all pneumonia patients who either are in local hospitals or have recently been discharged, Hershey said. At the same time, officials are querying the Legionnaires' patients to try to find a common thread in their activities during the incubation period, which is two to ten days. The average is five or six days, Hershey said.
Investigators want to know where the patients went during that time and what they did. Where did they shop? What social functions did they attend?
If investigators find a common thread, they will begin testing to see if the same bacterium is found in the common environment. But Hershey cautioned that could take weeks.
"Certainly," he said, "we have reason to suspect these cases are likely connected."
But he also cautioned that the bacterium is "widely distributed in the environment" and usually doesn't cause Legionnaires' disease. It is found in soil and in wet areas such as hot tubs, pools, water taps, coolers, air-conditioning systems, rivers and creeks. Typically, people with compromised immune systems become sick from inhaling the bacterium, Hershey said.
"It's possible," Schleupner said, "we'll never pin the exact cause down and it'll pass."
Virginia averages about 15 cases a year.
Symptoms include a rapid, high fever - between 103 and 105 degrees - that comes on within a day or so of flulike symptoms that include fatigue, body aches and headache.
"These people are sick," Hershey said. "This isn't typical cold symptoms."
He also cautioned against alarm, but encouraged people who are exhibiting these symptoms to see a doctor.
LENGTH: Medium: 74 linesby CNB