ROANOKE TIMES
Copyright (c) 1997, Roanoke Times
DATE: Friday, January 31, 1997 TAG: 9701310065
SECTION: VIRGINIA PAGE: C-1 EDITION: METRO
DATELINE: CHRISTIANSBURG
SOURCE: MARK CLOTHIER STAFF WRITER
THE CDC also announced seven newly confirmed cases of the disease that killed 2 men in the New River Valley.
The Centers for Disease Control and Prevention confirmed Thursday that a display hot tub at a Christiansburg home improvement store was the likely source of a fall outbreak of Legionnaires' disease in the New River Valley.
The preliminary finding, released in the CDC's "Morbidity and Mortality Weekly Report," also announced seven newly confirmed cases. The final word on the outbreak, which killed two men, will be an as-yet-unwritten medical journal article.
The results back up the initial announcement by the New River Health District that linked the outbreak to a since-removed hot tub at the Lowe's store in the busy U.S. 460-Virginia 114 retail hub.
Nationally, it marks the first outbreak of Legionnaires' from a hot tub that occurred without people actually entering the water, according to Dr. Jody Hershey, director of the New River Health District. The findings in this case could lead to new national guidelines for the maintenance of whirlpool spas and hot tubs, including those on display in stores.
The new cases - four women and three men - are October pneumonia patients who didn't test positive for Legionnaires' at the time. Follow-up testing confirmed the new cases within the past week.
The new cases bring the total for Virginia's first major outbreak to 23 - 17 men and six women. Of the 23 cases, 22 were hospitalized and two people died. Ages ranged from 42 to 86. Some 78 percent of the patients fell sick between Oct. 8 and 14.
The outbreak's geographic breakdown: 16 cases in Montgomery County; two each from Radford, Giles and Pulaski counties; and one from Floyd County. Of the newly confirmed cases, five were from Montgomery County and one each was from Giles and Pulaski counties.
The new cases were confirmed by comparing blood samples taken when the patients were sick with samples taken eight weeks later. In most cases, this was done in December. If the patient had the disease in the original sample, the second sample showed a four-fold rise in the number of Legionella antibodies, protein molecules the body creates to fight disease.
Testing for Legionella bacteria can be done with blood, urine or sputum samples. The tests range in accuracy from 70 percent to 96 percent, Hershey said.
The CDC also reported this was the first outbreak linked to a display-only hot tub. The Atlanta-based federal center is assessing existing guidelines for the public maintenance of hot tubs on cruise ships - adopted after an outbreak of Legionnaires' on a ship - to see if they might be applied to hot tub displays.
The Virginia Department of Health is recommending display hot tubs be inspected regularly and maintained with proper chemicals.
Legionnaires' is a form of pneumonia often linked to air-cooling systems. It is not contagious but can be found anywhere. The bacteria typically attack men older than 50 and those with weakened immune systems. Though the disease is considered vastly underreported, Virginia averages 15 cases per year. Including the New River outbreak, 41 were reported last year in Virginia.
The CDC report is the official publication of the preliminary findings on the outbreak. It is mailed to health departments, researchers and academics nationwide. It also is posted on the World Wide Web at: www.cdc.gov/
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