LD cases increase in East - Legionella cases increase in East

Legionnaires' cases increase in East
Akron Beacon Journal, OH - 5 Sep 2003

CDC investigator suspects wet summer, but Ohio officials say doctors more aware in wake of SARS From staff and wire reports

Blame it on the rain, or maybe on the SARS scare. Whatever the reason, incidences of Legionnaires' disease have increased sharply in several Eastern states this year, including Ohio.

An investigator with the U.S. Centers for Disease Control and Prevention suspects that the wet summer may be the reason why some states are seeing a doubling in the number of legionella infections.

The most noticeable increase in the sometimes deadly respiratory disease came in May and June after heavy spring rains, and it started to taper off by the end of August, said Dr. Daniel Feiken, a CDC epidemiologist.

``There's potential that, if there were more nutrients in the water because of runoff from overflooded rivers... it may lead to a bloom in legionella,'' Feiken said.

Officials with the Ohio Department of Health, though, wonder if the rise in Legionnaires' disease is simply because doctors are more diligent in investigating respiratory problems since SARS (severe acute respiratory syndrome) began making headlines in March.

``Perhaps doctors are just doing a little more investigation in this post-SARS environment,'' said ODH spokesman Kristopher Weiss.

In 2002, Ohio had recorded 67 cases of Legionnaires' at the end of August. This year, that number has grown to 150. All the cases were individual incidents, Weiss said. There have been no outbreaks or spread of the disease.

The number of cases in Pennsylvania so far this year is 163, compared with 69 cases at the same time last year. Florida's cases rose from 53 to 103, Maryland's cases went from 22 to 83, and Virginia reported an increase from 16 to 65. North Carolina, Kentucky and Tennessee also saw dramatic increases.

People contract Legionnaires' disease after inhaling mists from a water source contaminated with the legionella bacteria, which thrive in warm, stagnant water.

``We're trying to figure out how rain might cause legionella to be in either the water supply or cooling towers or other sources,'' Feiken said.

Feiken said investigators wondered whether the pneumonialike disease was just being more thoroughly reported and diagnosed, or if the trend was simply the result of chance, but those possibilities are starting to appear unlikely.

Symptoms of the disease include fever, chills, cough, body aches, headache, fatigue, loss of appetite and diarrhea. The disease can be treated with antibiotics, but between 5 percent and 30 percent of cases are fatal.

The illness is called Legionnaires' disease because it was first reported at an American Legion convention in 1976 in Philadelphia, where it made 182 people ill.