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Last year, I became acutely aware of Legionnaire’s disease while researching the controversial issue of using water heaters for both potable water and hydronic systems. While I was familiar with the 1976 outbreak in Philadelphia, I was not well-informed about the disease itself or the bacteria that causes it. A wealth of information is available, and I have found the world’s leading authorities are more than willing to share their knowledge.
One was circa 1947 from a soldier who had developed and died of pneumonia while at Fort Bragg, N.C. Further study revealed an outbreak occurred in 1957 at a meat-packing plant. Another form of infection caused by legionella bacteria is Pontiac Fever. Its name is derived from the first recorded outbreak in Pontiac, Mich., which affected 144 people at the Oakland County Health Department. Flu-like symptoms occur that last for several days. So who is at risk? Generally speaking, elderly people with immune systems that are compromised by medication or illness; smokers; heavy drinkers; and aids, heart and kidney patients. Blood samples have shown that a large percentage of the population has been exposed to legionella bacterium. As many as 10,000 to 100,000 cases of Legionnaire’s disease occur each year (depends on whose statistics you believe), and some think those are low numbers. Unfortunately, many cases go unreported because they are simply listed as pneumonia. Penicillin, a drug often prescribed to pneumonia patients, is ineffective. Erythromycin is the proper medication. "Amplifiers," a term often used with this issue, are devices capable of providing an environment suitable for the growth of legionella bacteria. Some examples include air conditioning cooling towers, potable water systems, humidifiers, whirlpool tubs, spas and domestic water heaters. Any device capable of creating a mist that can be inhaled (vegetable misters, shower heads, aerators) in an environment where people are present can deliver a potentially fatal dose if the bacteria are present in sufficient numbers to overwhelm the immune system. Human lungs are a virtually perfect environment for legionella bacteria.
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In 1976, while attending an American Legion Convention at the Bellevue Stratford Hotel, 211 people became ill and 34 of them died from what was thought to be a previously unknown type of bacterial pneumonia. After this outbreak and identification of the bacterial strain, the Centers for Disease Control and Prevention examined some previously collected tissue samples, which revealed earlier cases of Legionnaire’s disease.
