- The Washington Times - Tuesday, July 15, 2003

Maryland doctors are looking for Legionnaires’ disease among patients with flulike symptoms, following a recent advisory stating the number of U.S. cases has increased sharply this year.

“We want health care providers to keep this in mind, [but] I would not call it an outbreak,” said David Blythe, medical epidemiologist at the Maryland Department of Health and Mental Hygiene.

Maryland has 47 confirmed cases, including four deaths, in the first seven months of 2003. The state had 56 cases last year. Virginia has 44 cases, including one death. The state had 35 cases last year. The Centers for Disease Control and Prevention (CDC) had no reported cases this year or last year for the District.

The nationwide total was 624 cases as of last week, compared to 436 for the same period in 2002, according to the CDC.

Doctors and health officials are still baffled about what has caused the increase, but said the cases have not been linked to a specific outbreak or source.

The bacteria was detected as early as 1947, but was given the name Legionnaires’ disease in 1976 after at least 29 American Legion members staying in a Philadelphia hotel developed the flulike symptoms and died.

Maryland health officials issued the notice to hospital, clinic and other health agencies about two weeks ago and participated Friday in a conference call with officials from Delaware, North Carolina, Pennsylvania, Virginia and the CDC.

“Nobody has an explanation,” said Michelle Stoll, a spokeswoman for the Virginia Department of Health.

However, several theories have surfaced — from faulty testing, to the increase of people being tested for SARS turning up more confirmed cases of the other disease, to the wet, humid spring helping carry the airborne bacteria.

People contract the disease after inhaling mist from a water source that has the Legionella bacteria. The bacteria thrives in such warm, stagnant water as cooling towers, showers, spas, whirlpools and large air-conditioning systems.

Outbreaks are common at conferences or on cruise ships because the bacteria is spread through air conditioning and other moist ventilation systems. It cannot be spread from person to person.

Symptoms include fever, chills and a cough, but patients also can experience fatigue, difficulty breathing, head and muscle aches.

Legionnaires, a strain of pneumonia, can be treated with antibiotics, though about 5 percent to 15 percent of the cases are fatal, especially among the elderly, smokers, or those with weak immune systems.

The region’s most recent case is in Delaware and involves a Maryland resident who began experiencing symptoms July 10 and was hospitalized Sunday.

“If you are concerned, then you should contact your health providers,” Dr. Blythe said.

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