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Legionnaires' Disease — Description of an Epidemic of Pneumonia

List of authors.
  • David W. Fraser, M.D.,
  • Theodore R. Tsai, M.D.,
  • Walter Orenstein, M.D.,
  • William E. Parkin, D.V.M., DR. P.H.,
  • H. James Beecham, M.D.,
  • Robert G. Sharrar, M.D.,
  • John Harris, M.D.,
  • George F. Mallison, M.P.H.,
  • Stanley M. Martin, M.S.,
  • Joseph E. McDade, Ph.D.,
  • Charles C. Shepard, M.D.,
  • Philip S. Brachman, M.D.,
  • and the Field Investigation Team*

Abstract

An explosive, common-source outbreak of pneumonia caused by a previously unrecognized bacterium affected primarily persons attending an American Legion convention in Philadelphia in July, 1976. Twenty-nine of 182 cases were fatal. Spread of the bacterium appeared to be air borne. The source of the bacterium was not found, but epidemiologic analysis suggested that exposure may have occurred in the lobby of the headquarters hotel or in the area immediately surrounding the hotel. Person-to-person spread seemed not to have occurred. Many hotel employees appeared to be immune, suggesting that the agent may have been present in the vicinity, perhaps intermittently, for two or more years. (N Engl J Med 297:1189–1197, 1977)

Funding and Disclosures

Address reprint requests to the Center for Disease Control (attention of Dr. Fraser) Bacterial Diseases Division, Bureau of Epidemiology, Atlanta, GA 30333.

* Dennis Bregman, M.S., Robert B. Craven, M.D., Michael J. DiMeo, M.D., Robert Gens, M.D., Marshall F. Goldberg, M.D., Mark J. Goldberger, M.D., Robert A. Gunn, M.D., Philip L. Graitcer, D.D.S., William E. Halperin, M.D., Gregory F. Hayden, M.D., David L. Heymann, M.D., Richard A. Keenlyside, MBBS, Carlos E. Lopez, M.D., James S. Marks, M.D., William J. McKay, M.D., Vern Pidcoe, Dr. P.H., Philip J. Rettig, M.D., Cathryn L. Samples, M.D., John J. Seggerson, Michael D. Shasby, M.D., James D. Shelton, M.D., Edward W. P. Smith, M.D., and Stephen B. Thacker, M.D.

We are indebted to Calvin C. Edmonds, David A. Hall, Thomas Leonard, Robert L. Longenecker, John Kolnik, David Knorowski, Denis Lucy, M.D., Joel Mulder, Edward J. Powers, George Rogers, Jerry Shirah, Eleanor Streiff, R.N., M.P.H., public-health nurses of the Pennsylvania Department of Health, personnel of the City of Philadelphia — City Representatives Office, Department of Health, Licenses and Inspections Department, Manager Director's Office, Police Department and Water Department — personnel of the Region III Office, DHEW, and the staff at the Center for Disease Control for assistance during the field investigation, to Robert A. Pollard and Phyllis A. Wingo for assistance in statistical analyses and to John V. Bennett, M.D., for advice and criticism.

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