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Epidemiologic Notes and Reports Respiratory Infection -- Pennsylvania

As part of its commemoration of CDC's 50th anniversary, MMWR is reprinting selected MMWR articles of historical interest to public health, accompanied by a current editorial note.

Reprinted below is the initial report published August 6, 1976, on an outbreak of respiratory illness among persons who attended an American Legion convention in Philadelphia during the summer of 1976. Following that report is the special issue of MMWR published January 18, 1977, which announced the identification of the bacterium that caused Legionnaires disease. Tables from the special issue have been recreated to resemble the originals as closely as possible. A contemporary

Editorial Note

Editorial Note follows the outbreak reports.

A total of 152 persons associated with a state American Legion convention in Philadelphia July 21-24 have been hospitalized with respiratory infections. Onsets of illness were in the period July 22-August 3; the majority occurred from July 25 to July 31. Twenty-two of these patients have died. The deaths, reported over the past week, were primarily due to pneumonia.

Although information about the disease and its epidemiology is incomplete, it appears to be characterized by the acute onset of fever, chills, headache, and malaise, followed by a dry cough and myalgia. Some of the most seriously ill developed high fever and died in shock with extensive pneumonia. No etiologic agent has yet been incriminated. There is no information available concerning other Legionnaires who may be ill with less severe symptoms.

The patients, among several thousand attending the convention, stayed in at least 3 or 4 hotels while in Philadelphia. There is no evidence of increase in respiratory disease in Philadelphia residents, nor has there been any confirmed secondary spread to family members or other contacts. There have been several reports of similar disease in non-conventioneers who were in Philadelphia at the same time as the convention.

Reported by RG Sharrar, MD, City of Philadelphia Dept of Public Health; WE Parkin, DVM, Acting State Epidemiologist, Pennsylvania State Dept of Health; the Bur of Epidemiology and the Bur of Laboratories, CDC.

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