Celebration wasn’t the only thing in the air in Philadelphia in July of 1976. Over the course of several days during the 58th Annual Convention of the American Legion, a killer mist spewed out of the air conditioning units throughout the building and into the sidewalks nearby. The result was a large outbreak of unexplained febrile pneumonia, often fatal, that would acquire the name Legionnaires’ Disease. What was causing this terrifying disease and how could it be stopped? In this episode, we walk through the massive investigation into this outbreak that would lead to the discovery of the causative agent, Legionella pneumophila, and explore the biology of this mysterious pathogen. We wrap up the episode with a look at the current status of Legionnaires’ Disease and a potentially grim forecast for its prevalence as the world slowly gets back to normal.
| History | Biology |
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| Fields, Barry S. “The social life of Legionellae.” Legionella (2001): 135-142. | Edelstein, P.H., 1993. Legionnaires’ disease. Clinical Infectious Diseases, pp.741-747. |
| Fields, Barry S., Robert F. Benson, and Richard E. Besser. “Legionella and Legionnaires’ disease: 25 years of investigation.” Clinical microbiology reviews 15.3 (2002): 506-526. | Stout, J.E. and Yu, V.L., 1997. Legionellosis. New England Journal of Medicine, 337(10), pp.682-687. |
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| Khodr, A., et al. “Molecular epidemiology, phylogeny and evolution of Legionella.” Infection, genetics and evolution 43 (2016): 108-122. | Alli, O.T., Zink, S., von Lackum, N.K. and Abu-Kwaik, Y., 2003. Comparative assessment of virulence traits in Legionella spp. Microbiology, 149(3), pp.631-641. |
| Macfarlane, John T., and Michael Worboys. “Showers, sweating and suing: Legionnaires’ disease and ‘new’infections in Britain, 1977–90.” Medical history 56.1 (2012): 72-93. | O’Brien, S.J. and Bhopal, R.S., 1993. Legionnaires’ disease: the infective dose paradox. Lancet;(United States), 342(8862). |
| McDade, J. E. “Legionnaires’ Disease 25 Years Later: Lessons Learned. Legionella. R. Marre, Y. Abu Kwaik, C. Bartlett et al.” (2002): 1-10. | Centers for Disease Control and Prevention (CDC, 2011. Legionellosis—United States, 2000-2009. MMWR. Morbidity and mortality weekly report, 60(32), pp.1083-1086. |
| McDade, Joseph E., et al. “Legionnaires’ disease: isolation of a bacterium and demonstration of its role in other respiratory disease.” New England Journal of Medicine 297.22 (1977): 1197-1203. | Herwaldt, L.A. and Marra, A.R., 2018. Legionella: a reemerging pathogen. Current opinion in infectious diseases, 31(4), pp.325-333. |
| Mercante, Jeffrey W., et al. “Genomic analysis reveals novel diversity among the 1976 Philadelphia Legionnaires’ disease outbreak isolates and additional ST36 strains.” PLoS One 11.9 (2016): e0164074. | Hamilton, K.A., Prussin, A.J., Ahmed, W. and Haas, C.N., 2018. Outbreaks of legionnaires’ disease and pontiac fever 2006–2017. Current environmental health reports, 5(2), pp.263-271. |
| Newsome, Anthony L., et al. “Interactions between Naegleria fowleri and Legionella pneumophila.” Infection and immunity 50.2 (1985): 449-452. | Hsieh, T.S., Lopez, V.A., Black, M.H., Osinski, A., Pawłowski, K., Tomchick, D.R., Liou, J. and Tagliabracci, V.S., 2021. Dynamic remodeling of host membranes by self-organizing bacterial effectors. Science, 372(6545), pp.935-941. |
| Terranova, William, MitchellL Cohen, and DavidW Fraser. “1974 Outbreak of Legionnaires’ Disease Diagnosed in 1977: Clinical and Epidemiological Features.” The Lancet 312.8081 (1978): 122-124. | Chen, Y., Yang, Z., Dong, Y. and Chen, Y., 2020. Recombinant PAL/PilE/FlaA DNA vaccine provides protective immunity against Legionella pneumophila in BALB/c mice. BMC biotechnology, 20, pp.1-10. |
| Tsai, Theodore F., et al. “Legionnaires’ disease: clinical features of the epidemic in Philadelphia.” Annals of internal medicine 90.4 (1979): 509-517. | |
| Vance, Paula H., et al. “Legionella: a fascinating bacterium uncovered in the twentieth century.” Clinical microbiology newsletter 37.15 (2015): 119-123. | |
| Weisse, Allen B. “A Plague in Philadelphia: The Story of Legionnaires’ Disease.” Hospital Practice 27.6 (1992): 151-180. | |
| Winn Jr, WASHINGTON C. “Legionnaires disease: historical perspective.” Clinical Microbiology Reviews 1.1 (1988): 60-81. |
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