Eight days after a 1976 state American Legion convention in Philadelphia, Edward Hoak realized that something was dreadfully wrong and put out an alert.
Ray Brennan, 61, had died July 27, but everyone thought it was related to his heart disease. On Aug. 1, while attending the installation of officers at his home post in Manor, Pa., Hoak heard that Frank Harvey, 54, of McKeesport and Charles Chamberlain, 48, of Chambersburg were dead.
James (Posie) Flowers of Latrobe, one of Hoak's best friends, had a mysterious fever. A friend's wife also was ill. Hoak drove to the Legion's state headquarters near Harrisburg to find the grapevine humming with more news of strange illnesses.
Picky as a Sniper
By the night of Aug. 1, 11 Legionnaires were dead from an agent that seemed as picky as a sniper and as deadly as nerve gas.
No one then had heard of legionnaire's disease.
"It was scary," Hoak recalls. "You start seeing it multiply all over the place. When I heard people were sick, I got suspicious. You just didn't know what the hell it was.
"If we hadn't been such a close-knit group, if it had been a shoe salesmen's convention in San Diego, nobody would have ever known."
The morning of Aug. 2, a day eight more people would die, Hoak called The Associated Press to alert the media that something was wrong.
"A lot of people's lives were spared simply because the alarm was spread," Hoak says.
Had Attended Convention
The scourge was named legionnaire's disease because 182 of the 221 people who became ill had attended the July 21-24 convention at the Bellevue-Stratford Hotel. Twenty-nine of the 34 people who died were Legionnaires or their wives.
The others had attended the Eucharistic Congress, a candle-makers' convention, a magicians' convention or had been in or near the Bellevue.
The outbreak was neither the first nor the last, although it was the most deadly on record. It was the first time the virulent culprit, a rod-shaped bacterium that thrives in water and is carried by the air, was identified.
Medical SWAT teams mustered for one of the biggest germ hunts in history tracked down the killer in six months and found that the bug, which is not contagious, grows throughout nature.
Traced Back to 1947
The first known instance of its dirty work was traced back to 1947. In 1965, 14 people died and 67 contracted the disease in a mental hospital in Washington. In 1968, 144 people at a health department in Pontiac, Mich., fell sick.
It had even plagued Philadelphia before. In 1974, 20 cases, including two deaths, followed an Odd Fellows convention.
More than a dozen outbreaks have occurred since. Last spring the disease killed 28 people in Stafford, England, the second highest toll on record.
An estimated 25,000 sporadic cases occur nationally each year, according to the Centers for Disease Control.
Cooling Tower Suspected
The suspected source of the 1976 outbreak was a cooling tower atop the hotel. Epidemiologists theorize that the germ lurked in the water, then was carried like an aerosol when swept by the wind.
The bacteria have been found in air conditioners, lawn sprinklers, shower heads, recreational whirlpools, thermal springs in Yellowstone National Park and soil excavations.
The disease has struck in every state except Alaska and South Dakota. It also has been found in Canada, Great Britain, the Netherlands, Switzerland, Austria, Australia, Germany, Sweden, Denmark, Belgium, Israel and South Africa.
The microbe can be curbed with erythromycin, a common antibiotic. If untreated, it can cause death 15% of the time. Its victims die of shock or lung failure due to pneumonia.
'Sets Off a Panic'
"The picture the public has is that it's a severe illness that's almost always fatal. When someone is diagnosed as having legionnaire's disease, it really sets off a panic," says Dr. Suzanne Laussucq, an expert in respiratory diseases with the CDC.
"But we know how to treat it. We know what causes it--a bacterium ubiquitous throughout nature," Laussucq says. "We really don't understand why certain people are susceptible."
There are other puzzles. Men are three times more likely to catch the disease. Smokers and drinkers are at three times higher risk than abstainers. And one strain, called Pontiac Fever, causes illness but not pneumonia or death.
About 4,400 people attended the Legion convention to swap war stories, listen to patriotic speeches, march in a parade and cruise the hospitality suites.
5 Days Average Onset
About 4% were infected. They went home feeling played out. The disease struck in two to 10 days, with the average onset coming in five days.
At first, the afflicted shrugged off their malaise as post-convention blahs. Some thought it was a summer flu because of the fever, chills, dry cough, headache and achiness.
Russell Dugan, 63, felt it coming on when he drove back home to Kingston.
"I felt sluggish. My feet felt like they had lead weights on. I said to myself, 'What a hangover. I must have been at a wild party,' " says Dugan, a semiretired pub manager.
He Was Packed in Ice
But the malady persisted, despite a double shot of penicillin. On Aug. 1, Dugan was hospitalized. He was quarantined and packed in ice when his fever rocketed to 107 degrees. On the 6 o'clock news on Aug. 3, he learned that Elmer Hafer, a state vice commander from Lewistown, had died.
"Lo and behold, the last guy I shook hands with at the convention was dead. That's how I found out I had legionnaire's disease. I saw it on TV," Dugan said. "Some doctors didn't even want to go into my room. Nobody knew anything."
Microbe hunters dispatched by the CDC and state Health Department armed themselves with syringes and microscopes to track an extraordinary villain.
There was no smoking gun--no bad food, no bad water, no virus, no infected person sickening others. There were also no new cases after Aug. 18.
Parrot Fever Rejected
Medical sleuths probed and rejected theories that the outbreak was due to parrot fever, nickel poisoning or sabotage.
"It's very similar to detective work. You're asking the same kinds of questions. You're trying to sift through evidence. It's like looking for fingerprints," says Dr. Leonard Bachman, former state secretary of health who is now with the U.S. surgeon general's office.
Bachman says the media focused attention on the disease the same way it has on AIDS and toxic shock syndrome.
"The effort to solve the problem was influenced tremendously by the media. There were lots of resources invested because of all the attention," Bachman says. "The cause was discovered in six months. That's a tremendous accomplishment. The American scientific process did focus in and find an answer."
They Were Stumped
The best medical minds in the country were stumped because they were looking for something they had never identified before, according to Dr. David Fraser, who headed the CDC's epidemiology team.
"The most important thing about legionnaire's disease was the change in attitudes people had about infectious diseases. People thought we knew it all," says Fraser, now president of Swarthmore University.
The break came in January, 1977, when Dr. Joseph McDade of the CDC spied the culprit while peering through a microscope. He likened the search to "looking for a contact lens on a basketball court with your eyes four inches above the ground."
Before the germ was found, an AIDS-type hysteria had stalked Legionnaires. Charles Neubaum of Chambersburg recalls the hostile reception he got while having a drink at the NCO Club in Carlisle.
'Break His Glass'
"The club manager knew I had been at the convention and he told the waitress, 'After that guy drinks from that glass, you break it,"' said Neubaum, 68, a retired assistant state adjutant.
"All kinds of rumors were floating around. People wouldn't sit next to us. People went into a panic because people died so fast," Neubaum says. "Then the fear died down. It was announced it wasn't contagious, only infectious."
Ed Hoak encountered the same trouble at the funeral of one of the victims.
"We had our Legion hats on and went into a diner. Everybody got up and moved," Hoak recalls.
People Wore Masks
"A lot of posts had to close their bingo games because people were afraid to come. When we marched in a parade in Seattle about a month after the outbreak, I remember people outside the hotel putting those cloth masks over their faces."
Some Legionnaires believed that the name given the disease besmirched them, but it was later officially endorsed by the organization.
"Lots of members wanted the name changed. I fought that. It's a memorial to the people who died from it," Hoak said. "Twenty-nine of us died. They ought to get some recognition because of their sacrifice."
Those 29 names are inscribed on a monument outside Legion headquarters.
A Victorian Palace
There was one other victim, the Bellevue-Stratford, a 19-story Victorian palace that opened in 1904 and was known as the "Grand Dame of Broad Street."
It entertained kings, queens, prime ministers and presidents. But it died of bad publicity after a severe bout of loneliness. The occupancy rate had fallen to 3% when the hotel closed four months after the Legion convention.
It was resurrected in 1979, but it closed in March after losing $20 million in six years. Its owner wants to operate it as a small hotel, plus shops, offices and restaurants.
"The legionnaire's disease stigma didn't cause this. It wasn't a problem when we reopened in 1979. We don't think it had anything to do with the closing of the hotel this year," says Judith Morse of Rubin Associates, the hotel's principal owner. "Why don't they let that disease die?"