Pulmonary disease associated with cafeteria flooding.

An illness among office workers, consisting of cough, fever, chills, muscle aches, and chest tightness was associated with water leaks from a cafeteria. Mean single breath carbon-monoxide diffusing capacity (DLCO) of cases differed significantly from that of non-cases. There was a significant decrease in the percent of predicted DLCO with increasing number of symptoms. Testing for precipitating antibodies to microbial agents found in the building revealed no differences between cases and non-cases. DLCO is an appropriate cross-sectional instrument for field investigations of building-associated respiratory disease.

Chronic lead absorption. Result of poor ventilation in an indoor pistol range.

Three cases of mild lead poisoning were discovered among instructors at an indoor pistol range. These cases were characterized by blood lead levels greater than 100 mug/100 ml, free erythrocyte protoporphyrin levels greater than 450 mug/100 ml of red blood cells, abdominal pain, and, in one instance, by slowing of motor and sensory nerve conduction velocity. Exposure to airborne lead produced during revolver-firing and bullet-molding accounted for the lead absorption. Ventilation in the range was inadequate.

Pontiac fever. An epidemic of unknown etiology in a health department: I. Clinical and epidemiologic aspects.

In July 1968, an explosive epidemic of acute febrile illness occurred at a county health department facility in Pontiac, Michigan. Illness characterized principally by fever, headache, myalgia, and malaise affected at least 144 persons, including 95 of 100 persons employed in the health department building. The mean incubation period was approximately 36 hours. Illness was self-limited, generally lasting from two to five days. Secondary cases did not occur in family contacts and second attacks did not consistently follow re-exposure in the building. A defective air-conditioning system was implicated as the source and mechanism of spread of the causative factor. However, extensive laboratory and environmental investigations failed to identify the etiologic agent. Since these investigations a bacterium similar to or identical with the agent responsible for Legionnaires' Disease has been isolated from guinea pigs exposed to the Pontiac health department building in 1968 as well as from guinea pigs exposed to water from the evaporative condenser. Paired sera from 32 cases of Pontiac Fever showed seroconversion or diagnostic rises in antibody titers to this bacterium.

Outbreak of lymphocytic choriomeningitis virus infections in medical center personnel.

An outbreak of lymphocytic choriomeningitis (LCM) virus infections occurred in Medical Center personnel at the University of Rochester in 1972-1973. A total of 48 infections was discovered, 31 in staff of the radiation therapy area, 12 in the staff of the Vivarium facility, and 5 in other individuals who worked in the Medical Center. Twenty-one of the infections were associated with recent febrile illness with myalgia. Epidemiologic and virologic studies indicated that the source of the infection was Syrian hamsters which were used in tumor research; the tumor cell lines themselves were shown to be contaminated with LCM virus and probably represented the original source of contamination of the Rochester facility. Infection occurred not only through direct contact with infected animals but also from mere presence in the room where the animals were held. This outbreak emphasizes the need for restricting access to animal quarters and for surveillance of hamsters and tumor cell lines and indicate the necessity of separating animal facilities from patient-care facilities.