The "missing" investigation of Legionnaires' disease.

Abstract

The investigation of Legionnaires' disease was riddled with problems, and as a result, was largely ineffective. But the lesions it taught can be extremely valuable to future public-health efforts if they are heeded. This chapter has attempted to highlight those problems and offer some possible solutions. It is now up to the public-health hierarchy to use what is offered in these pages to spark the building of programs and systems that provide the level of effectiveness the American people have a right to expect from public-health departments. Finally, it was my intent to raise questions about the Center for Disease Control's new organism. The Center may, indeed, have found the responsible agent. We must not, however, allow ourselves to have tunnel vision in the continuing investigation--switching to other possibilities only if the microorganism theory is exhausted. The evidence and remaining questions demand a broader scope of investigation. How tragic it will be if we have not learned from the inflexibility and narrowness of the 1976 investigation of Legionnaires' disease.