title: Showers, sweating and suing: Legionnaires' disease and 'new' infections in Britain, 1977-90.
abstract: Legionnaires' disease is now routinely discussed as an 'emerging infectious disease' (EID) and is said to be one of the earliest such diseases to be recognised. It first appeared in 1976 and its cause was identified in 1977, the same year that Ebola fever, Hantaan virus and Campylobacter jejuni arrived. The designation of Legionnaires' disease as an EID was retrospective; it was not and could not be otherwise as the category only gained currency in the early 1990s. In this article we reflect on the changing medical understanding and social profile of Legionnaires' disease in the decade or so from its recognition to the creation of EIDs, especially its ambivalent position between public health and clinical medicine. However, we question any simple opposition, between public health experts who approached Legionnaires' disease as a new and worrying environmental threat that could be prevented, and clinicians who saw it as another cause of pneumonia that could be managed by improved diagnosis and treatment. We argue that in the British context of public spending cuts and the reform of public health, the category of 'new' diseases, in which Legionnaires' disease was central, was mobilised ahead of the EID lobby of the early 1990s, by interested groups in medicine to defend infectious diseases services.
authors.affiliation: Professor of Respiratory Medicine, University of Nottingham, and Visiting Professor, Centre for the History of Science, Technology and Medicine and Wellcome Unit for the History of Medicine, Faculty of Life Sciences, University of Manchester, c/o Watergate Barn, Loweswater, Cumbria CA13 0RU, UK. jtmacfarlane@gmail.com
authors.forename: John T
authors.initials: JT
authors.lastname: Macfarlane
authors.forename: Michael
authors.initials: M
authors.lastname: Worboys
mesh_terms: D000389:Air Conditioning; D000900:Anti-Bacterial Agents / Q000266:history / Q000627:therapeutic use; D001294:Attitude to Health; D021821:Communicable Diseases, Emerging / Q000266:history*; D004196:Disease Outbreaks / Q000266:history*; D006268:Health Facilities / Q000266:history / Q000331:legislation & jurisprudence; D049673:History, 20th Century; D006801:Humans; D016952:Legionella pneumophila; D007877:Legionnaires' Disease / Q000453:epidemiology / Q000266:history*; D013222:State Medicine / Q000266:history; D006113:United Kingdom / Q000453:epidemiology; D014871:Water Microbiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Air Conditioning Systems; Antibiotics; Building Regulations; Civil and Criminal Litigation; Diagnosing Pneumonia; Emerging Infectious Disease; Erythromycin; Failure of Penicillin; Invasive Lung Investigations; Legionnaires’ Disease; Media and Press Interest; Pneumonia; Public Attitudes to Infection; Showers and Hot Tubs; Water Systems