The Presidential Virus

Viral pneumonia is sometimes known, as Senator Sam Ervin Jr. referred to it in his lip-smackin' drawl, as "walkin' pneumonia." Often, as Dr. David J. Sencer of the U.S. Center for Disease Control pointed out, it is no worse than a bad cold or a touch of flu. But for some victims, especially those over 50, the bug that hospitalized President Nixon last week is a misery-making, debilitating illness. Victims can be reassured by the fact that viral pneumonia proves fatal in less than 1% of cases.

All forms of pneumonia are inflammations of the inner surface of the lungs. The classic form, deservedly dreaded before the era of sulfa drugs and antibiotics, is caused by bacteria. The vast majority of these cases can now be cured by drug treatment. More puzzling to specialists in infectious diseases has been the viral variety that attacked the President. This may be caused by any one of scores of different viruses, from those responsible for the common cold and laryngitis to those associated with measles and influenza. Infections provoked by these viruses do not yield to any known drugs, since medication that would kill the viruses would also destroy the cells that they parasitize.

Actually, one common form of "viral" pneumonia is caused by an organism that is neither a bacterium nor a virus. Known as Mycoplasma pneumoniae, or the "Eaton agent" (named for its discoverer), it is the smallest free-living agent capable of infecting man. The microbe is best known for downing whole barracks or dormitories of victims at a time. One of the few advantages of having Mycoplasma pneumonia is that, like the bacterial forms, it is susceptible to attack by antibiotics.

When Dr. Walter R. Tkach, Nixon's personal physician since 1969, concluded that his patient was suffering from viral pneumonia, he knew that it might take several days for lab tests to determine whether the infecting agent was Mycoplasma or a true virus. He decided to administer an antibiotic immediately on the theory that it might help. Though Tkach declined to identify the medicine, it was probably erythromycin or one of the tetracyclines, which are frequently prescribed for Mycoplasma pneumonia. From X rays, he concluded that only the lower lobe of Nixon's right lung was inflamed.

For all viral pneumonias, the prescriptions and prognoses are clear: analgesics (probably aspirin) to control fever and relieve headache, aching muscles and chest pain; bed rest; and lots of fluids. The President's fever of 101DEG-102DEG was neither unusual nor threatening. Still, the disease is considered serious enough for a man of his age to require the seven to ten days in hospital that Nixon was told to expect.

To the layman's natural curiosity about whether or not Nixon's illness may have been brought on by Watergate, there is a straightforward, nonpolitical answer. Anyone is more than usually susceptible to illness brought on by transient, everyday germs in periods of stress, when he may be sleeping poorly and working too hard. Thus it is most unlikely that Nixon's illness provides any psychosomatic insights into his feelings about Watergate--but quite possible that his first bout with illness since becoming President is the indirect result of that unhappy affair.

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