The Cuyahoga County Board of Health (CCBH) confirmed it is investigating 11 cases of Legionnaires’ disease, including the death of one person, all connected to the Saint Columbkille Church parish in suburban Cleveland.
All 11 victims were hospitalized, but the statuses of the remaining 10 patients, their names and genders were not released, citing privacy concerns.
The case count was amended after four additional cases were identified among those who attended services at the suburban Cleveland Catholic church.
The CCBH also confirmed the July 5th death of a 93-year-old Parma woman who was not one of the six initially identified as part of the cluster. The CCBH was able to connect her case to the cluster after the deceased woman’s family contacted the CCBH a few days ago.
Is church the hotspot?
CCBH officials have visited the church multiple times, conducting environmental testing to see if the bacteria exists on church grounds. The investigation began in early in early June, after the CCBH received notifications of cases from area doctors.
The focus of the investigation is on the parish’s air-conditioning system and a tower that recirculates water for the cooling system, according to CCBH communications officer Kevin Brennan.
The CCBH is interviewing victims to determine if the church or another location is the common source for Legionella bacteria, which causes Legionnaires disease.
“There is not a definite connection with the church,” Brennan told the Cleveland Plain Dealer. “It could be coming from a lot of different places. We don’t want to presume (the church) is a hotbed of infection.”
The church shut down the air conditioning in its sanctuary during Sunday’s masses as a precaution, and on the recommendation of the CCBH. The air-conditioning will not be used again until the environmental test results are returned.
“It is not transmitted from person to person,” CCBH health commissioner Terry Allan said. “That individual gets it, and that exposure point could be any range of water-misting sources. What we do not have is evidence in the environment that the Legionella is actually in a water-misting source at the church.”
Legionella, which causes a severe type of pneumonia (lung infection), are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor.
Members of the church or individuals who live within close proximity or even travel through the Parma neighborhood and are feeling flu-like symptoms (see below) are being advised to seek immediate care from their health-care provider. The Saint Columbkille Church parish, which serves about 3,000 households and includes an elementary school, is located at 6740 Broadview Road.
Are you at risk?
Legionella is not contagious and spread from person-to-person, and most people exposed do not become ill, according to the Ohio Department of Health. The bacteria are treatable with antibiotics when caught early.
The age range for the 11 who were sickened ranges from 74 to 93 years old. They reported their illnesses from early June to mid-July.
Individuals over the age of 50 are considered to be the highest-risk factor for Legionnaires’ disease. Others at greater risk for infection include smokers (current or former), heavy drinkers of alcoholic beverages, people with chronic lung disease, and people with compromised immune systems.
County and state see a rise in LD cases
Cuyahoga County has had 40 cases of Legionnaires’ reported this year through June, with 24 in June alone. That is a significant increase compared to 15 through June in 2017 and nine in 2016.
The state of Ohio reported approximately 55 cases annually between 2011 and 2015, but those numbers have increased each of the previous two years, with 80 in 2016 and more than 100 in 2017.
According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur yearly in the U.S. Only 5,000 cases are reported, however, because of its nonspecific signs and symptoms.
Approximately one in 10 patients infected with Legionnaires’ will die from the disease.
Legionnaires’ disease clusters and outbreaks have been linked to numerous sources, such as:
- cooling towers of air conditioning systems
- large plumbing systems
- water systems, such as those used in hospitals, nursing homes, and hotels
- hot-water tanks and heaters
- showers and faucets
- swimming pools
- hot tubs and whirlpools
- equipment used in physical therapy
- mist machines and hand-held sprayers
- decorative fountains.
Legionnaires’ disease, which is also known as legionellosis and Legionella pneumonia, is similar to other types of pneumonia, an infection of the air sacs in one or both lungs that can produce fluid in the lungs. Legionnaires’ disease symptoms can resemble common flu-like symptoms in the following forms:
- muscle aches
- loss of appetite
- difficulty breathing
- gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.