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New Jersey health officials are investigating a senior housing complex after three cases of Legionnaires’ disease were confirmed at the facility in the past 13 months. No other information was released on the patients.
The probe by the New Jersey Department of Health (NJDOH) is centered on the environmental safety of the Alvin E. Gershen Apartments in Hamilton, looking specifically at bacterial concerns.
The Mercer County facility, located on Klockner Road, is no stranger to Legionnaires’ disease. The apartment complex also was connected to an outbreak 10 years ago, according to the NJDOH. The World Health Organization defines an “outbreak” as the “occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season.”
“There has been a total of three cases of Legionnaires in the last 13 months in residents of this building,” NJDOH spokesperson Dawn Thomas wrote in an email to the Trentonian. “It is not known whether these residents contracted the illness at this building. It is the Department of Health’s standard protocol to initiate an investigation following the identification of two or more confirmed cases of Legionnaires’ disease associated with the same building within 12 months of each other.”
Gershen Apartments outbreak: issues last year
The first illness was confirmed last November, and sparked environmental tests that identified Legionella bacteria in the apartment’s potable (drinking) water system. Two additional cases have since been identified, with the most recent early this month.
Legionella bacteria, which causes Legionnaires’ disease, are contracted by inhaling microscopic droplets in the form of mist or vapor. According to the Environmental Protection Agency (EPA), the bacteria may be transported from potable water to air by faucets, showerheads, cooling towers, and nebulizers.
People also can contract Legionnaires’ disease by the aspiration of contaminated drinking water – that is, choking or coughing while drinking causes water to go down the wrong pipe and into the lungs.
“The Department of Health and Hamilton Health Department have an ongoing investigation at the Gershen apartments,” Thomas said. “The building has been following public health recommendations related to treatment of their water.”
Gershen Apartments outbreak: advice
If you are a resident or employee or have visited the Alvin E. Gershen Apartments and you are feeling pneumonia- or flu-like symptoms, you should visit your health-care provider immediately and inform them you were at an apartment building with a Legionella outbreak. This can help with proper treatment and assist with the investigation.
Gershen Apartments outbreak: May outbreak
The outbreak is not the first of this type for New Jersey this year. The Nevada Street Apartments, a senior apartment complex in Newark, was the site of a three-illness outbreak back in May.
Gershen Apartments outbreak: symptoms
Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following signs and symptoms:
- muscle pain
- fever, which can be 104 degrees Fahrenheit or higher.
By the second or third day, other signs and symptoms develop, including:
- cough, which can bring up mucus and sometimes blood
- shortness of breath
- chest pain
- gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
- confusion and other mental changes.
Although the disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.
Legionnaires’ disease is not contagious – that is, it cannot be passed from person to person. The condition is treatable with antibiotics when diagnosed early enough, although if that does not occur, it can lead to severe complications.
Gershen Apartments outbreak: overview
Legionnaires’ disease is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States on a yearly basis. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.
Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:
- air-conditioning system cooling towers
- large plumbing systems
- water systems of large buildings (hospitals, nursing homes, hotels, etc.)
- hot-water heaters and tanks
- bathroom showers and faucets
- swimming pools
- whirlpools and hot tubs
- physical-therapy equipment
- mist machines and hand-held sprayers
- decorative fountains.
Warm, stagnant water provides the right conditions for growth, according to the Occupational Safety and Health Administration (OSHA). The organism can multiply at temperatures between 68 degrees and 122 degrees Fahrenheit, and temps of 90 degrees to 105 degrees are optimal for that to occur.
Gershen Apartments outbreak: complications
Anyone can get the disease, but those at the greatest risk of infection include:
- people 50 or older
- smokers (current or former)
- heavy drinkers of alcoholic beverages
- people with chronic lung disease
- people with weakened immune systems.
After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:
- respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
- septic shock: this can occur when Legionella produce toxins that enter the blood stream and cause a drop in blood pressure, leading to loss of adequate blood supply to the organs.
- kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
- endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
- pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.