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Public health officials in Chicago are investigating the New Year’s first Legionnaires’ disease cases at not one but two North Side nursing homes.
Two residents at Balmoral Nursing Home (2055 West Balmoral) and one resident at The Admiral at the Lake (929 West Foster) were diagnosed with the pneumonia-like respiratory illness. The two facilities are less than two miles apart, but a news release from the Illinois Department of Public Health (IDPH) stated that the cases “do not appear to be related.”
Legionnaires’ disease – which is also known as legionellosis or Legionella pneumonia – is contracted when people inhale microscopic aerosolized water droplets (vapor or mist), such as those formed by showers, hot tubs, misting stations or large air conditioners.
Chicago outbreak: tests performed
The IDPH, which sent investigators to both facilities and conducted water testing, is working on the investigation with the Chicago Department of Public Health (CDPH) and the Chicago Department of Water Management. The agencies are trying to determine whether the three victims were sickened at their respective nursing homes or elsewhere.
Results from the IDPH’s water samples are expected before the end of the month.
December testing by Balmoral’s water consultants was negative for Legionella, the bacteria that causes LD.
“The facility is conducting water treatment and testing,” Balmoral administrator Meir Stern wrote in a statement. “The facility’s water has consistently tested negative for Legionella.”
Mark Dubovick, health services administrator for The Admiral at the Lake, released a similar statement: “We are taking precautionary steps as recommended by the Chicago Department of Public Health, Illinois Department of Public Health, and our water management consultant, Garratt Callahan. We are also following additional steps outlined in our Water Management Plan.”
The Admiral at the Lake resident who was sickened is receiving care at a local hospital. The condition of the two Balmoral residents was not released.
Chicago outbreak: symptoms
If you are a resident, an employee of, or are a recent visitor to the Balmoral Nursing Home or The Admiral at the Lake and are feeling flu- or pneumonia-like symptoms, you should seek care from your health-care provider. Symptoms often can be mistaken for the common flu, and they usually develop two to 10 days after exposure to Legionella.
Initial symptoms include:
- headaches
- muscle pains
- chills
- fever, which can be 104 degrees Fahrenheit or higher.
By the second or third day, symptoms can worsen to include:
- cough, which can bring up mucus or blood
- shortness of breath (dyspnea)
- chest pains (pleurisy or pleuritis)
- gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
- confusion and other mental changes.
Chicago outbreak: high-risk groups
Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart. Untreated, Legionnaires’ disease usually worsens during the first week, which is why early diagnosis is key to recovery.
A 2015 study by the CDC stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”
Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a much higher risk.
Other people more susceptible to infection include:
- recipients of organ transplants
- individuals who are on specific drug protocols (corticosteroids, to name one)
- heavy drinkers of alcoholic beverages.
This list also includes anyone with an immune system weakened by:
- frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
- organ inflammation and infection
- blood disorders, such as low platelet counts or anemia
- digestive problems, such as cramping, appetite loss, diarrhea, and nausea
- delayed growth and development.
After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death.
Chicago outbreak: busy 2019 for city
There were numerous outbreaks in Chicago and its surrounding suburbs in 2019:
- In April, the department investigated two illnesses at Mercy Hospital and Medical Center.
- In May, the IDPH reviewed two cases at the University of Chicago Medical Center.
- In June, four cases associated with Advocate Christ Medical Center in Oak Lawn, a suburb of Chicago, were examined. One of the four was an employee.
- In July, the IDPH looked at Rush Oak Park Hospital in Oak Park after two inpatients – one in May, the other in mid-July – were diagnosed with the disease.
- In mid-August, two guests of the Americinn by Wyndham Hotel in Schaumburg were diagnosed with Legionnaires.
- In late August, four senior residents of Covenant Living at the Holmstad were hospitalized with Legionnaires. By mid-September, that outbreak had sickened 12 residents, plus two additional people who lived near Covenant Living contracted the disease.