A fourth case of Legionnaires’ disease since Feb. 12 was confirmed at the Illinois Veterans Home in Quincy (IVHQ) after a positive laboratory testing, according to the Illinois Department of Public Health (IDPH) and the Illinois Department of Veterans’ Affair (IDVA). The resident is recovering and in stable condition.

It is the fourth consecutive year the IVHQ has had to deal with a Legionnaires’ disease outbreak. There were six confirmed cases of Legionnaires’ at IVHQ last year, including the death of one person. That outbreak increased the number who have died at the facility because of the disease to 13 since 2015. There were more than 50 illnesses and 12 deaths during the 2015 outbreak.

Representatives from the Centers for Disease Control and Prevention (CDC) returned to IVHQ last week, at the request of the IDPH, to review testing protocols, and offer additional support and guidance. Staff from the CDC are working with IVHQ and IDPH officials to complete the following checklist:

  • Conduct environmental and epidemiological assessments to identify potential exposure sources.
  • Increase clinical testing protocols for people with respiratory illness to include not only testing for Legionella, but also for influenza and other respiratory viruses.
  • Conduct clinical and environmental sample testing at the CDC.
  • Identify public health and infection control interventions.
  • Partner in communications with the local hospital to streamline testing.

Illinois Senator promises federal help

Democratic Illinois Senator Tammy Duckworth, who is a retired U.S. Army Lieutenant Colonel and former director of the IDVA, toured IVHQ this week and said she would work to get federal money to battle the Legionella problem at the home.

She also took a shot at Governor Bruce Rauner for not having fixed the problem.

“What he has failed to do is communicate accurately and completely with Sen. Durbin and myself,” Duckworth said. “We stand ready to help and find the federal resources.”

Duckworth said Rauner has made no formal request for assistance from the federal government to address the issues at the IVHQ.

Earlier this month, Rauner unveiled his 2019 budget proposal, which included an allocation of “$50 million for capital improvements to the Quincy Veterans’ Home in response to the health and safety concerns” caused by the Legionnaires’ disease outbreaks.

Sen. Tammy Duckworth was deployed to Iraq as a Black Hawk helicopter pilot for the Illinois Army National Guard. On Nov. 12, 2004, her helicopter was hit by an RPG and Duckworth lost her legs and partial use of her right arm.

Gubernatorial opponent slams Rauner

“What the hell is wrong with this Governor?” Rep. Jeanne Ives said in reference to the IVHQ situation. “Veterans and their families are getting sick and dying, Governor. Get them out of there now.”

Ives is running against Rauner in the GOP gubernatorial primary.

Ives said that if she were governor, she’d seek emergency federal funds. “This is a three-year crisis, and nothing has been done,” she said.

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of its nonspecific signs and symptoms.

Ten percent of those infected with the respiratory illness will die from the infection.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources:

  • large plumbing systems
  • water systems like those used in hospitals, nursing homes, and hotels
  • cooling towers in air conditioning systems
  • hot tubs and whirlpools
  • physical-therapy equipment
  • mist machines and hand-held sprayers
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • decorative fountains.

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs.

It’s also possible to contract Legionnaires’ disease from home plumbing systems, although the vast majority of outbreaks have occurred in large buildings because complex systems amplify the conditions for bacteria to grow and spread more easily.

Who is most susceptible? 

Anyone can get the disease, but those at the highest risk of infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcohol
  • people with chronic lung disease
  • people with weakened immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (such as corticosteroids).

More Legionella found in Illinois state offices

Elsewhere in Illinois, Legionella bacteria was detected in the hot water supply after testing at the state Comptroller’s office, according to an e-mail sent to staff Tuesday from Assistant Comptroller Marvin Becker.

Testing was ordered after the bacteria was found at the state Capitol Complex in January. The water supplies between the Capitol and the comptroller’s building are separate from each other.

Officials say they’re not aware of any Legionnaires’ disease illnesses affecting any state employees or the public from either the Comptroller’s office or the Capitol Complex.

The Illinois State Comptroller building is located at 325 West Adams Street in Springfield.

The embattled Illinois Veterans Home in Quincy (IVHQ) continues to come under heavy scrutiny after it was announced that three new cases of Legionnaires’ disease had been confirmed this month. The outbreak is the fourth in the past four years at the western Illinois long-term care and living facility.

The Illinois Senate overwhelmingly passed a resolution Thursday calling for an audit of the state’s response to the outbreaks. The resolution, which was passed 46-0, designates the Illinois auditor general to perform an examination of the Illinois Department of Veterans’ Affairs (IDVA) and probe their management of the outbreaks, which continue to plague the facility even after more than $6 million in upgrades to the water system were performed.

All of the currently infected residents are recovering and in stable condition.

After the confirmation of the latest round of illnesses, the IDVA announced it would boost disinfection levels in the water to further reduce potential exposure to residents or staff. The following preventative measures also have been enacted:

  • Laminar flow devices, which are filters that reduce the aeration of the water as it flows from the faucet, are being installed on all sinks.
  • Bathing has been limited to showers, which are protected with Legionella-blocking Pall filters.
  • Temperature checks will be conducted on residents every two hours while they are awake, and full vital signs will be recorded every four hours.

There were six confirmed cases of Legionnaires’ disease at IVHQ last year, including the death of one person, raising the number who have died at the facility because of the disease to 13 since 2015. There were more than 50 illnesses and 12 deaths during the 2015 outbreak.

Legionnaires' disease
Legionella bacteria

CDC: Eradication may not be possible

Representatives from the Centers for Disease Control and Prevention (CDC) returned this week to the IVHQ to review testing protocols for individuals with respiratory illness, at the request of the Illinois Department of Public Health (IDPH).

The CDC had warned last month in a 20-page report that the “complete eradication of Legionella in any large, complex building water system may not be possible.” The information was compiled in response to last year’s Legionnaires’ disease outbreak at the IVHQ.

“There is no known safe level of Legionella in building water systems, and cases have been associated with very low levels of bacteria,” the report concluded.

Despite efforts to eliminate Legionella from the IVHQ, the ST36 strain of the bacterium has been identified in the IVHQ water system in each of the past three years.

“It is probable that this strain persists in protective biofilm, scale, and sediment that are present in the plumbing infrastructure,” according to the CDC report.

Politicians look for answers

In December, Illinois Senator Dick Durbin (Dem.) called for the closure of the IVHQ. In January, he changed course.

“I don’t believe (closure) is necessary as long as we have a plan to move forward to make it even safer,” Durbin told the Chicago Tribune. “At the time that I made the statement, there was no plan in place, no suggestion of a plan.”

Illinois Governor Bruce Rauner (Rep.) completed a weeklong stay at the facility on Jan. 10 to show his commitment to finding a solution and learn more about the facilities’ water-management plan. Rauner showered and drank tap water every day during his stay.

Afterward, Rauner announced the state would replace the plumbing at the 130-year-old site. He also said he would assemble a task force to determine whether a state-of-the-art dorm should be built, and whether a safer groundwater source was available.

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of its nonspecific signs and symptoms.

Ten percent of those infected with Legionnaires’ disease will die from the infection.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets (usually mist or vapor). The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources:

  • cooling towers in air conditioning systems
  • large plumbing systems
  • water systems like those used in hospitals, nursing homes and hotels
  • hot tubs and whirlpools
  • equipment used in physical therapy
  • mist machines and hand-held sprayers
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • decorative fountains.

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs.

It’s also possible to contract Legionnaires’ disease from home plumbing systems, although the vast majority of outbreaks have occurred in large buildings because complex systems amplify the conditions for bacteria to grow and spread more easily.

Who is most susceptible? 

Anyone can get the disease, but those at the highest risk of infection include:

  • people 50 or older
  • smokers, both current and former
  • heavy drinkers of alcohol
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (for instance, corticosteroids).

Another illness in Illinois

The Illinois Department of Human Services also announced Wednesday that a patient at the Chester Mental Health Center had contracted Legionnaires’ disease. The patient is being treated and is in stable condition in the southern Illinois facility, the state’s only maximum-security forensic mental health facility for adult males.

The 2014-15 Legionnaires’ disease outbreak in Flint, MI, was caused by low chlorine levels in the municipal water system, according to a pair of new studies published recently in the Proceedings of the National Academy of Sciences and the journal mBio.

The outbreak, attributed to the ongoing Flint water crisis, killed 12 people and sickened nearly 90. The number of deaths produced by the water crisis increased to 13 in December. 

The studies were conducted by Michele Swanson and colleagues at the University of Michigan in Ann Arbor, Sammy Zahran of Colorado State University, and a team of researchers at Wayne State University in Detroit. Swanson has been studying Legionnaires’ disease for 25 years.

The research suggests that a complex set of factors is responsible for low chlorine levels during the crisis. Chlorine is responsible for killing microbes in the water. Lead, iron and organic matter in the water supply, however, can lead to decreases in the amount of chlorine available to kill bacteria.

A switch of Flint’s water source in April 2014 from Lake Huron to the Flint River introduced such heavy metals into Flint’s water system, causing the chlorine levels to lower and leading to the deadly outbreak.

“The really striking finding from our research is that the amount of chlorine that needs to be present is actually influenced by other factors in this large municipal water system,” says Swanson. “So, for example, during the Flint water crisis, the amount of chlorine that needed to be present to reduce the risk of disease was much higher than normal.”

The outbreak ended when the city switched back to its original water source.

According to NPR, the results of the study may be referenced in the ongoing court cases against six state and local water officials facing charges of involuntary manslaughter related to the Legionnaires’ disease deaths during the Flint water crisis.

 

Flint Water Treatment Plant

Chlorination explained

Chlorination is the process of adding chlorine to drinking water to disinfect it and kill germs, according to the Centers for Disease Control and Prevention (CDC). Different processes can be used to achieve safe levels of chlorine in drinking water.

Chlorine is available as compressed elemental gas, sodium hypochlorite solution (naOCI) or solid calcium hypochlorite (Ca(OCI)₂. While the chemicals could be harmful in high doses, when they are added to water, they mix and spread, resulting in low levels that kill germs but are safe to drink.

There are drawbacks to chlorination, according to the CDC:

  • relatively low protection against protozoa
  • lower disinfection effectiveness in turbid waters
  • potential taste and odor objections
  • potential long-term effects of chlorination by-products.

The benefits of chlorination, however, are numerous:

  • proven reduction of most bacteria and viruses in water
  • residual protection against recontamination
  • ease-of-use and acceptability
  • proven reduction of diarrheal disease incidence
  • scalability and low cost.

The third case of Legionnaires’ disease since August was confirmed this week at the Brooke Army Medical Center in Fort Sam Houston, TX, according to multiple news reports.

The sickened employee is the third civilian worker to come down with the serious respiratory illness in Building #15, an administrative building and clinic near the main BAMC hospital.

The two original cases, which were reported in August, had been defined as a “cluster” due to the dates of onset of the illness, according to the Emerging and Acute Infection Disease Guidelines. The announcement of a third case associated with the same facility within a one-year period changes the classification to an “outbreak.”

“The health and safety of our patients and staff is our top priority, and we are working diligently with local and regional public health officials to investigate this matter,” a BAMC spokesperson said. “We are not currently aware of any patients or clients who have moved through building number 15 who are exhibiting symptoms.”

The sickened employee is currently hospitalized, but no additional information was made available due to patient confidentiality laws.

The 200-plus workers and patients are being moved out of Building #15 for the second time since August. They will be relocated to a temporary workspace again as the facility is investigated to try and determine if the building is the source of Legionella bacteria, which causes Legionnaires’ disease.

In August, BAMC Commander Brigadier General Jeff Johnson said all tests of the building came back negative. “The great news is there is no indication of Legionella bacteria,” Johnson said then. “We have a team of experienced, dedicated specialists who have gone the extra mile and we’re very proud of the work they’ve done. The safety of our staff and patients is our utmost concern.”

Cleaning and maintenance of the building were performed, including inspecting and cleaning all HVAC systems, plus the flushing of all water lines and draining of water heaters.

BAMC is the U.S. Army’s largest and busiest medical center, and the Army’s only military Level I trauma center. It also operates the Department of Defense’s only burn treatment facility.

BAMC said its beneficiaries or military personnel who are suffering upper-respiratory or flu-like symptoms should contact their medical provider either at Fort Sam Houston or off-post clinics.

Legionnaires’ disease 101

Legionnaires’ disease is also called Legionellosis and Legionella pneumonia. It 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 the Legionella bacteria (Legionella pneumophila) occur each year. Only 5,000 cases are reported, however, because of the disease’s nonspecific signs and symptoms. Ten percent of people infected will die from the infection.

Legionnaires’ disease looks like other forms of pneumonia or even flu. Early symptoms can include:

  • chills
  • fever, which can be 104 or higher
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days, symptoms can worsen to include:

  • chest pain when breathing, called pleuritic chest pain (due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between contracting the bacteria and developing symptoms – is usually 2 to 10 days but can be as much as 16 days.

Fear of Legionnaires’ disease is hitting close to home for Illinois politicians after tests at the Illinois Capitol complex showed the “possible presence” of Legionella bacteria in the hot-water system, according to state officials. Legionella is the bacteria that causes Legionnaires’ disease.

Legionnaires’ disease has been a hot-button topic since last October after the deadly respiratory illness reared its ugly head at the Illinois Veterans Home in Quincy (IVHQ) for the third time in three years. Thirteen residents have died and dozens more sickened from the disease at the IVHQ since July 2015.

Employees at the Illinois Capitol complex have been warned to use just a “pencil-sized stream of water” to wash their hands.

Officials said they’re not aware of any cases of Legionnaires’ disease in state employees or visitors to the 14-building complex. Out of an abundance of caution, however, they’ve removed faucet aerators, shut down the showers, instructed employees to turn off all nebulizers and humidifiers, and to use just a “pencil-sized stream of water” to wash their hands to eliminate the spread of the disease.

How they can accomplish that in bathrooms with automatic faucets is unclear.

Preliminary testing, which came back positive, was originally ordered after a pipe burst in the nearby Illinois State Armory. The Armory’s hot-water system connects to all of the buildings in the complex. Additional testing has been performed and results will be returned this month.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources:

  • large water systems
  • large plumbing systems
  • cooling towers in air conditioning systems
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • hot tubs and whirlpools (often in hotel pool areas)
  • equipment used in physical therapy
  • mist machines and sink sprayers
  • decorative fountains.

Are you at risk of contracting Legionnaires’? 

Anyone can get Legionnaires’ disease, but those at higher risk of infection include:

  • people 50 or older
  • smokers, both current and former
  • heavy drinkers of alcohol
  • people with chronic lung disease
  • people with suppressed immune systems
  • organ-transplant recipients
  • individuals who are following specific drug protocols (for example, corticosteroids).

The state of New York led the nation last year with 1,009 cases of Legionnaires’ disease reported to the Centers for Disease Control and Prevention (CDC) – despite stricter state regulations meant to protect against the proliferation of Legionella bacteria in cooling towers, hospitals, and residential health-care facilities.

More than 40 percent of cases – a total of 441 – were reported in New York City in 2017, a 65 percent increase over 2016.

The state total was a 38 percent increase over 2016, and the NYC count was more than even 2015, the year of the worst outbreak in city history: 133 Bronx residents were sickened, and 16 people died.

“Unfortunately, we continue to see cases of Legionnaires’ disease climb in New York,” said Daryn Cline, a spokesperson for the Alliance to Prevent Legionnaires’ Disease (APLD), in a news release. “This is especially troubling since New York is holding itself out as the leader in Legionnaires’ disease prevention. The truth of the matter is their emphasis on water management inside the building has not had an impact on decreasing the rate of disease.”

The Alliance has been critical of regulations that were put in place after the Bronx outbreak in 2015. The APLD contends the regulations are too narrowly focused on building equipment and do not address the root problem: the public water supply and its distribution system, which is how bacteria infects buildings and cooling towers.

“The most important thing to remember is that Legionnaires’ disease is a waterborne illness, so water must be the focus of any preventive measure,” Tonya Winders, president and CEO of Allergy & Asthma Network, was quoted in the release. “Any solution that doesn’t address the bacteria entering our homes and buildings from the public water supply and distribution system is not a solution at all.”

Another key criticism of New York’s current approach is the failure to address individual cases of Legionnaires’ disease, which — according to the CDC — make up approximately 96 percent of the total recorded cases nationally. By focusing only on building equipment, New York’s regulations address only a portion of the 4 percent of cases attributed to outbreaks, leaving New Yorkers at continued risk of infection.

“Our public policies are being driven by outbreaks which generate news and political pressure,” Cline said. “There were only two known events in New York City that were classified as outbreaks in 2017, with the highest infecting 13 people. Yet, in 2017 an average of 19 people contracted Legionnaires’ disease each week across the New York state. During one week alone, there were 27 new cases in New York City, which went largely unnoticed. Worse yet, they were not fully investigated to understand the sudden spike or how to prevent similar spikes in the future.”

Warmer temperatures to blame?

Legionnaires’ disease – a severe type of pneumonia or lung infection – is “an emerging disease in the sense that the number of recorded cases of Legionnaires’ in the United States continues to increase,” said Laura Cooley, MD, MPH from the Respiratory Diseases Branch of the CDC.

Cooley said the increase is due to a rise in the susceptibility of the population, with more and more people on immunosuppressive medications. In addition, there could be more Legionella in the environment, with warmer temperatures creating the right conditions for bacterial growth. The last three years have been the hottest years on record, with NASA ranking 2016 as the warmest and 2017 second-warmest.

About 25,000 cases annually

The CDC estimates that 25,000 cases of Legionnaires’ disease occur in the U.S. yearly. Only 5,000 cases are reported, however, because of the disease’s non-specific signs and symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets (mist or vapor). The bacteria, which thrive in warm water, are found primarily in human-made environments, such as cooling towers and air-conditioning systems, to name two.

Cases are more commonly reported during the summer and early fall but can happen any time of the year.

Only a month after a new Legionnaires’ disease death was reported in the Flint water crisis, another case of the deadly respiratory illness was announced at a nursing home in Flint, according to multiple news reports. The disease was reported last week to the Michigan Department of Health and Human Services (DHHS).

The Genesee County Health Department (GCHD) is investigating a case of Legionnaires’ disease at Heritage Manor Healthcare Center, a senior services and aged-care facility. The patient’s condition, gender and age were not reported due to patient confidentiality. The GCHD also cannot confirm whether the individual was hospitalized.

The source of the infection has not been identified, and the health department has directed the facility to install filters on all faucets and shower heads.

Death in December

At the end of December, Karenise Westbrook, 52, died from the same Legionella bacteria strain as one of the victims in 2015. Individuals living near Heritage Manor, and recent visitors or employees who may be exhibiting symptoms of Legionnaires’ disease, should immediately contact their physicians.

Legionnaires’ symptoms 

Legionnaires’ disease looks like other forms of pneumonia or even flu, which is why so many cases go unreported every year. Early symptoms can include:

  • chills
  • fever (can be 104 or higher)
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days, symptoms can worsen to include:

  • chest pain when breathing, called pleuritic chest pain (due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between contracting the bacteria and developing symptoms – is usually 2 to 10 days and can be as much as 16 days.

Who is at risk

Anyone can get the disease, but those at higher risk of infection include:

  • people 50 years old or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with weakened immune systems
  • organ-transplant recipients
  • individuals following specific drug protocols (for example, corticosteroids).

A 52-year-old woman from Michigan’s Genesee County was killed by Legionnaires’ disease late in December, making her the 13th victim in the deadly outbreak caused by the Flint water crisis. Two waves of the outbreak in 2015 killed 12 and sickened nearly 90.

Karenise Westbrook of Flint died of the same Legionella bacteria strain as Robert Skidmore, who died in December 2015. Westbrook was named as the third victim in a litigation case against government officials facing charges in an ongoing case in state court.

Marc Edwards, the Charles P. Lunsford Professor of Civil and Environmental Engineering in the College of Engineering at Virginia Tech

Marc Edwards, the Virginia Tech professor who helped to uncover the crisis in 2015, said Westbrook’s case is concerning and needs to be investigated. “Legionnaires’ disease doesn’t just sit in a person’s body,” he said. “Westbrook had to have come in contact with the disease in recent months.”

The incubation period – the amount of time between breathing in the bacteria and developing symptoms – is usually 2 to 10 days after exposure and can be as much as 16 days.

Skidmore died after contracting Legionnaires’ disease while a patient at McLaren Flint, a regional hospital serving Flint and the Genesee County areas of mid-Michigan. Westbrook was never a patient at the hospital, but she worked at a nearby assisted living facility, according to special prosecutor Todd Flood, who contends the Legionnaires’ disease outbreak was caused by Flint switching its water supply to the Flint River in April 2014.

A relative of Westbrook’s was expected to testify in the case against four Michigan Department of Environmental Quality employees. Stephen Busch, Michael Prysby, Patrick Cook and Liane Shekter-Smith are facing a variety of charges:

  • Busch, the District 8 water supervisor, and Prysby, a District 8 water engineer, are facing four felonies and two misdemeanor charges, including involuntary manslaughter.
  • Cook, a specialist in the department’s community drinking water unit, is facing two felonies and one misdemeanor charge.
  • Shekter-Smith, the former chief of drinking water and municipal assistance, is facing two felonies and one misdemeanor charge, including involuntary manslaughter.
What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – 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 the Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms, and 10 percent of those will die from the infection.

How do you catch Legionnaires’ disease? 

Legionella bacteria are contracted by inhaling microscopic water droplets, usually mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources, such as:

  • large plumbing systems
  • large water systems, such as those used in hotels, hospitals, and nursing homes
  • cooling towers in air conditioning systems
  • hot water tanks/heaters
  • showers/faucets
  • swimming pools
  • hot tubs/whirlpools
  • equipment used in physical therapy
  • mist machines and sink sprayers
  • decorative fountains.

The Illinois Department of Public Health (IDPH) linked two cases of Legionnaires’ disease to Northwestern Memorial Hospital in Chicago, according to news reports.

The Centers for Disease Control and Prevention (CDC) notified IDPH last Thursday that an out-of-state patient treated at the hospital in November had contracted the disease. Another patient was treated at the hospital in May with Legionnaires’, according to the IDPH.

When two or more cases of Legionnaires’ disease occur at a single site in a period of six months or more, they are categorized as “linked.” If the two cases had occurred within a six-month period, it would have been considered a Legionnaires’ disease “outbreak” or “cluster.”

The IDPH said it is working with the hospital, the Chicago Department of Public Health and the CDC to ensure that the following protocols occur:

  • providing guidance on what patients to test and when;
  • reviewing all pneumonia cases that occurred on the floors where the two patients stayed;
  • discuss flushing protocols on the floors where the two patients stayed;
  • discuss expanding use of filters for shower heads and sink on the floors where the two patients stayed;
  • reviewing environmental water testing logs and water sampling approaches.

Northwestern is Illinois’ top hospital

Northwestern Memorial Hospital is ranked No. 13 on the 2017-18 U.S. News & World Report Best Hospitals Honor Roll, the sixth consecutive year the hospital made the prestigious honor roll. It is ranked No. 1 in both the Chicago metro area and in the state of Illinois for the sixth consecutive year. It scored high in patient safety and demonstrating a commitment to reducing accidents and medical mistakes.

 Legionnaires’ on the rise in health-care facilities

In June, the CDC released information from a new study of the U.S. health-care industry and found that 76 percent of the facilities studied in 2015 reported cases of Legionnaires’ disease.

The findings are especially alarming for residents living at, or patients admitted to the facilities, as 1 in 4 people infected in a health-care facility will die. The death rate is higher than for people who get the infection elsewhere; 1 in 10 are estimated to succumb to the disease overall.

According to the CDC’s analysis, among the Legionnaires’ disease cases associated with health-care facilities:

  • 80 percent were linked to long-term facilities; 18 percent with hospitals, and 2 percent with both
  • cases were reported from 72 unique facilities, with the number of cases ranging from 1 to 6 per facility
  • 88 percent were in people 60 years of age or older.

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. The CDC estimates that 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms. Ten percent of those infected will die.

How is Legionnaires’ contracted? 

Inhaling microscopic water droplets in the form of mist or vapor is how Legionella bacteria infect people. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a range of sources, such as:

  • cooling towers in air conditioning systems
  • water systems
  • large plumbing systems
  • mist machines
  • hot tubs and whirlpools
  • hot water tanks and heaters
  • showers and faucets
  • swimming pools
  • equipment used in physical therapy
  • decorative fountains.

Two members at the Yakima (WA) Athletic Club were confirmed with Legionnaires’ disease, according to a Dec. 15 news release from the Yakima Health District. The men’s hot tub has been identified as the source of the Legionella bacteria.

The health district took water samples from the athletic club – located at 2501 Racquet Lane – on Dec. 4 after it was alerted that a club member was diagnosed with Legionnaires’. After the samples were sent to the testing lab, a second member was determined to also have the serious respiratory illness.

Results of the testing samples taken from the hot tub in the men’s locker room confirmed the presence of Legionella, the bacteria that causes Legionnaires’ disease.

The athletic club voluntarily closed the hot tub after the positive test results were returned Dec. 13.

In addition, we shut all of our wet areas down, just on our own accord, because we’re very concerned,” general manager Carrie Sattler told the Yakima Herald-Republic. “We hyper-chlorinated all of our wet areas over the weekend,” although the hot tub was the only area that tested positive for Legionella.

The health district was scheduled to re-test the facility today. The wet areas will remain closed until officials are confident the threat has been eliminated.

The condition of the two patients and whether they needed hospitalization was not reported due to patient privacy regulations.

Members, recent visitors, and employees of the club who may be exhibiting symptoms of Legionnaires’ disease (see below) should immediately contact their physicians for care.

Third 2017 outbreak in Washington

Other outbreaks in the state of Washington this year include:

  • In August, two individuals contracted Legionnaires’ disease while patients at the University of Washington Medical Center. A woman in her 20s died, but she had multiple underlying conditions so it’s unclear whether Legionnaires’ caused her death. The other patient recovered. A third patient was admitted with Legionnaires’, but their illness was a case of community-acquired Legionella-infection and not contracted at the hospital.
  • In July, a hot tub at Gold’s Gym in Kennewick was also the culprit in the sickening of three members who were diagnosed with Legionnaires’ disease. All three recovered. Test results from the hot tub confirmed the presence of Legionella.

Do you have Legionnaires’ symptoms? 

Legionnaires’ disease looks like other forms of pneumonia or even flu, which is why so many cases go unreported every year. Early symptoms can include:

  • chills
  • fever, which can be 104 degrees or higher
  • headaches
  • loss of appetite
  • muscle aches.

After the first few days, symptoms can worsen to include:

  • chest pain when breathing (due to inflamed lungs)
  • confusion and agitation
  • a cough, which may bring up mucus and blood
  • diarrhea (about one-third of all cases result in gastrointestinal problems)
  • nausea and vomiting
  • shortness of breath.

The incubation period – the amount of time between contracting the bacteria and developing symptoms – is usually 2 to 10 days. However, it can be as much as 16 days.

Are you at risk of contracting Legionnaires’? 

Anyone can get the disease, but those at higher risk of infection include:

  • people 50 years old or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with weakened immune systems
  • organ-transplant recipients
  • individuals following specific drug protocols (for example, corticosteroids).