Health officials in Ohio are investigating a Legionnaires’ disease outbreak of three illnesses at a nursing facility in suburban Columbus that has been under water restrictions.
The Arlington Court Skilled Nursing and Rehab Center, which is about 6 miles northwest of downtown Columbus in Upper Arlington, has recorded three cases of Legionnaires’ disease since last October, according to Mitzi Kline, Franklin County Public Health (FCPH) director of communication. Two cases were reported in February, while the first was reported in October.
No additional information on the patients was released by officials at Arlington Court, which is a 125-bed skilled nursing facility that has been in operation for more than three decades.
Arlington Court Legionnaires outbreak: test results puzzling
According to officials at Arlington Court (1605 NW Professional Plaza), results from water testing uncovered non-pneumophila, a type of Legionella bacteria not typically known to cause Legionnaires’ disease.
Legionnaires’ disease – a type of bacterial pneumonia that is also called legionellosis or Legionella pneumonia – is a respiratory illness that is contracted when microscopic aerosolized water droplets (vapor or mist) – such as those formed by misting stations or large air conditioners – are inhaled.
Legionella pneumophila serogroup 1 is the most harmful strain, and also the one that causes the majority of infections. Non-pneumophila species normally are considered incapable of causing disease (nonpathogenic).
James Muckle – vice-president of operations for Vrable Healthcare Companies, Arlington Court’s parent company – said company officials are working closely with the FCPH to investigate the matter.
Arlington Court Legionnaires outbreak: ‘business as usual’
According to the Centers for Disease Control and Prevention (CDC), “if the patient has pneumonia and the test is positive, then you should consider the patient to have Legionnaires’ disease.” Muckle said Legionella was found in patient urine samples.
Arlington Court implemented water restrictions on Feb. 10 that included the installation of filters in showers, bathrooms, ice machines, in the kitchen and visitor areas throughout the facility.
The FCPH’s Kline told Columbus’ NBC4 News: “I believe they are doing business as usual. As long as they can operate with showers and they are providing bottled water, we have not limited their business at all other than water restrictions.”
Arlington Court Legionnaires outbreak: unhappy family
According to a local family, facility officials accepted a new patient without disclosing the outbreak.
Kim Kessler told Columbus’ ABC 6/Fox 28 that she checked her mother, 90-year-old Bette Kessler, into Arlington Court last Friday. Bette was suffering from flu symptoms, and Kim said she was unable to care for her mother at home, so a hospice care company arranged a five-day “respite stay” at Arlington Court.
Kim said she did not realize that Arlington Court was having LD issues until two days later, when Bette’s sink wouldn’t work Sunday morning. A hospice aide was told the sinks had been shut off, but communal showers fit with special filters could provide water, and bottled water was available by request.
According to Kim, the aide was not told why filters had been installed or sinks shut off. Kim also said she learned Sunday morning during a phone call with the facility’s director that the restrictions were in place because of a Legionella issue.
“If they would have told us that (before or during check-in), we would have said, ‘OK, thanks but no thanks, we’ll move on to the next one,’ but they didn’t even give us the option of making the decision,” Kim told NBC4 News.
Wrote Muckle: “The facility has been transparent with our residents and families during this period of time. Letters were mailed out and posted in the facility by Feb. 11. These initial notices and further updates have remained prominently displayed in the facility.”
Kim said she is working with the hospice care company to relocate her mother.
Arlington Court Legionnaires outbreak: symptoms
Patients, employees, or recent visitors to Arlington Court should seek care from their health-care provider if they are feeling flu- or pneumonia-like symptoms, such as:
- severe headaches
- muscle aches
- fever, which can be 104 degrees Fahrenheit or high, and chills.
By Day 2 or 3, symptoms can worsen and include:
- coughing, which can produce mucus or blood
- shortness of breath (dyspnea)
- pleuritic chest pains (pleuritis or pleurisy)
- gastrointestinal symptoms (diarrhea, vomiting, nausea)
- confusion and other mental changes.
Arlington Court Legionnaires outbreak: patients at risk
Almost all of Arlington Court’s patients fit one or more of the criteria of people susceptible to infection. To wit:
- organ-transplant recipients
- anyone on a specific drug protocols, such as corticosteroids
The list also includes anyone with an immune system that has been compromised because of:
- frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
- organ inflammation and infection
- blood disorders, such as anemia or low platelet counts
- digestive problems, such as cramping, appetite loss, diarrhea, and nausea
- delayed growth and development.
In the most severe LD cases, complications can include respiratory failure, kidney failure, septic shock, and even death.
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