Just months after a Legionnaires’ disease outbreak in West Virginia’s Hancock County, neighboring Brooke County has experienced a cluster of six cases in the past two months.
“It’s certainly something that sent up a red flag because typically we don’t have many cases,” said Mike Bolen, Brooke County Health Department administrator. “At this time, there appears to be no related link to the cases.”
In October, six Legionnaires’ disease cases were reported to the Hancock County Health Department. Included in that total was an outbreak that infected four employees at Mountaineer Casino, Racetrack and Resort.
There have been “no new cases in Hancock County” since that time, Hancock County administrator Jackie Huff said.
The western borders of the neighboring counties are on the Ohio River; their eastern borders lie on the border with Pennsylvania.
West Virginia experiences about 20 to 30 cases of Legionnaires’ disease yearly.
There are about 25,000 annual cases of pneumonia due to Legionella bacteria (Legionella pneumophila) each year in the United States, according to the Centers for Disease Control and Prevention (CDC). However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.
Legionnaires’ disease is also known as legionellosis and Legionella pneumonia. If diagnosed early enough, it is treatable with antibiotics; if not diagnosed early enough, however, severe complications can develop: About 10 percent of people infected with Legionella bacteria will die from the infection.
Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and they even can resemble those of influenza (flu), which is why the disease is under-reported. Early symptoms can include:
- fever (104 degrees or higher) and chills
- severe headaches
- muscle pains
- lack of appetite.
By the second or third day, however, symptoms, can worsen and include:
- pleuritic chest pain, also called pleurisy (pain caused by inflamed lungs)
- dyspnea (shortness of breath)
- coughing, which can bring up mucus and even blood
- gastrointestinal problems (diarrhea, nausea, vomiting; about one-third of Legionnaires cases produce these symptoms)
- mental agitation and confusion.
Anyone can become ill after breathing in Legionella bacteria, but people most susceptible to infection include:
- anyone 50 or older
- smokers, current or former
- anyone with chronic lung disease or COPD (most commonly, emphysema or bronchitis)
- anyone with a weakened immune system
- organ-transplant recipients
- anyone on a specific drug protocol, such as corticosteroids
Legionnaires’ disease clusters and outbreaks have been linked to a number of sources, such as:
- water systems, like those in hospitals, nursing homes, and hotels
- cooling towers of air conditioning systems
- large plumbing systems
- hot-water tanks and heaters
- bathroom showers and faucets
- mist machines, like those used in the produce sections of grocery stores
- swimming pools, whirlpools, hot tubs
- equipment used in physical therapy
- hand-held sprayers
- decorative fountains.
Brook County: Cluster?
The terms “cluster” and “outbreak” are used when more than one case of Legionnaires’ disease is reported in or around the same proximity and within a designated period. To wit:
- If two or more illnesses occurred in the same general vicinity within three to 12 months, the term “cluster” would be used, which is the case with the occurrence of six cases in Hancock and Brooke counties.
- If two or more cases are reported within days or weeks, rather than months, and they occurred in a more limited geographic area – that is, officials can pinpoint a specific area within a city where illnesses occurred, such as at Mountaineer – then the term “outbreak” would be used.
Finally, there is a third term, “community-acquired,” that is used when there are no commonalities found. This is the most common kind of Legionnaires’ disease case.
A milder form of Legionella illness is called Pontiac fever, which can produce symptoms – fever, chills, headaches, muscle pains – similar to Legionnaires’ disease. Pontiac fever, however, does not infect the lungs, and symptoms usually clear within two to five days.
Elliot Olsen has decades of experience representing people harmed by Legionnaires’ disease. You can contact him for a free consultation by filling out the following form and submitting it: