Cherokee Casino Resort investigated in Legionnaires outbreak

Three people contracted Legionnaires’ disease after visiting Harrah’s Cherokee Casino Resort in Cherokee, North Carolina, prompting an investigation by multiple organizations.

The Jackson County Department of Public Health (JCDPH), the Eastern Band of Cherokee Indians Public Health and Human Services (PHHS), and the North Carolina Division of Public Health (NCDPH) are all looking into the illnesses. The Eastern Band of Cherokee Indians is owner of the facility, which is its flagship casino.

The three guests visited the western North Carolina casino between May and November. No additional information on them was released.

Cherokee Casino Resort: remediation begun

Officials at Harrah’s Cherokee Casino Resort said they are working with a consultant to conduct remediation and testing to ensure that Legionella – the bacteria that causes Legionnaires’ disease – is not present or – if present – eliminated.

If you are an employee or have visited the Cherokee Casino Resort in the past seven weeks and are feeling pneumonia- or flu-like symptoms, you should see see your doctor out of an abundance of caution.

Anyone with questions can call the JCDPH at 828-587-8201 between the hours of 8 a.m. and 5 p.m. (Eastern time) Monday through Friday. You can also visit online at health.jacksonnc.org/.

(Note: The Centers for Disease Control and Prevention (CDC) considers this a Legionnaires’ disease “outbreak” because two or more cases associated with the same location have occurred in a 12-month period.)

Three people contracted Legionnaires’ disease after visiting Harrah’s Cherokee Casino Resort in Cherokee, North Carolina, prompting an investigation by multiple organizations.

Cherokee Casino Resort: symptoms

Legionnaires’ disease is a severe lung infection that is contracted when one inhales small droplets of water containing Legionella. The disease is similar to other types of pneumonia, and symptoms can even resemble those of flu (influenza), which is why the disease often goes under-reported (only about 20 percent are, according to the CDC).

The early symptoms generally include:

• fever, which can be 104 degrees or higher
• chills
• severe headaches
• muscle pains
• lack of appetite.

After two to three days, symptoms can worsen to include:

• pleuritic chest pain, which is pain caused by inflamed lungs
• dyspnea, or shortness of breath
• coughing, which can produce mucus or blood
• gastrointestinal problems, which includes diarrhea, nausea, and vomiting (about one-third of Legionnaires’ disease cases produce these symptoms)
• mental agitation and confusion.

Approximately 10 percent of people who become infected with Legionella bacteria – technically called Legionella pneumophila – will die from the infection.

Cherokee Casino Resort: high risk

Anyone can become ill from Legionella, but people most susceptible to developing Legionnaires’ disease include:

• anyone 50 or older
• smokers, current or former
• people 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 is also known as legionellosis and Legionella pneumonia. It is treatable with antibiotics, although if not diagnosed early, it can lead to severe complications, and it even can become deadly.

Cherokee Casino Resort: sources

Outbreaks of Legionnaires’ disease have been linked to numerous sources, such as:

• water systems, such as those used in large facilities, such as casinos, hotels, hospitals, and nursing homes
• large plumbing systems
• cooling towers of air-conditioning systems
• hot-water tanks and heaters
• bathroom showers and faucets
• mist machines, like those used in the produce sections of grocery stores
• hand-held sprayers
• swimming pools, whirlpools, hot tubs
• physical-therapy equipment
• decorative fountains.

Warm, stagnant water provides ideal conditions for growth for Legionella, according to the Occupational Safety and Health Administration (OSHA). At temperatures between 68 and 122 degrees Fahrenheit, the bacteria can multiply, and temperatures of 90 degrees to 105 degrees are ideal for growth.

Cherokee Casino Resort: a severe illness

The severity of Legionnaires’ disease is illustrated in a new Epidemiology & Infection study from the University of Minnesota that reported that, based on data from the CDC and the Centers for Medicaid and Medicare Services (CMS), “approximately 9 percent of legionellosis cases, caused by waterborne Legionella bacteria, are fatal, and 40 percent require intensive care.”