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Two cases of Legionnaires’ disease were reported in Nashua, NH, both occurring in August.

The two Nashua residents who fell ill have no connection to the Hampton outbreak of Legionnaires’ disease cases 44 miles away, said Jake Leon, a spokesperson for the New Hampshire Department of Health and Human Services (DHHS). One person sickened in Nashua contracted the disease out of state, and the other has no ties to Hampton.

“It’s just a coincidence,” Leon said.

Leon went on to say that New Hampshire experiences an average of 30 to 35 cases of Legionnaires’ disease annually.

Hampton outbreak unrelated to two Nashua cases: officials

Two Legionnaires’ disease cases in Nashua, New Hampshire, are unrelated to the Hampton outbreak of 14 illnesses 44 miles away, state health officials said.

Hampton outbreak: Legionella found at The Sands

Meanwhile, the DHHS ordered immediate remediation efforts at The Sands Resort at Hampton Beach after Legionella bacteria were detected in the facility’s water system. The news broke shortly after state health officials confirmed two additional cases in the Hampton outbreak, increasing the case count to 14.

Test results returned elevated levels of Legionella bacteria, which causes Legionnaires’ disease, in several areas at The Sands: the hot tub, the water heater, an outdoor shower hose, and the sinks and shower heads of three guest rooms. Nine of the 14 people who became ill were guests there.

The outbreak of 14 illnesses, all of which were confirmed between June 14 and August 24, includes 12 victims hospitalized and the death of an elderly male.

Hampton Beach is a resort area in the town of Hampton. Eleven victims were visitors to the popular tourist destination, which is the busiest beach community in the state.

Hampton outbreak: The Sands not only culprit?

Test results are pending from other locations in the affected area, including the Harris Sea Ranch Motel, which was one of two facilities suspected by officials as a potential source. The majority of cases stayed at or resided in the Ashworth Avenue area between Island Path and M Street. The Sands Resort is located at 32 Ashworth Avenue.

Hampton outbreak: Legionnaires’ info

Legionnaires’ disease is also known as legionellosis and Legionella pneumonia. It is a severe type of pneumonia, or lung infection.

An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) happen yearly in the U.S., according to the Centers for Disease Control and Prevention (CDC). However, only 5,000 cases are reported because of the nonspecific signs and symptoms of Legionnaires’ disease.

In addition, 10 percent of people who become infected with Legionnaires’ disease will die from the infection.

Legionella sources
Legionella bacteria are contracted by inhaling microscopic water droplets (vapor or mist). The bacteria grow best in warm water, and they are found primarily in human-made environments, such as:

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

Legionnaires’ symptoms
Legionnaires’ disease is similar to other types of pneumonia, and its symptoms can even resemble those of influenza (flu), which is why the disease often goes under-reported. Symptoms generally include:

  • coughing
  • shortness of breath (dyspnea)
  • high fever
  • severe headaches
  • muscle pains
  • gastrointestinal symptoms (diarrhea, nausea, vomiting, etc.).

High-risk categories
Anyone can become ill from Legionella, but those most susceptible to infection include:

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

Warmer weather to blame?
In a 2017 interview, Laura Cooley – MD, MPH at the CDC’s Respiratory Diseases Branch – called Legionnaires’ disease “an emerging disease in the sense that the number of recorded cases of Legionnaires’ in the United States continues to increase.”

Cooley said the increase is due to a rise in the susceptibility of the population – that is, more and more people are on immunosuppressive medications. She also pointed out that there could be more Legionella in the environment because warmer temperatures are creating the right conditions for the growth of bacteria.

Seventeen of the 18 warmest years since modern record-keeping began have happened since 2001, according to both the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA). The four warmest years have occurred since 2014, with 2017 being the warmest non-El Niño year ever recorded.

2018 is shaping up to be the fourth-hottest year on record. The only years hotter were the three previous ones.