Illinois Legionnaires clusters under investigation

Officials for the Illinois Department of Public Health (IDPH) said they are investigating two Legionnaires’ disease clusters, one on the near South Side of Chicago and the other in McHenry and Lake counties.

“The two recently identified clusters of Legionnaires’ disease are not connected,” IDPH director Nirav D. Shah, M.D. said in a news release. “IDPH is continuing to investigate possible sources, identify other individuals who may have been exposed, and recommend remediation and prevention measures.”

Three residents from McHenry and Lake counties in the northeast corner of Illinois along the Wisconsin border have been confirmed with Legionnaires’ disease. The Walmart Supercenter in the village of Johnsburg in McHenry County has been identified as a possible source of Legionella bacteria, which causes Legionnaires, the IDPH said.

In Chicago, two residents at the Warren Barr South Loop transitional rehabilitation center were diagnosed with the sometimes-deadly bacterial infection.

A timeline for the clusters was not released, nor was any information on the patients.

(Note: Both groups of illnesses are being categorized as a “cluster” because the cases are linked in time and space. If a common source is found for the illnesses, officials would recategorize them as an “outbreak.”)

Two Illinois Legionnaires clusters are under investigation by the state’s Department of Health. One is in Chicago, the other in McHenry and Lake counties. The Walmart in the village of Johnsburg in McHenry County is one potential Legionella source.

Illinois Legionnaires clusters: actions taken

According to a news release from Walmart, the Johnsburg location “has taken action, including turning off the produce water sprayers. Health officials will continue to investigate any other potential sources and identify other cases of Legionnaires’ disease.”

On the near South Side of Chicago, the IDPH said, “The Warren Barr nursing home has taken numerous steps, including revising its water-management plan, increased environmental sampling, and heightened clinical surveillance.”

Warren Barr officials said they have notified residents, staff and the families involved about the incidents. Officials also said they were following the Centers for Disease Control and Prevention (CDC) protocols for surveillance, mitigation, and remediation, and they have retained experts to conduct environmental testing.

One of the services offered at Warren Barr (1725 South Wabash Avenue) is a pulmonary care unit that specializes in complex lung disease and other chronic progressive respiratory problems.

Two Illinois Legionnaires clusters are under investigation by the state’s Department of Health. One is in Chicago, the other in McHenry and Lake counties. Two residents at Chicago’s Warren Barr South Loop transitional rehabilitation center were diagnosed with the illness.

Illinois Legionnaires clusters: nothing new

Over the summer, 12 people contracted Legionnaires’ disease between June 7 and July 1 in McHenry County. The McHenry County Department of Health identified an area within a 1.5-mile radius of the intersection of Walkup Road and Route 175 in Crystal Lake as the source of six illnesses. No cause for the remaining illnesses was identified.

In July 2015, a resident at Warren Barr Gold Coast – about 4 miles from the South Loop facility – died from Legionnaires’ disease. A Legionella source was never found.

More than 300 cases of Legionnaires’ disease are reported in Illinois annually, according to IDPH statistics. There were 332 cases in 2017, and 318 in 2016.

Illinois Legionnaires clusters: disease info

Legionnaires’ disease is also known as legionellosis and Legionella pneumonia. It is a severe type of lung infection that can become deadly, if not treated in a timely fashion.

When caught early enough, it is treatable with antibiotics. If it is not diagnosed early, however, it can lead to severe complications.

An estimated 25,000 cases of pneumonia due to Legionella bacteria (called Legionella pneumophila) occur every year in the United States. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

Legionnaires symptoms
Symptoms of Legionnaires’ disease are similar to those of other types of pneumonia, and they can even resemble those of influenza (flu):

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

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

• people 50 or older
• smokers, current or former
• heavy drinkers of alcohol
• people with a chronic lung disease or COPD (most commonly emphysema or bronchitis)
• people with a weakened immune system
• organ-transplant recipients
• anyone on a specific drug protocol (for instance, corticosteroids).

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

Legionella can grow in many parts of a building’s water system that is continually wet, and certain devices can spread contaminated water droplets. Some examples of devices where Legionella can grow and spread through aerosolization or aspiration (when water accidentally goes into the lungs while drinking) include:

• centrally installed misters (like the produce sprayers at Walmart), atomizers, air washers, and humidifiers
• faucets, shower heads, and hoses
• ice machines
• water heaters, and hot- and cold-water storage tanks
• cooling towers
• medical equipment (such as CPAP machines, hydrotherapy equipment, bronchoscopes, etc.)
• faucet-flow restrictors and water filters
• pipes, valves, and fittings
• aerators
• non-stream aerosol-generating humidifiers
• water hammer arrestors
• expansion tanks
• infrequently used equipment, such as eyewash stations
• decorative fountains.