McLaren Macomb outbreak: 7 Legionnaires cases since July

Michigan health officials have begun an investigation into the McLaren Macomb Hospital after seven cases of Legionnaires’ disease were connected to the building since July.

Six of the seven cases were diagnosed at the Mount Clemens hospital since the middle of last month.

“Though the investigation is ongoing and a definite source has not been identified, we are responding with an abundance of caution and partnering with the Macomb County Health Department (MCHD) to identify targeted areas in the hospital to implement additional precautions to our water management efforts,” read a statement by hospital officials.

The statement went on to outline the precautions being taken, including: increased water testing at the facility, installing filters, removing aerators, and providing bottled water options. Recent testing has not indicated any presence of Legionella bacteria, which causes Legionnaires.

McLaren Macomb outbreak:
Disease on rise in county

Macomb County has recorded 45 legionellosis cases this year, and 96 in the past 12 months. (Legionellosis is the umbrella term for diseases caused by Legionella: Legionnaires’ disease and its milder sibling, Pontiac fever.)

County officials also reported an increase in legionellosis cases in each of the previous four years, with a record 102 cases being reported last year. Those totals:

• 2019: 45
• 2018: 102
• 2017: 56
• 2016: 34
• 2015: 25

Michigan health officials have begun an investigation after a McLaren Macomb outbreak of seven cases of Legionnaires’ disease at the Mount Clemens hospital.

McLaren Macomb outbreak:
Officials issue warning

Legionnaires’ disease – which is also known as Legionella pneumonia – is a respiratory infection with radiologic findings consistent with pneumonia. It is most common in the summer and early fall, when temperatures are higher, and stagnant waters present the best environment for the growth of Legionella in water systems.

Legionnaires’ disease is contracted when microscopic, aerosolized water droplets (vapor or mist) are inhaled. It generally develops two to 10 days after exposure to Legionella, and frequently begins with the following symptoms:

• headaches
• muscle aches
• fever, which can be 104 degrees Fahrenheit or higher, and chills.

By Day 2 or Day 3, other symptoms develop, including:

• coughing, which can produce mucus or blood
• shortness of breath (dyspnea)
• chest pains (called pleuritic chest pains; also: pleurisy, pleuritis)
• gastrointestinal symptoms (diarrhea, vomiting, nausea)
• confusion and other mental changes.

MCHD director William Ridella told the Macomb Daily: “We are urging anyone who has been a recent patient at McLaren Macomb, or been at the hospital, and is experiencing any of the symptoms to contact their primary doctor.”

McLaren Macomb outbreak:
High-risk demographics

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk.

Others more susceptible to infection include:

• organ-transplant recipients
• people on a specific drug protocol (corticosteroids, for instance)
• alcoholics.

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.

McLaren Macomb outbreak:
Consequences can be severe

After Legionnaires’ disease is confirmed, hospitalization is almost always required. In the most severe cases, complications can include respiratory failure, kidney failure, septic shock, or even death.

The illness’ severity is illustrated in an Epidemiology & Infection study from the University of Minnesota. Based on data from the Centers for Disease Control and Prevention (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.”