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The Cuyahoga County Board of Health (CCBH) confirmed that the Saint Columbkille Legionnaires’ outbreak has increased to 11 cases.
The CCBH also confirmed the death of a 93-year-old Parma woman on July 5. She was not one of the six victims initially identified. The CCBH was able to connect her case after her family contacted the CCBH a few days ago.
All 11 victims – parishioners at Saint Columbkille Church in Parma, Ohio, a suburb of Cleveland – were hospitalized. The statuses of the remaining 10 patients, their names and genders were not released, citing privacy concerns.
The case count increased after four additional cases were identified among parishioners who attended services at the Catholic church.
Saint Columbkille Legionnaires’ outbreak: church inspected
CCBH officials have visited the church on more than one occasion, conducting environmental tests to determine if Legionella bacteria exists on church grounds. The investigation began in early June, after the CCBH was notified of cases from area physicians.
The investigation is focused on the church’s air-conditioning system and a tower that recirculates water for the cooling system, CCBH communications officer Kevin Brennan said. He said the CCBH is interviewing victims to determine the common source of the Legionella, which causes Legionnaires’ disease, a severe type of pneumonia (lung infection).
“There is not a definite connection with the church,” Brennan told the Cleveland Plain Dealer. “It could be coming from a lot of different places. We don’t want to presume (the church) is a hotbed of infection.”
Church officials turned off the air conditioning in the church sanctuary during Sunday’s masses as a precaution. They said the air-conditioning will not be turned on until environmental test results are returned.
“It is not transmitted from person to person,” CCBH health commissioner Terry Allan said. “That individual gets it, and that exposure point could be any range of water-misting sources. What we do not have is evidence in the environment that the Legionella is actually in a water-misting source at the church.”
Legionella are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor.
Parishioners, people who live within close proximity of the church, and even those who have traveled through the Parma neighborhood and are feeling flu-like symptoms are being advised to seek immediate care from their health-care provider. The Saint Columbkille Church parish, which serves about 3,000 households and includes an elementary school, is located at 6740 Broadview Road.
Saint Columbkille Legionnaires’ outbreak: high risk
Legionella cannot be spread from person-to-person, and most people exposed do not become ill, the Ohio Department of Health said. The bacteria are treatable with antibiotics when caught early.
The age range for the 11 victims ranges from 74 to 93 years old. They reported their illnesses from early June to mid-July.
Individuals over the age of 50 are considered to be the highest-risk factor for Legionnaires’ disease. Others at a greater risk for infection include smokers (current or former), heavy drinkers of alcohol, people with chronic lung disease, and people with weakened immune systems.
Saint Columbkille Legionnaires’ outbreak: county, state increase
Cuyahoga County has reported 40 cases of Legionnaires’ disease in 2018 through June, with 24 in June alone. That is a significant increase compared to 15 through June in 2017 and nine in 2016.
The state of Ohio reported an average of 55 cases annually between 2011 and 2015. Those numbers, however, have increased in each of the past two years, with 80 in 2016 and more than 100 in 2017.
Saint Columbkille Legionnaires’ outbreak: disease info
An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur 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.
Approximately 10 percent of Legionnaires’ disease victims will die from the infection.
Legionnaires’ disease is also known as legionellosis and Legionella pneumonia. It is similar to other types of pneumonia, which is an infection of the air sacs in one or both lungs that can produce fluid in the lungs.
Symptoms of the disease can resemble those of the common flu, such as:
- high fever and chills
- coughing and difficulty breathing
- muscle pains
- severe headaches
- appetite loss
- mental agitation
- gastrointestinal symptoms (diarrhea, nausea, vomiting, etc.).
Legionnaires’ disease outbreaks and clusters have been linked to numerous sources, such as:
- air-conditioning system cooling towers
- large plumbing systems
- water systems of large buildings (hospitals, nursing homes, hotels, etc.)
- hot-water heaters and tanks
- bathroom showers and faucets
- swimming pools
- whirlpools and hot tubs
- physical-therapy equipment
- mist machines and hand-held sprayers
- decorative fountains.