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The St. John’s Fountain Lake outbreak of Legionnaires’ disease has added a fourth victim.

Officials at the senior community in Albert Lea, in southwestern Minnesota, said remediation efforts are continuing. This latest illness, however, has officials baffled about the outbreak’s source.

“The exit to the cooling tower is a locked door, so this doesn’t make sense to us,” Scot Spates, CEO of St. John’s Fountain Lake, told the Albert Lea Tribune.

Legionella, the bacteria that causes Legionnaires’ disease, was discovered during testing at St. John’s Fountain Lake that was conducted after confirmation of the first three illnesses.

The first resident took ill in early June; the second reported their illness to the Minnesota Department of Health (MDOH) on July 19, and the third on July 21. The fourth tested positive July 30 after remediation efforts had begun. None of the four required hospitalization.

St. John's Fountain Lake outbreak up to 4; source a mystery

The St. John’s Fountain Lake outbreak of Legionnaires’ disease has a fourth victim, but officials at the senior community in Albert Lea, MN, are baffled about the source.

St. John’s Fountain Lake outbreak: efforts continue

St. John’s Fountain Lake hired two companies to aid in the investigation and cleanup: Innovational Concepts, Inc., is assessing the water systems, and Minnesota Valley Testing Laboratories is testing water samples.

According to officials, the following actions have or will be taken:

  • The facility’s cooling tower has been tested three times.
  • The water main and water lines in the Waters Ege Independent Living building were chemically treated. In addition, water samples were collected for testing.
  • Water in the nursing home, assisted living and town center has been treated, and samples for testing have been collected.

“I feel confident that the chemical treatment … will eliminate any Legionella in the water, but we will know for certain after we have results from the lab,” Spates said. “St. John’s will continue with the drinking water restriction until all four buildings have been treated and tested.”

Lab results are expected soon.

St. John’s Fountain Lake outbreak: restrictions in place

Officials said bottled water will be supplied to residents until remediation clears the facility of Legionella. Other actions include:

  • A restriction on using ice machines and water sprayers.
  • Filters were installed on shower heads, allowing residents to resume showering.
  • Water lines and faucets are being flushed every other day, based on a recommendation from the MDOH.

According to the Occupational Safety and Health Administration (OSHA), frequent flushing of water lines to drain stagnant areas limits the growth of Legionella.

St. John’s Fountain Lake opened last October and has approximately 100 residents. The facility provides independent living, assisted living, memory care, skilled nursing care, and short-term care for seniors.

St. John’s Fountain Lake outbreak: disease info

Legionnaires’ disease is also known as legionellosis and Legionella pneumonia. The disease is similar to other types of pneumonia, which is an infection of the air sacs in one or both lungs that might produce fluid in the lungs.

Symptoms can resemble flu-like symptoms, such as:

  • shortness of breath (dyspnea) and cough
  • fever
  • severe headaches
  • muscle aches and pains
  • gastrointestinal symptoms (diarrhea, nausea, vomiting).

High-risk categories
Anyone can contract Legionnaires’ disease, but those most susceptible to infection include:

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

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.

Outbreaks have been linked to a number of sources, including:

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

An underreported disease
An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, according to the Centers for Disease Control and Prevention (CDC). However, only about 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

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