Union County Legionnaires cluster: 5 dead, 17 sickened

Health officials in New Jersey are investigating a Union County Legionnaires cluster that has claimed five lives since the beginning of March.

Officials confirmed that there are 22 total cases of the potentially deadly bacterial disease, and said those sickened, who live in or have visited Union County, became ill between March 8 and May 13. The five victims who died were described as “older adults” with other “significant” health problems.

Other information – such as the ages, genders, and residences of those infected – was not released, although it was confirmed that a “vast majority” of the victims live in Union County.

Union County Legionnaires cluster: Numerous agencies investigating

The New Jersey Department of Health (NJDOH) is working with the Centers for Disease Control and Prevention (CDC) and regional health departments to locate the source of the Legionella bacteria, which causes Legionnaires’ disease.

“We haven’t identified a confirmed source,” a NJDOH spokesperson said. “We’re still re-interviewing the individuals who got sick. It’s a complex investigation.”

The state is conducting epidemiologic and environmental investigations, and potential sources have been identified, but officials are not naming those sources. Remediation efforts have begun.

Union County Legionnaires cluster: Advisory issued

“The risk to any resident of or recent visitor to Union County is very small,” Dr. Shefeer Elnahal, the state health commissioner, said in a statement. “Out of an abundance of caution, the department recommends that individuals who live in Union County who become ill with pneumonia-like/respiratory symptoms – such as fever, chills, cough, shortness of breath, muscle aches, and headache – visit their health-care provider.”

Residents of Union County, especially those living or working in buildings with cooling towers or large plumbing systems, have been advised to follow these extra precautions until a Legionella source has been identified:

• Take a bath instead of a shower, since a shower could create mist. Try to minimize your time in the bathroom while the tub is filling.
• When brushing teeth, or washing hands dishes, fill the sink slowly to avoid creating a mist.
• When heating water for tea, coffee, or cooking, start with cold water from the tap. You cannot get Legionnaires’ disease by drinking water.

Health officials in New Jersey are investigating a Union County Legionnaires cluster that has killed five of 22 victims in less than two months.

Union County Legionnaires cluster: Other symptoms

Legionnaires’ disease usually develops two to 10 days after exposure to Legionella. It frequently begins with the symptoms listed above by Dr. Elnahal, but other signs you should be aware of include:

• chest pain (called pleurisy)
• fatigue
• unusual weakness
• gastrointestinal symptoms (nausea, vomiting, and diarrhea, which occur in about one-third of Legionnaires cases)
• confusion and other mental changes

Although Legionnaires’ disease primarily affects the lungs, it can cause infections elsewhere in the body, including the heart. The disease is not contagious – that is, it is not transferred through people-to-people contact.

Union County Legionnaires cluster: Greatest risk

Anyone can get Legionnaires’ disease, but people at the most significant risk of infection include:

• anyone 50 years old or older
• smokers, current and former
• anyone with a chronic lung disease, such as chronic obstructive pulmonary disorder (COPD; most commonly, emphysema or bronchitis)
• anyone with a compromised immune system
• alcoholics.

Union County Legionnaires cluster: NJ woes

New Jersey officials report that there are between 250 and 350 Legionnaires cases annually in the state. The CDC’s 2014-15 Legionnaires’ Disease Surveillance Summary Report showed that New Jersey ranked in the Top 10 for states in the number of “reported confirmed cases of Legionnaires’ disease.”

Earlier this month, it was announced that New Jersey health officials were investigating an outbreak in which three residents of a Newark senior apartment complex (Nevada Street Apartments) were sickened. And last summer, after a West Orange municipal worker was diagnosed with Legionnaires, six of the city’s municipal buildings tested positive for elevated levels of Legionella. A few months later, nine of the city’s 12 schools tested positive.

Union County Legionnaires cluster: Cluster, not outbreak

The term “cluster” is used if multiple cases of Legionnaires’ disease are linked in time and space but have no common source. The term “outbreak” is used if the illnesses have a common source.

The World Health Organization (WHO) defines an “outbreak” as the “occurrence of cases of disease in excess of what would normally be expected in a defined community, geographical area or season.”