Legionnaires Disease in Brooke County, West Virginia

Posted in Legionella,Legionnaire's disease,Our Blog,Outbreaks & Recalls on February 9, 2019

West Virginia is hit again with reports of legionnaires’ disease. At this time there have been five cases reported in Brooke County, WV, but they have yet to locate a common source or location tying them together. Here’s what you need to know about Legionnaires Disease in Brooke County.

At Issue

In October, there were four cases in Hancock County tied to the Mountaineer Casino, Racetrack and Resort, but the track has taken steps to remediate the issue and no further cases have been tied to that location.

There was little information on the Brooke County Health Department website about the outbreak, and not much in the news. The announcement was made just mid-January, here’s hoping they have a break through soon in locating the source.

What is Legionnaires’ Disease?

A soldier in a red plume doubles over coughing and clutching his breastplate, his skin is pale and when his cohort touches his forehead under the helmet he is burning with fever. He has pneumonia, but unless he choked on stagnant water or rubbed contaminated dirt in his wounds, probably not legionnaires’ disease.

In fact, Legionnaires’ disease didn’t have a name and hadn’t been documented before 1976, when 200 people walked out of an American Legion convention and were subsequently hospitalized with pneumonia like symptoms. After a stunning 34 people died, the CDC named the disease Legionnaires’, and the little bacteria responsible, Legionella pneumophila.

Legionnaires’ disease is a respiratory disease contracted by inhaling water droplets or mist containing Legionella pneumophila. Its less severe manifestation is called Pontiac Fever, and collectively they are referred to as legionellosis. The symptoms are similar to pneumonia and typically start to manifest 2 to 10 days after exposure.

According to the Mayo Clinic, symptoms start with headaches and muscle pain, and may be accompanied by chills and a fever of 104 or more. By the second or third day the symptoms progress to include symptoms such as a cough, shortness of breath and chest pain. There may also be gastrointestinal symptoms like nausea, vomiting or diarrhea. As with pneumonia, symptoms can also include confusion or mental changes.

Pontiac Fever, the milder form of legionellosis, doesn’t progress to a lung infection but makes your life sufficiently miserable with fever, chills, headache and muscle pain.

It doesn’t sound life threatening, but the truth is that Legionnaire’s disease, if left untreated, can lead to lethal complications like respiratory failure, septic shock and acute kidney failure. It must be diagnosed by a doctor and then treated as soon as possible to prevent these possible consequences.

The Culprit

Legionella pneumophila is a naturally occurring bacteria found in lakes and streams. But it becomes a real problem when it grows in man-made water systems. Being a bacterium, it loves warm standing water, the advent of modern plumbing provides lots of delightful nooks and crannies for it to thrive. The more complex the system, the higher the risk. Though bacteria are everywhere, legionellosis typically only infects people who breathe in–or aspirate—contaminated mist, vapor, or water. (Aspiration is when you choke in such a way that spittle or water goes into your comparatively defenseless lungs instead of down to your stomach where the good bacteria in your gut and your stomach acid deal with dangerous intruders). It is also possible to get Legionnaires’ disease from working in contaminated soil (remember those lakes and streams), and it occasionally occurs as a wound infection.

Legionella pneumophila have the potential to spread through any system which produces mist or vapor and hasn’t been properly cleaned or disinfected; legionella habitats may include air conditioning systems, sprinkler systems, produce sprinklers, humidifiers, or hot tubs. You could also contract legionellosis by choking or breathing steam in the shower if the plumbing system was tainted.

Risky Business

Legionnaires’ disease is relatively uncommon, but when it occurs it is very serious. There is an estimate that 10,000 to 18,000 of people in the United States become infected by the Legionella pneumophila bacteria each year. According the CDC, approximately 1 in 10 of those people who contract Legionnaires’ disease will die. There is no vaccine.

The people most at risk are those with fragile health or a compromised immune system (especially those on immune suppressing medication), people over age 50, and people who smoke. Smokers are more vulnerable than other otherwise healthy people because their aspiration prevention mechanism is dysfunctional. Consequently, they are far more likely to inhale water droplets than a nonsmoker. Folks who have lung disease such as COPD or emphysema have the same vulnerability, though significantly less control over the vulnerability.

In the rare event that an otherwise healthy person contracts Legionnaires’ disease, hospitalization is still likely, even advisable. Admission to intensive care is also common. Legionnaires’ is treated with antibiotics, and in most cases (9 out of 10) treatment is successful. Symptoms can hang on for long periods of time after the disease is mostly eradicated. Survivors sometimes show persistent fatigue, neurological or muscular issues in the months after release. Most will recover entirely within a year.

How you can keep your family safe

The single biggest thing you can do to prevent Legionellosis is to quit smoking or help a loved one quit smoking. If you or a loved one have lung disease, cancer, or a recent organ transplant, be very careful when traveling and pay attention to health notices and outbreak alerts. Look for hotels or rentals that are clean and well maintained. Maybe skip the public pool or hot tub, at least until your health is fully restored. If you are very fragile, perhaps also send someone to grocery shop for you or use a food delivery service so you won’t risk inhaling water from the produce sprinkler systems.

If you or a loved one fall ill within a few days of inhaling water or mist, pay very close attention to the symptoms and the progression. If the symptoms escalate or persist, go see a doctor for testing immediately. It’s better to go early and be told to relax (“It’s only pneumonia.” Haha.), then to go late and deal with a much worse illness with potentially life threatening complications. After a Legionellosis diagnosis, consider speaking with a Legionnaires’ disease lawyer about your legal options for compensation.

By: Abigail Cossette Ryan, Contributing Writer (Non-Lawyer)