Legionnaires’ Disease in Genesee County — Summer 2019 Update

GENESEE COUNTY — As summer winds down, the Genesee County Health Department (GCHD) reminds residents of the continued risk of Legionnaires’ disease (LD).

The GCHD continues to investigate LD cases and provides this update to ensure that residents, healthcare providers, and building managers are aware of the risk of Legionella bacteria and how to prevent or protect against LD.

In 2019 (through Aug. 27) there have been 16 confirmed cases of Legionnaires’ disease reported in Genesee County, compared to 18 cases during the same time period last year. Case residences have been throughout Genesee County and on multiple municipal and private well water sources.

Ten of the 16 cases this year reported a visit or stay in a healthcare setting as a patient or employee sometime in the 10 days before symptom onset. LD is more common during the summer and early fall because of the ideal environment that warmer temperatures create for bacterial growth in water systems.

But Legionella bacteria growth can occur year-round, especially inside buildings or structures that have complex water systems such as in longterm care facilities, hospitals, hotels, and cruise ships. While Legionella occurs naturally in freshwater environments, like lakes and streams, it can become a health concern when it grows and spreads in human-made building water systems.

If a water system is not managed adequately, Legionella will grow where disinfectant levels are low, water is stagnant, or water temperatures are ideal. Proper maintenance and disinfection of the water systems in which Legionella grow, including hot tubs, hot water tanks, large plumbing systems, nebulizers, cooling towers, and decorative fountains, are the most effective measures in preventing LD.

Cleaning, disinfecting and maintenance should occur following manufacturer recommendations.

People can contract LD when they breathe in droplets of water in the air that contain Legionella or by aspiration of contaminated water or ice. People can be exposed inside or outside of buildings. Most healthy people do not get LD after being exposed to Legionella. LD does not spread person to person.

Symptoms typically appear two to 10 days after exposure to the bacteria. Individuals at higher risk of developing LD include those ages 50 and above, current or former smokers, and people with chronic lung disease or weakened immune systems from other underlying illnesses or medications.

Risk factors for exposure to Legionella include recent stay in a healthcare facility, recent travel with an overnight stay, exposure to hot tubs and settings where the plumbing has had recent repairs or maintenance work. Symptoms resemble other types of pneumonia and can include cough, shortness of breath, fever, muscle aches, headaches, and sometimes diarrhea and confusion.

Legionnaires’ disease requires treatment with antibiotics and most cases can be treated successfully. Smoking increases the chances of developing LD for individuals who are exposed to the bacteria. Avoiding smoking is the single most important thing that you can do to lower your risk of contracting LD.

While there are no vaccines that can help protect you from LD, pneumococcal and influenza vaccines can prevent other types of pneumonia. If you develop symptoms of pneumonia we encourage you to see and speak with your healthcare provider and ask about specific testing for Legionnaires’ disease.

Be sure to tell your provider about your working conditions, if you have been around any possible sources like fountains or hot tubs, and if you have traveled, stayed at a hotel or healthcare facility within the two weeks prior to symptoms. This information can help to correctly diagnose and treat the disease, locate a possible source of the bacteria, and prevent others from being exposed to it.

GCHD will continue to monitor cases and provide updates to the public. Further information regarding LD is available from the CDC website at www.cdc.gov/legionella and on the Genesee County Health Department website at www.gchd.us. G.G.