Legionnaires Outbreak Centered Around N.C. Nursing Home

July 01--Wilson County health officials confirmed an eighth case of Legionnaires' disease Monday linked to Wilson Pines, a nursing and rehabilitation facility.

Joyce Wetherington, Wilson County Health Department spokeswoman, could not comment on whether that person was a visitor or facility patient.

In addition, health officials here said there are other suspected cases of the disease that are not related to any facility. Last year, 12 percent of Legionnaires' cases reported in North Carolina were in Wilson County, according to state statistics.

The county makes up less than 1 percent of the state's population. Wilson County reported 11 cases last year and is up to 8 cases this year. There were 90 cases reported in North Carolina last year.

The Centers for Disease Control and Prevention has been consulted for what state officials termed an outbreak in Wilson.

Legionella is a bacterium commonly found in the environment, usually in hot water and in systems producing aerosols or mist. People can get infected when they breathe in a mist or vapor that has been contaminated with Legionella bacteria. But most people who are exposed to that bacteria do not get sick, state officials said.

Legionnaires' disease is a bacterial pneumonia and can't be spread from person to person.

The first confirmed case was announced June 13. There are now six total confirmed cases linked to Wilson Pines and two cases linked to Longleaf Neuro-Medical Treatment Center, a state-operated facility. Wetherington said she couldn't comment as to whether Monday's confirmed Wilson Pines' case was a visitor. But she did say that person was being treated at the hospital for pneumonia.

One person did contract the disease while visiting Wilson Pines several weeks ago.

SECOND FACILITY

N.C. Department of Health and Human Services officials announced Saturday that two confirmed cases of Legionnaires' disease were linked to Longleaf.

The state's public health division learned of the first case at Longleaf on June 19, state officials said Monday. They publicly disclosed the case on Saturday.

The second Longleaf case, which was "retrospective," was confirmed Friday. That case is no longer symptomatic and discovered during routine testing after the initial discovery and diagnosis, state officials said.

That case was also publicly disclosed Saturday.

"Two cases associated with a health care facility are considered an outbreak, regardless of the fact that one of the cases is a retrospective case," said Kirsti Clifford, N.C. Department of Health and Human Services spokeswoman. "DHHS issued the health advisory upon learning that the facility met the definition of an outbreak."

Clifford said they would not release the conditions of any patients due to privacy reasons.

Agencies involved in the Longleaf investigation include the state's division of public health, state operated health facilities, Longleaf and the Wilson County Health Department.

Clifford said it is common practice to consult with the Centers for Disease Control and Prevention for Legionnaires' disease cases and that they have consulted with the CDC.

Clifford said state officials worked with Longleaf and their on-site contractor Saturday to conduct an environmental assessment.

"Samples were taken from various environmental sources within the facility," she said, adding they have not determined the source yet.

Internal control measures have since been put in place at Longleaf for protection of residents, visitors and staff. Longleaf is not taking any new clients and some visitor restrictions are still in place.

The facility is using bottled water for drinking, mouth rinsing and shaving, the state said. Wilson Pines is also under water restrictions as well.

TESTING

Wetherington said Monday that two other suspected cases related to Wilson Pines tested negative.

Several samples were also collected from various locations within Wilson Pines. Last week county health officials announced results from Wilson Pines did test positive for Legionella bacteria.

Water restrictions will remain in place until follow-up shows negative test results of Legionella in the facility, officials said.

"The facility was treated," Wetherington said. "But in the meantime, a person affiliated with Wilson Pines tested positive for Legionnaires'."

State public health officials are working with the health department on the investigation into Wilson Pines, officials said.

'NO LINK TO PUBLIC WATER'

Public health officials are taking measures to investigate the outbreaks in the two facilities as well as working with the facilities to make sure residents, staff and visitors are protected, state officials said Monday.

"We are looking into all potential exposures, but no links between these outbreaks or other cases in the community have been identified," Clifford said. When the Wilson Times asked if any other facilities were being investigated in Wilson, the state referred that question to the Wilson County Health Department. State officials said Wilson County would take the lead in investigating any additional facilities.

Wetherington said as of Monday there aren't other facilities being investigated.

Matt Shaw, City of Wilson's communications coordinator, said tests were conducted to the city's water supply since the confirmed cases.

"There is no link between our public water and these breakouts," Shaw said Monday. "These problems seem to have occurred within their own plumbing systems. There is no evidence that this is being transmitted by our water system."

Shaw said the public should not be concerned about their water.

"We are very vigilant about testing our water to make sure it is safe," he said.

CONTINUED SURVEILLANCE

Wetherington said they are encouraging those who have symptoms to contact their doctor. She said their doctor will assess those symptoms and make a decision as to whether that patient needs to be tested for Legionnaires' disease.

"We are continuing surveillance," Wetherington said.

She also said most doctors are testing those who present respiratory problems.

Symptoms include high fever, chills, cough, body aches, headache and fatigue. The disease typically begins two to 10 days after exposure to the bacteria and can be treated effectively with antibiotics, according to the state.

Most healthy individuals do not become infected with Legionella bacteria after exposure. People at higher risk of getting sick include ages 50 and older, current or former smokers, those with chronic lung disease, those with weak immune systems from disease like cancer, diabetes or kidney failure and those who take drugs that weaken their immune systems like chemotherapy.

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Copyright 2014 - The Wilson Daily Times, N.C.