As congregation worships, Legionnaires’ disease lurks
PARMA — An usher clutching a stack of yellow fliers stopped Maria Vegel as she entered Mass on July 22. “Take this paper; it is very important,” the usher said.
That was how Vegel, 79, learned that six of her fellow parishioners at St. Columbkille Parish Roman Catholic Church in Parma had been stricken with Legionnaires’ disease, a severe form of pneumonia that can be fatal.
Five more parishioners were confirmed with the disease on July 23, bringing the total for the outbreak cluster to 11.
The flier explained that, because of the cases, the sanctuary air conditioner had been turned off. Legionnaires’ disease spreads through airborne water droplets.
Everyone in the St. Columbkille cluster was over 70 years old and fell ill between early June and midJuly, including a 93-year-old Parma woman who died July 5, according to the Cuyahoga County Board of Health, which is investigating the outbreak.
Those sickened are in “various stages of recovery,” and may or may not still be hospitalized, according to the board of health.
Vegel took extra copies of the flier for her daughter and elderly neighbor. She skipped weekday mass at St. Columbkille for a few days, but returned Wednesday.
“Yes, I was a little bit worried,” she said, then shrugged. “I will die anyway. That’s why I’m here (worshipping).”
Cuyahoga County Board of Health inspectors aren’t sure if the church building is the source of the outbreak. An inspection July 23 focused on the sanctuary’s air conditioning system and a tank in the basement that recirculates water for the cooling system. Results are expected in about a week.
“They will find it sooner or later,” said parishioner Jerry Kubek, 73, of Parma. He has continued attending services at St. Columbkille, and is confident with the way the church is handling the situation.
“We’ll do what we have to do,” Kubek said.
How Legionnaires’ spreads and sickens
The bacteria that causes Legionnaires’ disease, called Legionella, is in water everywhere. It’s in rivers and lakes, and in the pipes carrying water to showers, drinking fountains and sinks.
Most people don’t get sick from exposure to the bacteria because their immune systems eliminate the threat. But if Legionella multiplies in indoor building water systems and infects ill or elderly people, it can lead to serious illness and death.
Legionella breeds in warm, stagnant water in pipes where chlorine levels are low, said Ohio Department of Health (ODH) spokesman J.C. Benton.
Legionnaires’ disease spreads when water droplets containing the bacteria are inhaled into the lungs. It does not spread from person to person.
Those at risk for the illness are people 50 and over, and current or former smokers, Patients with chronic lung disease, cancer, weakened immune systems or illnesses such as diabetes, kidney failure or liver failure, said Dr. Jennifer Hanrahan, medical director of infection prevention at MetroHealth Medical Center.
Severe symptoms such as fever, cough, muscle aches and chills require a doctor’s attention, Hanrahan said.
An aging population, increased use of immune-suppressive drugs, increased screening for the disease and a higher prevalence of chronic ill health have boosted the occurrence of the illness worldwide and locally, ODH said. The state had 601 cases in 2017, up from 510 in 2016.
There are other reasons for the increased number of cases, too, such as our dependence on air conditioning, complex indoor plumbing systems in large buildings and water-saving fixtures.
Outbreaks like the one at St. Columbkille are usually associated with a building or structure with water and a fan as part of a centralized cooling system, such as hotels and resorts, longterm care facilities and hospitals. Culprit bacteria are often found in water used for showering, hot tubs, decorative fountains and in cooling towers, according to the Centers for Disease Control and Prevention (CDC).
Home and car air-conditioning units, which do not use water to cool the air, aren’t at risk for Legionella growth.
Legionnaires’ traced to unknown bacteria
Legionnaires’ disease was unknown in 1976, when a mysterious lung infection sickened 182 people, most of whom had attended an American Legion convention in Philadelphia; 29 of the victims died.
It took several months of medical sleuthing before two scientists at the CDC announced that the disease was caused by a newly discovered bacteria, now called Legionella.
The bacteria was found to be flourishing in the cooling tower of the hotel’s air conditioning system, which spread droplets containing the bacteria throughout the building.
Researchers then linked Legionella to past medical mysteries, including epidemics and outbreaks in Pontiac, Michigan in 1969 and Philadelphia in 1974.