Legionnaires cases up locally and nationwide
Disease can be mistaken for the flu or a stomach bug.
Legionnaires disease is becoming increasingly prevalent in the Dayton region — and across the United States — yet the symptoms are so common they can be mistaken for the flu or a stomach bug.
Reported cases of Legionnaires disease in Montgomery County this year surpassed cases reported in the past two years, and are well above what was reported a decade ago.
Across Ohio, the number of Legionnaires disease cases rose by more than 160 percent within the past decade, according to data analyzed by the Dayton Daily News. The information was collected from 2007 to 2017 by the Ohio Department of Health.
The state has seen rising cases in recent years with 510 in 2016; 566 in 2015; and 409 in 2014.
From 2004 to 2012, the number of cases each year stayed in the 200s with the exception of an increase in 2011 when 390 cases were reported in Ohio.
Cough, fever, chills, shortness of breath, muscle aches and diarrhea are all early symptoms of Legionnaires disease.
Legionella is a type of bacterium found 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 like showerheads and sink faucets, cool- ing towers, hot tubs and large plumbing systems, according to the Centers for Disease Control and Prevention.
Local health department officials urge people to seek medical help if they believe they’ve contracted the disease.
After Legionella grows and multiplies in a build- ing water system, Legion- naires’ disease can be spread by breathing in small droplets of water in the air that contain the bacteria.
Approximately 36 cases have been reported in Mont- gomery County so far this year, an increase from 24 cases last year and 26 in 2016. It’s down from the 51 cases reported in 2015, but well above the eight cases reported in the county in 2008 and the five reported in 2009.
Elderly, smokers most at risk
Experts theorize the uptick in reported cases country- wide could be attributed to an aging population, climate change, increased testing and outdated infrastructure.
The elderly, smokers and those with a chronic lung disease or weakened immune system are most at risk of dying from the disease. The disease is not thought to be transmit- ted from person to person.
“We’re c oncentrated on stopping the spread of disease,” said Dan Suffoletto, spokesman for Public Health-Dayton & Mont- gomery County.
Leaky air conditioning units, dirty hot tubs and standing water in basements are all likely environments for the Legionella bacteria to grow. Legionnaires’ disease can be deadly.
Dr. Steven Burdette, medical director of infection prevention at Miami Valley Hos- pital, said cases typically spike in the hot summer months. It’s challenging to diagnose, Burdette said, and the number of ways to treat it are limited.
Routine tests for pneumo- nia do not detect Legion- naires disease, so a urine test is used to diagnose it. Only three antibiotics are used to treat Legionnaires compared to the multiple antibiotics that can be used to treat pneumonia.
While Burdette doesn’t think this summer will be a record high for Legionnaires cases in the region, the hospital saw “quite a few cases” in July, he said.
“We were not as bad as two or three years ago,” he said.
The Ohio Department of Health said it does not have complete data for Legion- naires cases in 2018, but a large outbreak earlier this summer in Parma, Ohio, left 10 sick and one dead — a 93-year-old woman.
Two veterans in Columbus were also diagnosed with Legionnaires disease this summer, according to the Columbus VA Ambulatory Care Center.
The Dayton region battled its own Legionnaires’ outbreak in 2011 when 11 patients were sickened at Miami Valley Hospital. Insufficient heating of the hospital’s hot-water system caused an outbreak that, at the time, was the state’s largest Legionnaires’ outbreak since 2004. The Ohio Plumbing Code required the hospital to make water supplied to showers and faucets was heated to no more than 120 degrees Fahrenheit.
Possible link: warm temperatures
Legion n aires disease reports are rising across the U.S., according to medical professionals, though the causes are hotly debated.
The annual number of reported cases has increased nearly 4.5 times since 2000 when 1,110 cases were reported, according to a recent article published in the Jour- nal of the American Medical Association. In 2016, 6,141 cases were reported, about the same as in 2015 but higher than the approximately 5,000 reported cases in 2014.
Some experts attribute the rise in cases to unseasonably warm temperatures caused by climate change. A study by Ohio University researcher Jeff Vasiloff showed it was likely that warmer water tem- peratures could be contributing to increased cases of Legionnaires disease.
Vasiloff, an assistant clinical professor, found that weather changes and infectious diseases have been associated for centuries.
The Ohio University study found there were 3,515 reported cases of Legionnaires disease from 2005 to 2016 in Ohio. Incidence per 100,000 of Legionnaires’ disease jumped from 1.8 in 2005 to 4.4 in 2016, according to Vasiloff ’s research. Over that time, the average annual air temperature in Ohio increased by 0.8 degrees Fahrenheit. Additionally, the maximum ice coverage of Lake Erie decreased from 89.4 percent from 1975-1995 to 76 percent in 1996-2016, according to the study.