• By Yalonda Miller
• Posted Tuesday, July 1, 2014

FC County Health Officials Confirm 3 Cases of Legionnaire's Disease in a Winston-Salem Nursing Home

The Forsyth County Department of Public Health (FCDPH) has identified three cases of Legionella Pneumonia (Legionnaire's disease) at Oak Forest Health and Rehabilitation. The health department is working closely with the North Carolina Division of Public Health and Oak Forest Health and Rehabilitation to implement internal control measures to protect residents, visitors and staff.

The control measures include the suspension of new admissions and some visit restrictions to the facility. Additional measures being taken include minimizing exposure to water from the facility by using bottled water for drinking, mouth rinsing, brushing teeth, and shaving. The facility has also performed water superheating by turning hot water tank and boilers to 160 degreen Farenheit for three hours then purging the water lines for at least five minutes. Precautions are being taken not to scald residents or staff. Oak Forest will be consulting with an engineering company with experience in the control of Legionella to conduct a thorough environmental assessment of the facility building water system. At this time the source of the Legionella bacterium has not been identified. Testing will be ongoing.

Legionnaire's disease does not spread from person-to-person. Legionella is a bacterium commonly found in the environment, particularly 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 the Legionella bacteria do not become ill.

Symptoms include high fever, chills, cough, body aches, headache and fatigue. The disease typically begins 2-10 days after exposure to the bacteria and can be treated effectively with antibiotics.

Most healthy individuals do not become infected with Legionella bacteria after exposure. People at higher risk of getting sick are:

• Older people (usually 50 years of age or older)
• Current or former smokers
• Those with a chronic lung disease (such as COPD or emphysema)
• Those with a weak immune system from diseases like cancer, diabetes, or kidney failure
• People who take drugs that suppress (weaken) the immune system (like after a transplant operation or chemotherapy)

After one case of Legionnaire's disease was diagnosed in a patient of Oak Forest Health and Rehabilitation, testing was conducted to determine if there had been previous, unrecognized cases. As of June 30, 2014, there were 43 confirmed and probable cases in the state and 5 in Forsyth County. This does not include any cases that are still being investigated by the FCDPH.

Representatives from the FCDPH made a visit to the facility after the second case was confirmed to recommend control measures. We have not identified the source of bacteria at the facility, and have restricted the use of water as a precautionary measure until future testing. We are continuing to work with the North Carolina Division of Public Health and the Oak Forest Health and Rehabilitation nursing facility to prevent additional cases.

For more information, please visit CDC/Legionella website.