Ohio Hospital Searches for Source of Deadly Legionnaires' Outbreak

Health officials in Ohio are on high alert as a Legionnaires’ disease outbreak linked to a new hospital has turned deadly.

According to the Ohio Department of Health, there have been 8 cases of the disease documented between May 12 and May 31 and 1 death. In a rare adjudication order issued on May 31^st, Amy Acton, MD, MPH, director of the Ohio Department of Health, demanded that the Mount Carmel Grove City Hospital take immediate action to contain the outbreak.

The hospital is a 200-bed, 7-floor facility that was first opened on April 28, 2019. The first patient in the current outbreak arrived at the facility the following day and remained at the facility until May 7, 2019 after contracting Legionnaires’. This outbreak is a cause for concern as Legionnaires’ disease has a mortality rate of 25% when acquired in a health care setting.

As part of the investigation, health officials confirmed all cases through urine antigen testing and conducted surveillance of the facility. According to the adjudication, test results confirmed the presence of Legionella bacteria at 20 colony forming units (cfu) on the 7^th floor and detection of Legionella through polymerase chain reaction testing in the Emergency Department.

Acton’s order requires that the hospital:

• Flush all hot and cold water lines and fixtures throughout the entire facility;
• Implement practices to disinfect hot and cold water lines and fixtures;
• Test and sanitize ice machines;
• Ensure on-site cooling towers are cleaned and serviced;
• Provide any and all test results to the Ohio Department of Health;
• Provide water management plan to the Ohio Department of Health.

Should the facility fail to implement the actions, Acton will order the facility to cease acceptance of new patients.

According to Mount Carmel Health System, the facility is working alongside the Franklin County Public Health Department, Ohio Department of Health, and the US Centers for Disease Control and Prevention to identify a source of the bacteria. To quell the outbreak, the facility is running tests on water sources throughout the hospital and the water supply is undergoing supplemental disinfection.

“We are deeply saddened to confirm that one of the patients who was diagnosed with Legionnaires' disease passed away today,” Richard Streck, chief clinical operations officer of Mount Carmel Health System, said in a statement. “Out of respect for the family's privacy and in keeping with patient privacy laws, we are not discussing the specifics and complexities of patient information. We can say that it's too early to determine the final cause of death.”

The health system also stated that in general the risk of developing Legionnaires' disease is low; however, individuals with chronic, underlying medical conditions are at increased risk. Patients of Mount Carmel Grove City who have developed cough, muscle aches, headaches, fever, or shortness of breath should contact their primary care physician.

This is not the only ongoing Legionnaires’ disease outbreak in the United States. As of May 23, 2019, the New Jersey Department of Health has confirmed 22 cases of the disease in Union County. According to health officials, there have been 5 deaths associated with this outbreak as well.

The cases in the New Jersey outbreak have not been linked to a specific location or source of transmission at this time; however, Shereef Elnahal, MD, the New Jersey Health Commissioner, echoes the Ohio health system’s sentiment and is assuring the public that the overall risk of contraction Legionnaires’ disease is low for the average person.

For the most recent case counts in the Legionnaires’ disease outbreaks in Ohio and New Jersey, check out the Contagion® Outbreak Monitor.