4 Cases Of Legionnaires’ Disease Reported In Mercer County

MERCER COUNTY, NJ — Two cases of Legionnaires’ disease were recently reported in Hamilton Township, Mercer County, served by Trenton Water Works (TWW), officials said. Two additional cases were reported, in April this year and December 2021. Of the four, one person has died, officials said.

Legionnaires’ disease is a type of pneumonia that people can contract after breathing in small droplets of water in the air containing Legionella bacteria.

One cannot get Legionnaires’ disease by drinking water that has Legionella.

The Hamilton Township Division of Health is working closely with the New Jersey Department of Health to investigate these cases. This is part of a larger ongoing investigation to determine potential sources of Legionella. Health officials continue to conduct surveillance for Legionnaires’ disease in other municipalities served by Trenton Water Works.

Hamilton Township Division of Health and NJDOH recruited 20 homeowners from Hamilton to voluntarily have their homes tested for Legionella. Water samples collected from more than half of the homes served by TWW identified the presence of Legionella, including in samples of the cold water.

It is possible for Legionella to enter buildings and homes when receiving treated drinking water, officials said. However, health officials are concerned about the number of homes with Legionella in areas serviced by TWW. There is concern that Legionella may be present in other buildings and homes in the area, particularly in the areas of Hamilton Township served by TWW.

Hamilton Township and NJDOH are partnering with the New Jersey Department of Environmental Protection (NJDEP) and TWW to investigate factors that may be contributing to the growth of Legionella bacteria and to evaluate actions that can be taken to reduce Legionella in the system.

Investigators are also assessing if the other municipalities served by TWW are impacted.

“I want to thank Hamilton’s Division of Health, NJDOH, and NJDEP for their joint and thorough investigation into the causes of Legionnaire’s disease here in Hamilton,” Mayor Jeff Martin said in a statement.

“This has been an issue for many years and their tireless work will hopefully reveal a cause for the high number of cases here in the Township – specifically those in the TWW service area.”

The New Jersey Department of Health (NJDOH) receives approximately 250–350 reports of Legionnaires’ disease each year throughout the state. Public health departments routinely conduct disease surveillance to identify suspected clusters or outbreaks.

When an outbreak is identified, affected individuals are notified so they are aware of steps they can take to reduce their risk.

It is rare for a healthy person exposed to Legionella to become sick with Legionnaires’ disease. However, people who are 50 years or older, especially those who smoke, or have certain medical conditions, including weakened immune systems, chronic lung disease or other chronic health conditions, are at increased risk for Legionnaires’ disease.

Symptoms of Legionnaires’ disease include cough, shortness of breath, fever, muscle aches, and headaches, which are similar to symptoms caused by other respiratory infections, including COVID-19. Legionnaires’ disease can be fatal but is treatable with antibiotics. It is important that anyone who thinks they have symptoms of Legionnaires’ disease contact their health care provider and seek medical evaluation.

“There are simple precautions that residents can take to help protect themselves – such as regularly flushing water at their taps, cleaning their showerheads, and maintaining their water heaters,” State Epidemiologist Dr. Tina Tan said in a statement. “Additionally, home and car air-conditioning units do not use water to cool the air, so they are not a risk for Legionella growth.”'

Here are some steps to decrease the risk of Legionella exposure:

• Avoid high-risk activities: If you are at an increased risk for Legionnaires’ disease, consider avoiding hot tubs, decorative fountains, power washing, or similar activities, which may generate increased amounts of aerosols or mist. A conversation with your healthcare provider may help you assess your individual level of risk based on underlying health conditions and co-morbidities.
• Maintain in-home medical equipment: If using medical equipment that requires water for use or cleaning such as non-steam generating humidifiers, CPAP or BiPAP machines, nasal irrigation devices such as Neti Pots, and attachments for nebulizers, follow manufacturer’s instructions for use and maintenance. This often includes using sterile water instead of tap water in the device.
• Clean and/or replace your showerheads and faucet aerators (screens) per manufacturer’s instructions whenever buildup is visible: This is important if you haven’t cleaned your showerheads or faucet aerators recently.
• Keep your water heater set to a minimum of 120°F: This temperature will reduce Legionella growth and avoid potential for scalding (hot water burns). Setting the heater to a higher temperature may better control Legionella growth, especially if you have household members at increased risk for Legionnaires’ disease.
• After cleaning showerheads and faucet aerators and increasing the temperature of the water heater, thoroughly flush the water at each tap (e.g., sink, showerhead) for 20 minutes: Try to minimize exposure to splashing and mist generation, for example, by leaving the room while the water is running.
• Conduct routine flushing: Sinks and shower taps that are not used often can increase the risk of Legionella growth in other areas of the home. Let your faucets and showers run for at least three minutes when they have been out of use for more than a week.
• Follow manufacturer’s instructions for maintaining your water heater and expansion tank: This includes periodic flushing, draining, and removal of sediment. If manufacturer’s instructions are unavailable, seek advice from a licensed professional.
• Clean and/or replace all water filters per manufacturer’s instructions: All whole-house (e.g., water softeners) and point-of-use filters (e.g., built-in refrigerator filters) must be properly maintained.
• Drain garden hoses and winterize hose bibs: Detach and drain the hose, shut the water valve off inside the home, and drain the pipe when not in use for the season.
• Follow manufacturer’s instructions for maintaining your hot tub: Ensure disinfectant levels (e.g., chlorine) and maintenance activities (e.g., cleaning, scrubbing, replacing the filter and water) are followed. For more information, be sure to review CDC’s recommendations for residential hot tub owners found here: www.cdc.gov/healthywater/swimming/residential/index.html.
• Operate and maintain your indoor and outdoor decorative fountains according to manufacturer’s instructions: Household members at increased risk for Legionnaires’ disease should avoid exposure to decorative fountains. If manufacturer’s instructions for cleaning and maintenance are not available, minimum cleaning frequency recommendations can be found in CDC’s Legionella Control Toolkit available at: Controlling Legionella in Decorative Fountains (PDF).
• Remove, shorten, or regularly flush existing dead legs: Plumbing renovations can lead to the creation of dead legs, a section of capped pipe that contains water but has no flow (or is infrequently used). For future renovations, ensure your plumber avoids creating dead legs.

For more information, click here.

Have a correction or news tip? Email sarah.salvadore@patch.com