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Published Date: 2012-09-13 14:41:20
Subject: PRO/EDR> Legionellosis - USA (05): (PA) hotel
Archive Number: 20120913.1293109

LEGIONELLOSIS - USA (05): (PENNSYLVANIA) HOTEL
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Date: Tue 11 Sep 2012
Source: travelerstoday.com [edited]
http://www.travelerstoday.com/articles/3003/20120911/legionnaires-disease-outbreak-discovered-hotel-grantville-pa-illness-pennsylvania-chicago-canada-hotels-travel.htm

The Comfort Suites hotel in Grantville, Pennsylvania is dealing with an outbreak of legionnaires' disease. Guests who stayed at the Comfort Suites hotel in Grantville have contracted legionnaires' disease. Recent hotel guests have been notified as an ongoing investigation takes place. It is unclear how many guests have been affected so far.

The Pennsylvania Department of Health and the Pennsylvania Department of Environmental Protection are leading the investigation. In a test of the water conducted on [23 Aug 2012], officials found that the hotel's water system tested positive for _Legionella_, the bacteria that cause the disease.

The hotel is working with the health departments to clean the water system and to develop a plan to prevent future legionellosis outbreaks. Guests have been advised to seek medical attention if they become ill and to report the illness to health departments.

Legionnaires' disease is a severe form of pneumonia that comes from _Legionella_ bacteria that live in warm water. The bacteria can be breathed in from water particles in the air. Symptoms start to show 2 weeks after exposure and include a high fever, headache, and chills. This then develops into pneumonia-like symptoms, such as a cough, chest pain, or shortness of breath.

Between 8000 and 18 000 people are infected with legionnaires' each year in the US, according to the federal Centers for Disease Control and Prevention. Most people exposed to _Legionella_ do not become sick, but between 5 and 30 percent of cases are fatal.

Recently, the JW Marriott [hotel] in downtown Chicago also had a legionnaires' disease outbreak, which resulted in 3 fatalities [see ProMED-mail post Legionellosis - USA (03): (IL) hotel 20120823.1259486]. Quebec City in Canada is also dealing with a legionnaires' disease outbreak [see ProMED-mail post Legionellosis - Canada (06): (QC) fatal, L. pneumophila 20120909.1287573]. At least 169 people have been infected since July [2012] and 11 have died [in Quebec City;] officials believe it stems from cooling towers around the city.

[Byline: Katie McFadden]

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[For a discussion of legionellosis, see ProMED-mail post: Legionellosis - Spain (05): Madrid 20101115.4142.

The number of Comfort Suites hotel guests who may have come down with legionnaires' disease or Pontiac fever is not given in the news report above. Further information is needed in addition to the number of cases, such as the timeline over which the cases occurred; exposure to a common aerosolized contaminated water source, such as cooling towers, public fountains, hot tubs, misting machines, showers, etc; how the clinical diagnosis was made (such as, culture, urinary antigen, or serology); genotyping the clinical isolates, to see if a single genotype is identified, which would suggest a common source; and also genotyping the environmental isolates, to see if there is a match with that of the clinical isolates, which would confirm linkage of clinical cases to the environmental source.

A diagnosis of a single case of legionnaires' disease implies the presence of an environmental source to which other susceptible individuals are likely to have been exposed. According to the US CDC, about 20-25 percent of all legionnaires' disease reported to CDC is travel-associated (http://www.cdc.gov/legionella/faq.htm). Travelers typically disperse to their homes widely separated from one another and perhaps at a very great distance from the source of infection before developing symptoms, so that a cluster of cases of legionnaires' disease in other travelers associated with the same source may not be readily appreciated. A travel history is essential and should be actively sought from patients with community-acquired pneumonia, and _Legionella_ testing should be performed for those who have traveled in the 2 weeks before onset of symptoms. Cases of travel-associated legionnaires' disease need to be reported to the appropriate authorities to be able to detect these outbreaks.

The Comfort Suites/Grantville is a 96-room hotel with an indoor pool and a spa tub. Grantville, with a population of 3769 in 2000, is a village in Dauphin County, Pennsylvania, United States. Grantville is located 19 miles [31 km] northeast of Harrisburg (the capital of the state of Pennsylvania) and is part of the Harrisburg-Carlisle Metropolitan Statistical Area. Comfort Suites/Grantville is very near Hollywood Casino and Penn National Race Track and is about 7 miles [11 km] north of Hershey Park (a family theme park) and Hershey medical school and medical center (a large academic healthcare facility associated with Penn State University). A map of Dauphin County on which Grantville, Harrisburg, and Hershey can be located is available at https://maps.google.com/maps?hl=en&q=dauphin+county+pa.

Pennsylvania may be found on the interactive HealthMap/ProMED-mail map at http://healthmap.org/r/3pq8. - Mod.ML]

[Map of Comfort Suites Grantville, location:
http://www.destination360.com/north-america/us/pennsylvania/grantville/comfort-suites-grantville/hotel-map
Photo of Comfort Suites Grantville:
http://www.comfortsuites.com/media/eBrochure/ebrochure/PA/PA295/PA295A1.JPG - Mod.JW]

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