New Hampshire Reports Legionnaires' Disease Outbreak

The New Hampshire Department of Health and Human Services’ (DHHS) Division of Public Health Services are working with the US Centers for Disease Control and Prevention (CDC) to investigate an outbreak of Legionnaires’ disease in the state.

According to the DHHS, there have been 18 confirmed cases of Legionnaires’ disease between June 10, 2018 and August 26, 2018.

Between 2013 and 2017, an average of 32 cases of Legionnaires’ disease were reported each year in the state, with a usual increase of cases in the summer months, due to increased exposure to sources that harbor Legionella bacteria such as cooling towers.

While Legionnaires’ disease is not unfamiliar to the state, an outbreak is considered when 2 or more people who fall ill after exposure to Legionella bacteria in the same place at the same time.

Of the 18 reported cases, 16 of the ill have been hospitalized and 1 elderly adult has died due to complications from the disease.

Public health officials are working alongside officials from the town of Hampton—which is located in the southeast area of the state, along the coast—where all 18 cases have been reported.

Initially, health officials closed the hot tub spa at the Sands Hotel and Harris Sea Ranch—both located in the area that has been presumed to be responsible for the source of the outbreak.

Initial tests conducted by the CDC identified the presence of Legionella bacteria in multiple sources within the water system at the hotel, including the hot tub. Preliminary results from environmental cultures are expected this week, but the full culture results can take up to 2 weeks.

On September 2, the DHHS issued an order to the Sands Resort to take immediate action to notify guests that bacteria had been found in the water and to take steps to remediate bacteria found at the facility.

"We are working hard to identify the exact source of these infections," Lisa Morris, MD Director of the Division of Public Health Services said in a recent statement. "Even though the information is preliminary, we want to allow the public to make informed decisions about visiting the area and their activities in the area."

As a result of the order, the resort has hired an environmental consultant to begin making adjustments and corrections to the water system.

Other locations in the Hampton community have had their water systems sampled and results are expected in the coming days, according to the DDHS.

In a health alert, the DPHS advised health care providers to consider Legionnaires’ disease infection when evaluating community-acquired pneumonia patients and ask patients about any travel in the 10 days prior to the onset of symptoms. If Legionnaires’ is suspected, diagnostic testing should include both urine antigen and culture of respiratory specimens.

The investigation is ongoing and health officials will provide updates as they become available.

For the most recent case counts associated with the New Hampshire Legionnaires’ Outbreak, check out the Contagion^® Outbreak Monitor.