The Legionnaires’ outbreak linked to the Sheraton Atlanta Hotel appears to be much wider than previously thought, with state health officials reporting 57 more “probable cases” Tuesday.

The Georgia Department of Public Health announced 55 probable cases Monday and added two more Tuesday, all of which have not been confirmed in a lab. However, they involve people with illnesses consistent with Legionnaires' disease, such as pneumonia. The number of confirmed cases has remained at 11 since Friday.

The Sheraton Atlanta shut down voluntarily about two weeks ago after three guests who had recently visited or stayed at the Courtland Street hotel tested positive for the disease, which can cause a serious lung infection.

No deaths related to the Legionnaires’ outbreak have been reported, according to the DPH.

Until testing is complete, health officials say they can’t be sure that the hotel is the source of the outbreak, though no other locations are being tested for Legionella. The Sheraton Atlanta will remain closed until at least Aug. 11 but may remain closed for several weeks longer, depending on the test results and whether remediation is necessary.

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The Department of Public Health and the Fulton County Board of Health investigators have been reviewing hundreds of survey responses from people who stayed or visited the hotel between June 12 and July 15. The survey responses are being analyzed to compare activities at the hotel between people who became sick and those who didn’t. It could take weeks to parse through the surveys, the DPH said.

Investigators have also taken environmental samples for testing and remediation. The first round of environmental samples was collected July 19, and a second round of samples was collected Monday.

When testing hotels for Legionella bacteria, which cause Legionnaires’ disease, investigators typically begin in pools, hot tubs and water fountains, the most likely culprits of the bacterium, DPH spokeswoman Nancy Nydam said. The investigation can expand well beyond those water sources, stretching into the hotel’s water supply system, including the plumbing system, she said. The team of investigators will look for clues — such as whether all of the sickened guests stayed on the same floor – that could help find the contaminated source.

MORE: What is Legionnaires' disease? FAQs about the severe form of pneumonia

Legionella bacteria are found naturally in freshwater environments, like lakes and streams, according to the Centers for Disease Control and Prevention. But, the agency says, it can become a health concern when it grows and multiplies in human-made building water systems.

In Georgia, there have been close to 90 confirmed cases this year, according to the state Department of Public Health. Last year, there were 180 confirmed cases and nine suspected cases in the state. That’s up from 41 in 2008.

A variety of factors may be contributing to the increase, according to the CDC. More awareness of the disease could mean more reporting. But there’s also improved testing, and an aging population is more susceptible. Another factor could be more Legionella in the environment.

Officials stressed that the disease is not spread from person-to-person contact. The bacterium makes its way into the lungs of most people who become ill after they breathe in mist or steam infected with Legionella.

Those who get the sickest and face complications from Legionnaires’ tend to be over 50, have medical conditions such as chronic obstructive pulmonary disease or diabetes, or have a history of smoking.

About one in 10 people who come down with Legionnaires’ disease will die due to complications from the illness, the CDC said.


Guests who stayed at the Sheraton Atlanta between June 12 and July 15 should speak to their health-care provider if they are experiencing symptoms of respiratory illness.

The Georgia Department of Public Health said when seeking treatment, former guests should tell their doctors that they stayed at a hotel with a Legionella outbreak. This can help with proper treatment and assist with the investigation.

LEGIONNAIRES’ DISEASE

What is Legionnaires’ disease?

It’s a severe form of pneumonia — lung inflammation usually caused by infection — caused by a bacterium known as Legionella.

How does it spread?

You can’t catch Legionnaires’ disease from person-to-person contact. Instead, most people get the disease from inhaling the bacteria. Older adults, smokers and people with weakened immune systems are especially susceptible.

What are the symptoms?

Legionnaires’ usually develops two to 10 days after exposure to the bacteria and often begins with these symptoms: headache, muscle pain, chills and a fever that may be 104 degrees or higher. By the second or third day, other symptoms may include cough, shortness of breath, chest pain, gastrointestinal symptoms and confusion or other mental changes. Left untreated, it can be fatal.

How is it treated?

Prompt treatment with antibiotics usually provides the cure, but some people continue to experience problems after treatment.

SOURCE: MAYO CLINIC