Legionnaires’ outbreak tied to Atlanta hotel now largest ever in state

When Margo and David Jakobs checked into the Sheraton Atlanta last month, they looked forward to a jam-packed, four-day visit with their youngest son, Bryce, who recently relocated here.

The three enjoyed an outdoor concert, sightseeing and scenic hike together before events took a sudden, unexpected turn. Returning to the hotel on July 15, the Illinois couple found the Sheraton Atlanta in the middle of an evacuation.

At the time, Margo Jakobs was annoyed that they had to move to another hotel and miss a dinner reservation.

She didn’t know that, according to her doctor, she was already a casualty of the largest Legionnaires’ outbreak ever recorded in Georgia, one that now includes 12 confirmed diagnoses, including one death, and another 63 probable cases.

State health officials have not confirmed Jakobs' diagnosis of Legionnaires' disease, though her case was reported to the Centers for Disease Control and Prevention by her doctor. As she continues recovering from illness, health authorities are still trying to pin down the source of the outbreak, with all efforts concentrated on the Sheraton Atlanta.

Three weeks into the painstaking investigation, the CDC also has joined the effort, The Atlanta Journal-Constitution has learned. In recent days, the agency has begun testing patient specimens, according to CDC spokesman Benjamin Haynes.

There’s a common thread with all those sickened: They either stayed at or visited the Sheraton Atlanta between June 12 and July 15, according to the state department of public health. The illness is not spread by person-to-person contact. Most people get sick when they breathe in water droplets contaminated with the bacteria and it makes its way into the lungs.

The downtown Atlanta hotel voluntarily shut down after three guests who had visited or stayed there tested positive for the disease.

Earlier this week, health authorities confirmed that Legionella played a role in the death of Cameo Garrett, a 49-year-old woman who attended a conference at the hotel last month. While the Decatur woman died of coronary artery disease, DeKalb County Medical Examiner Pat Bailey said the bacteria was a contributing factor.

In a statement Friday, hotel General Manager Ken Peduzzio offered the Sheraton’s “deepest sympathies to all of those affected by the Legionella outbreak.”

He went on to say a “thorough cleaning of the hotel’s entire water distribution system has been completed as a precautionary measure, including cleaning, scrubbing and chlorination of all water features. At this time, we are awaiting additional testing results and we will complete a review of those results, as will the Georgia Department of Public Health.”

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The Jakobs were very much caught off guard when they came back to a whirlwind of evacuation activity at the hotel last month. When a fellow guest mentioned a possible Legionnaire’s outbreak, Margo joked and feigned a cough.

She and her husband moved to a nearby hotel for the last two days of their trip, then headed home.

Margo Jakobs said it was four days later, when the couple was back in Illinois, that she started feeling ill, with chills, achiness, a throbbing headache. She had a fever of 102. Then came a relentless cough.

The 60-year-old — known in her family as the “Energizer Bunny,” a woman who is fit, eats well and exercises regularly — said she couldn’t get out of bed for two days.

“I didn’t feel good and, honestly, I was like, ‘You’ve got to be kidding me,’” she said in a recent interview interrupted every couple minutes by bouts of coughing.

At times, the cough was so overwhelming that she vomited, she said. On July 25, Jakobs went to the Whiteside County Health Department in Rock Falls, Ill., where they have infectious disease specialists. A urine test for Legionella came back negative, though Dr. Kelley Guthrie was not convinced.

Guthrie said a sputum sample is the preferred way to test, but the procedure can be expensive. And, in the case of Jakobs, the doctor considered it unnecessary.

Guthrie said she had no doubt Jakobs was sick with Legionnaires’ because her patient had all of the telltale signs.

Guthrie, who is a family medicine doctor, consulted with infectious disease specialists, and reported Jakobs’ probable case of Legionnaires’ to the CDC. On Friday, the state public health department was unable to confirm whether Jakobs’ case is part of the overall count.

“People who get Legionnaires’ go from zero to 100 very quickly,” said Guthrie. “Margo was very sick, very weak. She was coughing and had lots of chest pain from all of the coughing.”

About 1 in 10 people who come down with Legionnaires' disease die due to complications from the illness, the CDC said. People who are older than 50, have medical conditions such as chronic obstructive pulmonary disease or diabetes, or have a history of smoking are the most likely to face complications.

Nearly 7,500 people contracted Legionnaires’ disease in 2017, a more than five-fold increase in the number of cases in 2000, when it was about 1,100, according to the CDC. It is believed the actual number was far higher, since many people might have gotten sick and weren’t tested.

So far this year in Georgia, there have been 107 confirmed cases, according to the Georgia Department of Public Health.

Some of the most common culprits in the spread of the Legionella bacteria are cooling towers, hot water tanks and condensers in large air-conditioning units. Pools and hot tubs are also sometimes sources of the disease.

Ten years ago, four patients at Grady Memorial Hospital were sickened with Legionnaires’ disease. Widespread testing pinpointed high concentrations of Legionella bacteria in the patient areas of the 11th and 12th floors of the A tower. Several remedial measures, including repeatedly flushing the water system with chlorine, were taken to disinfect the water. All four patients were treated with antibiotics and discharged from the hospital.

Until testing is complete, health officials said 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 Wednesday, but may remain closed for several weeks longer, depending on the test results and whether remediation is necessary.

The Department of Public Health and Fulton County Board of Health investigators have been reviewing hundreds of survey responses from people who stayed or visited the hotel. It could take weeks to parse through the surveys, comparing activities between those who got sick and those who didn’t, the health department said. The survey is available on the agency’s home page.

Meanwhile, Jakobs, who has been taking antibiotics and undergoing nebulizer treatments, is getting better, little by little. Her cough is beginning to abate.

Jakobs said she wants to know how the outbreak happened and what might have prevented it. She also said she doesn’t think information about the outbreak was communicated effectively.

A Sheraton Atlanta spokesperson said the hotel gave a letter to guests about Legionnaires’, including a fact sheet from the CDC. But Jakobs said she never received an email, letter or phone call from the Sheraton Hotel about the outbreak.

“There are at least 60 more people sick like me. I don’t know what’s going on down the road. I have numbness in my fingers and things going on I can’t explain,” said Jakobs. “And I am so sad about the woman dying.”

The Legionnaires’ outbreak

The Legionnaires’ outbreak linked to the Sheraton Atlanta is now considered the largest ever recorded in Georgia, according to the state Department of Public Health.

Number of suspected cases: 63

Number of confirmed diagnoses: 12

Number of deaths: 1

The Georgia Department of Public Health is asking all guests who stayed at the Sheraton Atlanta between June 12 and July 15 to fill out an online survey on its home page. (http://sendss.state. ga.us/survey/form/11178). The responses will assist in the investigation into the outbreak of Legionnaires' disease.