CHARLOTTE, N.C. -- A severe type of pneumonia that can be fatal is on the rise across the country, with confirmed cases up by more than 300 percent alone in North Carolina over the last decade.
In the first half of this year, doctors in the Carolinas diagnosed about 100 people, including people in Charlotte, with Legionnaires' disease, according to records from both states.
The bacterial infection got its name after 34 people died while attending an American Legion convention at a Philadelphia hotel in the 70s. In response to the growing concern about Legionnaires' disease, Salisbury VA Medical Center is taking extreme measures to keep veterans safe.
"The most serious type of Legionella is the one that people catch when they are in the hospital setting," Salisbury VA Chief of Medicine Dr. Charles De Comarmond said.
Every veteran who spends the night at the Salisbury VA now sleeps in a room with faucets that turn on automatically every hour and run for three minutes at a time.
While Salisbury VA reports no Legionnaires' disease cases in recent history, the plumbing change follows a VA directive. The directive's goal is to make sure water circulates, maintaining chlorine levels to keep away the bacteria that causes the infection.
"The prevalence of Legionella in the United States has been continuously increasing and just like other hospitals in the country, the VA has not been spared of Legionella outbreaks," Dr. De Comarmond said.
The Pittsburgh VA previously experienced an outbreak that killed six several years ago. In Illinois, 13 others died at a veterans' home. In the last two weeks, more than a dozen people reportedly got sick at a New Hampshire beach resort with one person dying.
Public records show North Carolina was home to more than 200 reported cases in 2017, up from just 49 in 2007. Public records show South Carolina averages roughly 55 cases a year. North Carolina's yearly average is three times higher.
Adults 50 and older with weaker immune systems are most at risk. People contract the infection by breathing in small droplets of water tainted by the bacteria. Legionella is found mostly in warm water like hot tubs, hot water tanks, large plumbing systems and air conditioning cooling towers.
VA's prevention efforts aren't just focused on auto-run faucets. The facility also uses temperature controls. The proactive steps are so extreme, the facility's scenic indoor pond, once home to stagnant water, is now drained, replaced by televisions with a loop of water video and sound.
"I would say in general that as a healthcare system, the VA is way ahead of any other types of healthcare industries," Dr. De Comarmond said.
While VA may be leading the way, the area's major hospital systems are taking preventative measures too.
"Atrium Health implements several infection prevention protocols throughout our system to ensure we maintain a safe, healthy environment for all patients, teammates and visitors," a spokesperson said. "Specifically with Legionnaires, we take preventative measures including flushing protocols and scheduled monitoring of water cultures to check for legionella in high risk units."
"At Novant Health, we have an ongoing water quality safety plan to monitor and maintain the safety of our water," Novant said in a statement. "This safety plan includes testing for Legionella."
The symptoms of Legionnaires' disease include cough, shortness of breath, fever, muscle aches and headaches, according to the Centers for Disease Control and Prevention.
"Legionnaires' disease can also be associated with other symptoms such as diarrhea, nausea, and confusion," the CDC reports. "Symptoms usually begin two to 10 days after being exposed to the bacteria, but it can take longer so people should watch for symptoms for about 2 weeks after exposure. If you develop pneumonia symptoms, see a doctor right away. Be sure to mention if you may have been exposed to Legionella, have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks."