PO Box 360 Trenton, New Jersey 08625-0360

Commissioner Judith M. Persichilli For more information, please contact: Communications Office (609) 984-7160

Between May and August 2021, 4 cases of Legionnaires' disease were reported in Hamilton Township, Mercer County, and one more case was reported in November 2020. The Hamilton Township Department of Health continues to work closely with the New Jersey Department of Health (NJDOH) to investigate these cases as part of a larger investigation, which was launched in August 2020 after four cases were reported. The town of Hamilton reported two deaths in August 2020. Among the nine reported cases reported at the end of last month, one elderly town resident died.

Legionnaires' disease is a type of pneumonia. People may get this type of pneumonia after inhaling atomized water (small droplets in the air) containing Legionella bacteria. The symptoms of Legionnaires' disease include cough, shortness of breath, fever, muscle aches, and headaches. These symptoms are similar to those caused by other respiratory infections, including COVID-19. Most healthy people who are exposed to Legionella will not get sick. However, people 50 years of age or older, especially smokers, or people with certain diseases (including weakened immune systems, chronic lung disease, or other chronic health conditions) have an increased risk of Legionnaires’ disease.

Legionnaires’ disease can be treated with antibiotics, so anyone who thinks they have symptoms of Legionnaires’ disease must contact their healthcare provider and seek medical evaluation. Health care providers use chest X-rays or physical exams to check for pneumonia. Your provider may also ask for urine and sputum (sputum) samples to be tested to determine if your lung infection is caused by Legionella.

Health officials urged residents and business owners in Hamilton to take action to reduce the risk of Legionella growth in pipes in homes and buildings. The following provides advice for homeowners and landlords. When receiving treated drinking water, Legionella bacteria may enter buildings (including homes). Health officials are working with the New Jersey Department of Environmental Protection (NJDEP) and Trenton Water Works (TWW) to monitor Legionella bacteria in the Hamilton Town water system owned and operated by TWW. Although the water samples collected at the TWW treatment plant and the central pumping station always showed the absence of Legionella, the water samples collected from households and businesses in Hamilton town served by TWW have confirmed the presence of Legionella. There is concern that Legionella may be present in other buildings and houses in the area. 

"Drinking water is safe, but residents can take some basic precautions to help protect themselves-such as regularly flushing the tap and maintaining the hot water tank," said state epidemiologist Dr. Tina Tan. "In addition, household air-conditioning devices are not cooled with water, so these household devices do not atomize water and pose no risk of legionella growth."

"We continue to work with partners in the New Jersey Department of Health and Hamilton Township to let Hamilton and the residents of our service area understand how to protect themselves and their families from Legionnaires' disease," said the principal Mark A. Lavenberg. The City of Trenton Water and Sewer Department is responsible for operating the Trenton Water Plant. "For this reason, starting on October 1, Trenton Water Works will launch a public awareness campaign to educate consumers in our service area about this critical public health issue."

Hamilton Township Division of Health and NJDOH want to remind healthcare providers to maintain high levels of suspicion of Legionnaires’ disease when assessing patients’ community-acquired and healthcare-related pneumonia, especially among Hamilton Township residents. This is important to ensure that patients receive appropriate and timely treatment.

"I would like to thank NJDEP and NJDOH for their participation in researching the frustrating frequency of Legionnaires' disease cases in Hamilton over the past decade, and working with TWW and our health department to ensure the safety of Hamilton residents," said Mayor Jeff Martin. "Clean and safe drinking water is a human right-we will continue to fight for this right to ensure that all residents can comfortably know they are available." 

According to NJDOH, residents can follow recommended best practices to reduce the growth of Legionella in household water. For more information on best practices, please visit NJDOH’s Legionella webpage: https://www.nj.gov/health/cd/topics/legion.shtml

Suggested actions for owners

When reopening your facility after prolonged closure or reduced operations due to the COVID-19 pandemic, follow the recommendations of the New Jersey Department of Health. Suggested location: bit.ly/2XxlBaw

About Legionnaires' disease and Legionella

NJDOH receives approximately 250-350 reports of Legionnaires' disease throughout New Jersey each year. Legionnaires' disease is a type of pneumonia (pulmonary infection) caused by Legionella bacteria. Legionella is a kind of bacteria that naturally exists in freshwater environments such as lakes and streams. When it enters and grows in artificial water systems, it becomes a health problem. People can contract Legionnaires' disease by inhaling aerosolized (small droplets) water containing Legionella bacteria. Atomized water may come from piping systems and equipment, such as cooling towers (air conditioning units in large buildings), hot tubs, cooling sprayers, and decorative fountains. It is less common that people get sick from inhaling tap water that contains Legionella bacteria. This happens when water accidentally enters the lungs while drinking ("into the wrong pipe"). People at increased risk of inhalation include those who have difficulty swallowing. Household A/C devices are not cooled by water, so these household devices do not atomize water and pose no risk of Legionella growth. Legionnaires' disease generally does not spread from person to person.

Follow the New Jersey Department of Health on Twitter @njdeptofhealth, Facebook /njdeptofhealth, Instagram @njdeptofhealth, and LinkedIn /company/njdeptofhealth.

This feature requires JavaScript, please enable JavaScript in your current browser/device or use a browser/device that supports JavaScript

Shereef Elnahal, MD, MBA Specialist PO Box 360 Trenton, NJ 08625

2013-2018 Chronic Disease Prevention and Control Plan

New Jersey has more than 2,000 licensed hospitals, nursing homes and medical institutions. The New Jersey Department of Health is committed to ensuring that citizens receive the appropriate level of care in every regulated facility.

The local and county health departments in New Jersey are community-based public health services and are also the first point of contact for public health services or health issues.