Alleghany Highlands Situation Update

Posted on by shannonbowles

5.12.25 Action Update #5: Roanoke City & Alleghany Health Districts (RCAHD) staff continue to systematically explore possible factors related to the cluster of reports of elevated levels of carboxyhemoglobin in the Alleghany Highlands, including lab quality assurance.  

The ongoing lab performance for the measurement of carboxyhemoglobin (COHb) at LewisGale- Alleghany has been reviewed and has been found to be within acceptable limits.

As of May 12, 2025, RCAHD staff has identified 220 people who had COHb testing at local healthcare facilities during January 31–February 7 and March 26–April 9, 2025. Among all 220 people tested, 174 (79%) people agreed to be interviewed.

A total of 246 COHb tests were conducted during these periods. Some people were tested more than once. RCAHD developed case definitions to classify and count cases of elevated COHb test results based on the person’s age, smoking status, and test result. RCAHD identified 171 cases of elevated COHb test results.

    • The most commonly reported symptoms among case-patients were headache (91%), fatigue or weakness (86%), nausea or vomiting (51%), and dizziness or lightheadedness (48%).
    • We are not aware of any hospitalizations connected to any of the COHb test reports. The majority of case-patients who were interviewed reported that their symptoms improved or improved some after going outside (95%).
    • The majority of people tested (72%) were children aged 13 years or younger.
    • The majority (81%) of people interviewed reported having a carbon monoxide detector in their homes. The Alleghany Foundation has made household carbon monoxide detectors available for local residents.

VDH state toxicology office staff assisted the investigation to create a GIS-driven map of carboxyhemoglobin test results, as of April 29. See below. (Data and analysis should be considered preliminary as the investigation is still in progress.)

Alleghany Highlands Carbon Monoxide (CO) Test Results (illustration showing map of the area) Data as of April 29, 2025 and should be considered preliminary while the investigation is still in progress. Radius center point: Covington Middle School, 606 S Lexington Ave, Covington, VA. RCAHD received carboxyhemoglobin (COHb) test results from 220 Alleghany Highlands residents (collected between January 31-April 9, 2025). Definitions: Not a Case = COHb levels below 1.5% Suspected Case = COHb levels between 1.5% - 5% Confirmed = COHb levels 5% or greater *The Virginia Department of Health suppresses data to protect individual privacy when counts are between 1-4.

Next steps in the ongoing investigation:

VDH is working with the Virginia Department of Environmental Quality's Office of Air Quality Monitoring to explore the next steps in this ongoing investigation.

-end update-