A spokesman for a Springfield, VA, continuing care retirement community said the community is acting “with an abundance of caution” to ensure resident welfare after two residents have died and 53 additional residents have become ill with respiratory symptoms since June 30.

Greenspring, managed by Erickson Living, is temporarily not accepting move-ins, has canceled group activities, is keeping ill residents in their units and has increased cleaning efforts, the Fairfax County Health Department said. Officials praised the “excellent collaboration” the department has had with personnel at the CCRC as it conducts an outbreak investigation.

“Respiratory outbreaks at facilities for vulnerable, older adult populations are not uncommon, as we typically see five to 10 per year,” officials said in a statement. “This outbreak differs in that it is occurring in July, whereas most outbreaks of this kind are in the winter / flu season.”

Twenty residents have been hospitalized, including the two who died, the department said. All affected residents live or lived in assisted living or skilled nursing.

Greenspring “has acted with an abundance of caution, and in partnership with the Fairfax County Department of Health has taken all necessary measures to fully implement proven infection prevention and control strategies,” Dan Dunne, Erickson Living’s director of external communications, said in a statement to McKnight’s Senior Living. “We remain vigilant in our response and will continue to provide frequent and transparent updates to residents, staff and family members.”

A specific cause for the illnesses, with symptoms ranging from upper respiratory symptoms (cough) to pneumonia, has not been identified. The Virginia Department of Health and Inova Health System are conducting additional tests, according to the county health department.

The two residents who died were hospitalized with pneumonia.

“Both were older adults and had complex medical problems,” the Fairfax Department of Health said. “The Health Department does not know the full medical history and the extent to which the pneumonia contributed to the deaths.”

The department is asking all senior living and care communities in the area to “maintain a heightened index of suspicion for an increase in the number of respiratory illnesses, including pneumonia,” because of the outbreak at Greenspring and the fact that staff members may work at more than one community. Proper infection control precautions and handwashing and respiratory etiquette also should be followed, the department said.

Update July 15: The Fairfax County Health Department says that hospitalizations now total 23 and the number of people who are or have been ill is 60.