Legionnaires’ Disease Outbreak In Alabama Kills Elderly Woman: 5 Things To Know About Legionella Bacteria

Health officials have connected the death of an elderly woman in northwest Alabama on Thursday to an outbreak of Legionnaires’ disease, a serious and life-threatening type of pneumonia. According to the Associated Press, there were 13 lab-confirmed cases of Legionnaires’ at a nursing home in Florence, a city 206 miles north of Montgomery.

The death of the 80-year-old woman, who was not named, marks the first death associated with the Legionnaires’ disease outbreak at the center. She died Thursday in a hospital in Tuscaloosa.

Authorities identified the outbreak of Legionnaires’ earlier this month. Health officials determined the center of the outbreak to be a northwest Alabama nursing home, the Associated Press reported Wednesday. The exact source of the disease is still under investigation.

Ten of the 13 people infected with Legionnaires’ disease were residents of the northwest Alabama nursing home belonging to Glenwood Healthcare. The three others, including the woman who died on Thursday, were visitors to the home.

Legionnaires’ disease was first coined in 1976 when 34 people were killed at a convention in Philadelphia of the American Legion, a veterans’ organization that includes members of the U.S. armed forces.

More than 2,000 people, mostly men, attended the convention. Two hundred were sickened by the outbreak. Health investigators traced the cause of the infections to a bacterium called Legionella, which circulated through the convention hotel’s air conditioning system.

In August of this year, Ohio experienced its largest outbreak of Legionnaires’ disease when five people were killed and 39 others became sick at a retirement community in Reynoldsburg. Victims of the outbreak at Wesley Ridge Retirement Community ranged in age from 63 to 99, according to the Associated Press…

Original article at: http://www.ibtimes.com/legionnaires-disease-outbreak-alabama-kills-elderly-woman-5-things-know-about-legionella-bacteria

Hotel with Legionnaires’ Cases Plans Tests Prior to Reopening

OCEAN CITY — The hotel where several people contracted Legionnaires’ Disease will have consulted with a water systems expert and will have regular water testing done by the health department when it reopens in the spring.

The Plim Plaza Hotel, which closed for the season a few days early this fall after some of its guests developed Legionnaires’ Disease, has been required by the Worcester County Health Department to consult with a water expert to develop a plan for treating its water before it reopens in April 2012.

“We’ll be monitoring the effectiveness of the plan,” said Debra Stevens, nursing program manager at the Worcester County Health Department. “This is an ongoing investigation.”

When it opens in the spring, the oceanfront hotel will also have its water tested regularly for about six months by the health department.

Plim Plaza spokesperson Betsy FauntLeRoy said the hotel had been working closely with the health department since the bacteria was discovered in its water pipes and had hired a water expert immediately.

“We had remediation done,” she said. “All the bacteria has been cleared from the building, everything is good to go.”

She said an exact source of the bacteria had not been determined. “The source is unclear, but we did everything in our power to clean out every pipe and drain,” she said.

The Plim Plaza Hotel closed after three former guests developed Legionnaires’ Disease after staying there in September. Once it closed, four more guests contracted the disease, which can show up anywhere between two and 14 days after exposure to the Legionella bacteria. One of the seven sickened, an elderly out-of-state hotel guest, died.

Legionnaires’ Disease, a form of pneumonia, has symptoms similar to the flu including a high fever, cough and shortness of breath. People develop the illness after exposure to the Legionella bacteria, which is common in the environment, according to the Maryland Department of Health and Mental Hygiene.

Original article at: delmarvanow.com

Cases of Legionnaires’ Disease In Maine, Massachusetts, and Connecticut Nearly Double

The total number of Legionnaires’ cases in Maine, Massachusetts, and Connecticut has nearly doubled from last year, reports Reuters. Many states in New England had dramatic increases as well, but surprisingly states in other parts of the country did not. For example, California confirmed only slightly more cases than last year.

New York and Pennsylvania also saw large jumps in Legionnaires’ cases.

Legionnaires’ disease is a very serious form of pneumonia that results in long term health effects or a flu-like illness called Pontiac Fever. Most individuals become infected by inhaling Legionella bacteria in the air; it is not spread from person to person. The bacteria spread through mist or vapor from contaminated water in hot tubs, cooling towers, faucets, showerheads, and other water systems. A current or previous smoking habit, chronic lung disease, age (usually 50 years or older), and the use of certain rheumatoid arthritis and chemotherapy drugs can increase the risk of contracting Legionnaires’ disease.

Epidemiologists have not yet given a reason for the increase, but they are considering various explanations, including increased awareness of Legionnaires’ causing more testing, climate changes, more air conditioner use, and a larger number of seniors who are more vulnerable than younger people.

Original article at: webwire.com

Overview of the Dangers of Legionnaire’s Disease

A recent outbreak of Legionnaires’ Disease at an Orlando hotel serves to remind us about this dangerous disease:

“The Orange County Health Department says two laboratory-confirmed cases of Legionnaires’ disease are linked to the Quality Inn near Universal Studios. The hotel is in the International Drive tourist corridor, popular with tourists visiting nearby theme parks.

Officials believe the outbreak may have started in the hotel’s hot tub, which may not have been properly chlorinated.

At least two people were hospitalized as a result of the water contamination, Action News has learned, however no further information about their condition was available. They remain in a Pinellas County hospital. Pinellas County officials first alerted Orange County officials to the potential problem. The patients had stayed at the hotel within the last two weeks.”

According to the Mayo Clinic website:

“Legionnaires’ disease usually develops two to 14 days after exposure to the legionella bacteria. It frequently begins with the following signs and symptoms:
• Headache
• Muscle pain
• Chills
• Fever that may be 104 F (40 C) or higher

If you have Legionnaires’ disease, by the second or third day, you’ll develop other signs and symptoms that may include:
• Cough, which may bring up mucus and sometimes blood
• Shortness of breath
• Chest pain
• Fatigue
• Loss of appetite
• Gastrointestinal symptoms, such as nausea, vomiting and diarrhea
• Confusion or other mental changes”

It is usually contracted when a person inhales the bacteria into their lungs. Legionnaires’ Disease complications can include a number of fatal complications, such as respiratory failure, acute kidney failure, and septic shock, so it should be taken extremely seriously and be treated as soon as you suspect you have contracted it.
If you have any of the symptoms of Legionnaires’ Disease, please see a medical professional immediately so that you can get started on the proper antibiotics. It is an easily treatable disease if caught quickly, but if you let it develop it could turn into a fatal problem.

Original article on AVVO.com

Legionnaires’ Disease Linked to Aria

The federal Centers for Disease Control and Prevention informed the Southern Nevada Health District last year that two cases of Legionnaires’ disease had been possibly linked to the Aria. But it wasn’t until last month that local officials tested the water at the posh Strip resort and discovered the type of bacteria that causes the disease.

The tests were done only after health officials determined that six former patrons of the hotel had been diagnosed with the disease, a form of pneumonia.

And that, says a CDC official, is the proper protocol.

“We recommend what they did there at first, an environmental assessment,” said Laurel Garrison, a CDC specialist in the disease.

Health officials explained their procedures in the wake of the news Thursday that Aria officials are notifying patrons who stayed at the hotel from June 21 to July 4 that they might have been exposed to the sometimes-fatal Legionnaires’ bacteria.

It’s the latest bad news for the CityCenter development, whose mothballed Harmon tower came under scrutiny earlier this week after a structural engineer said it had construction defects that could cause it to collapse in an earthquake.

Six former patrons of the Aria, people who stayed there between December 2009 and April, have come down with the disease. All have recovered. It wasn’t until all six cases were linked that officials felt the need to test the hotel’s water.

Though the Aria cases stretch back almost to the Dec. 16, 2009, grand opening of the 4,000-room hotel, officials say they need to notify only those guests who stayed during the recent two-week period because of the disease’s incubation period of two to 14 days. So far, none of the notified patrons, nor any hotel employees, has reported contracting the disease, according to the health district’s Jennifer Sizemore.

The notification letter informs people of symptoms and advises them to seek medical attention if they feel ill. The letter also urges anyone who has further questions to contact company representatives at 1-877-326-2742. Alan Feldman, senior vice president of public affairs for MGM Resorts International, declined to say how many letters had been sent out to customers of the hotel.

NO INDICATION OF OUTBREAK IN JUNE 2010

When health district environmental health employees inspected the Aria in June 2010, they found nothing to make them think that a possible outbreak was under way.

“We then did a stem-to-stern assessment of the Aria,” said Mark Bergtholdt, a district environmental health supervisor. “What we found was a hot water system that was in great shape.”

Legionella, the bacterium that causes Legionnaires’ disease, is often found in air-conditioning cooling towers, whirlpool spas, showers, faucets or other water sources. The bacterium can rapidly reproduce in warm, stagnant waters.

The two cases that had been reported to the CDC by state health officials — and then reported to the Southern Nevada Health District — were several months apart, in 2009 and 2010, according to Bergtholdt.

Even as the Aria was being inspected in 2010, another report of a possible case linked to the hotel came to the health district from the CDC.

Yet given what Bergtholdt and other environmental specialists found during the inspection at the Aria — what appeared to be complete compliance with guidelines — the determination was made not to test the water.

“If we had found anything to suggest that they had a breeding ground for Legionella, we would have tested water for it,” Bergtholdt said.

“What we’re doing is risk assessment,” he said.

And officials, he admitted, are conscious of the cost of testing.

“It costs $200 a test,” he said. “Just one room of faucets and showers and so forth can cost $1,000. Test ten rooms and you’re talking about $10,000.”

During this year, Bergtholdt said, three more cases possibly stemming from the Aria were reported to the health district from the CDC. The two most recent cases, from this spring, were reported in June.

“That showed a definite association (with the Aria), and testing began,” he said. Elevated levels of the bacteria causing the disease were found during tests between June 21 and July 4.

Multiple rooms were found to have the bacterium in either faucets or showers. Bergtholdt won’t specify which rooms were found to have it or exactly how many rooms had it. MGM’s Feldman said three rooms were involved but did not say which ones.

Bergtholdt said to ensure that none of the bacteria continue to exist at the Aria, extra chlorine has recently been fed into the hot water system of rooms that are fed by a single water outlet.

“You let it sit and then you flush the system,” Bergtholdt said.

Blocks of 500 to 1,000 rooms of the 4,000 room hotel are closed off during the cleansing effort, which he said “takes overnight to complete.”

Public health officials don’t have to test other hotels in the CityCenter complex because water lines that go to Aria aren’t shared with other hotels, he said

At this point the health district, or taxpayers, are picking up the tab for the work at the Aria, said Bergtholdt, who added that the district might ask the Aria to pick up the tab. He said the district has conducted water tests on fewer than 15 rooms, and the Aria is doing tests of its own on water outlets in other rooms.

A ‘UBIQUITOUS ORGANISM’

CDC’s specialists Garrison and Laurie Hicks called Legionella a “ubiquitous organism” that can be found in many locations, including in natural as well as artificial water systems. Although tests can show evidence of bacteria, they said, the disease is only caught through inhaling contaminated water vapor.

It is possible, Garrison said, that others came down with symptoms of the disease and were treated with anti­biotics, but the cases were never diagnosed as Legionnaire’s disease.

Doctors must do a specific test to confirm the diagnosis, she said.

The disease can be very serious; the CDC reports that it can cause death in 5 percent to 30 percent of cases. Most cases can be treated successfully with antibiotics, and healthy people usually recover from infection.

“In an abundance of caution, we are attempting to notify guests who may have been exposed to these bacteria during this short period,” Paul Berry, vice president of hotel operations at Aria, wrote in a letter mailed to guests and posted online at www.arialasvegas.com/facts.

Feldman said the hotel has implemented a comprehensive abatement effort.

All subsequent tests have come back with no detectable levels of active Legionella, Feldman said.

Berry said Legionella is a concern for all large buildings, and Aria has a comprehensive water management program in place, which includes regular testing.

“We will continue to monitor our water quality on an ongoing basis to ensure the safety of the water system and our guests,” he said.

DISEASE FIRST IDENTIFIED IN 1976

Legionnaires’ disease was first identified in 1976 when an outbreak of pneumonia sickened hundreds of people who had attended an American Legion convention at Philadelphia’s Bellevue-Stratford Hotel, resulting in dozens of deaths. Initially a mystery, the cause of the disease was not identified for several months.

Over the years, there have been a number of cases of Legionnaires’ disease in the Las Vegas Valley, including at least one confirmed death in 1981. After an outbreak at the Polo Towers in 2001, in which three guests of the time-share condominiums on the Strip had contracted the disease, health district officials issued new regulations designed to protect the public.

The regulations required property owners to maintain proper chlorine levels in pools and spas and ensure temperatures in water heaters are escalated periodically to 150 degrees to kill the bacteria.

The regulations targeted hotels, motels and resorts as well as other commercial buildings with large air-conditioning system or cooling towers.

The CDC’s Garrison noted that new national guidelines to keep Legionella at bay are being formulated by the American Society of Heating, Refrigeration, and Air-Conditioning Engineers.

“The document is not yet final and when it is, it will be up to governing bodies in communities to adopt it,” said Garrison, who said the CDC has played a role in drafting it.

How the valley has fared

Several outbreaks of Legionnaires’ disease have occurred over the past two decades in the Las Vegas Valley but only one death of a local resident partially attributable to the disease has been reported by health officials since the bacterial infection first surfaced in 1976 in Philadelphia.

A 70-year-old Las Vegas man died of Legionnaire’s disease at Valley Hospital in April 1981, Clark County health officials reported that year. The man had been battling chronic pulmonary disease before he was exposed to Legionnaires’ disease and entered the hospital.

A chronology of past Legionnaires’ disease cases tracked by Clark County epidemiologists in the 1990s include:

• 36 cases in 1992
• five cases in 1997
• six cases in 1998
• six cases in 1999

A number of guests at Polo Towers contracted Legionnaires’ disease after 2000. The first outbreak triggered the health district to adopt regulations to keep tourists safe from the Legionnaires’ bacterium. The list of cases linked to the Polo Towers includes:

• three cases in 2001
• two cases in 2007
• four cases in 2008

The cases in 2008 were reported after the Polo Towers’ water system tested positive for Legionnaires’ bacterium. All four guest who were diagnosed with the disease recovered after treatment for it.

Nearly 300 guests were relocated by management to other Las Vegas hotels or safe locations on the Polo Towers property during the 2008 outbreak.

Original article published on Las Vegas Review-Journal