Legionnaires’ Disease Outbreak: Who’s Liable?

By the time New York City officially declared the end of its Legionnaires’ disease outbreak this month, 12 innocent people had already died.

Others became seriously sick — 128 — numbers that exceeded most serious projections when the outbreak first began back in early July.

Officials are calling it the worst outbreak in the history of New York. Thankfully, it appears to be over.

The state’s health commissioner confirmed on August 20 that there had been no new Legionnaires’ reports since August 3 — more than the disease’s two-week incubation period.

Now it’s time to look back and ask the harder questions: How? and Why?

Experts are pointing the finger at the Opera House Hotel in South Bronx. An investigation revealed that the hotel’s cooling tower was releasing contaminated water mist, spreading Legionnaires’-causing bacteria.

Determining Legal Liability for the New York Legionnaires’ Disease Outbreak

Legionnaires’ disease is an unusual and severe form of pneumonia, caused by exposure to harmful Legionella bacteria. The disease spreads through the air, and cooling towers like the one at the Opera House Hotel are common culprits.

Legionella thrive in warm water. Other trouble spots include:

  • Showers
  • Humidifiers
  • Hot water tanks
  • Whirlpool spas
  • Hot tubs
  • Air conditioning units.

Notably, you can find all of those things at most hotels, condos, and apartment complexes.

Legionnaires’ outbreaks like the one in the South Bronx are more common than many people realize. They aren’t always avoidable, but poor maintenance can make an outbreak more likely.

Property owners have a duty under state law to maintain safe conditions for their residents and guests. Those who suffer injury after exposure to harmful bacteria may have a claim to compensation under New York premises liability law.

Maintenance Matters

Investigators will need to inquire more closely to determine whether negligence played a role at the Opera House Hotel.

In the meantime, as premises liability attorneys, we encourage residents and tourists alike to choose apartment complexes and hotels with a reputation for excellent maintenance and inspection standards.

The End of the Outbreak

At last, the outbreak is over! Let’s all take a breath and enjoy what’s left of summer in the city. And let’s hope this latest surge was Legionnaires’ last.

WA Police Stations Tested for Disease

Environmental health tests are being carried out at police stations in Karratha and Port Hedland after an officer contracted a strain of Legionnaires disease.

The West Australian Police Union believes continuing issues of mould at the Pilbara stations may be behind the Karratha officer’s illness, diagnosed last week.

Some officers had to be relocated because of mould problems at the two stations last year.

Police union president Russell Armstrong said he disagreed with a WA Police statement that the strain of the Karratha officer’s disease was likely associated with breathing in bacteria from garden soils.

A WA Police statement said health tests at the station’s were continuing and the force remained committed to taking any measures to make sure stations were safe for all employees.

Original article at: WAtoday

Outbreak of Legionnaires’ Disease Traced to Hospital Fountain

WEDNESDAY, Jan. 11 (HealthDay News) — A decorative fountain in a hospital lobby was the cause of a 2010 Legionnaires’ disease outbreak in Wisconsin, a new study says.

Legionnaires’ disease is a severe and potentially deadly form of pneumonia caused by the bacteria Legionella, which can be inhaled from contaminated water sources.

State and local health officials launched an investigation after eight people in southeast Wisconsin developed Legionnaires’ disease. After interviewing the patients, investigators identified one hospital as the origin of the outbreak.

Environmental testing within the hospital found notable amounts of Legionella in samples collected from the “water wall” decorative fountain in the hospital’s main lobby. All eight patients had spent time in the lobby, the study said.

The fountain was shut down when it was first suspected as a source of the outbreak and hospital officials alerted staff and about 4,000 potentially exposed patients and visitors. All eight patients recovered and no further cases of Legionnaires’ disease occurred after the fountain was shut down.

Before the outbreak, the fountain had undergone routine cleaning and maintenance, the researchers said.

“Since our investigation, the Wisconsin Division of Public Health has developed interim guidelines advising health-care facilities with decorative fountains to establish strict maintenance procedures and conduct periodic bacteriologic monitoring for Legionella,” study lead author Thomas Haupt, an epidemiologist with the Wisconsin Division of Public Health, said in a journal news release.

“The guidelines stress that until additional data are available that demonstrate effective maintenance procedures for eliminating the risk of Legionella transmission from indoor decorative water fountains in health-care settings, water fountains of any type should be considered at risk of becoming contaminated with Legionella bacteria,” he added.

The study appears in the February issue of the journal Infection Control and Hospital Epidemiology.

More information
The U.S. Centers for Disease Control and Prevention has more about Legionnaires’ disease.

Original article at: Yahoo! News

Elderly Man Dies of Legionnaires’ Disease in Howard County

The Howard County Health Department is reporting the death of an elderly male resident of the Lighthouse Senior Living facility in Ellicott City, Maryland due to Legionnaires’ disease. The death occurred in the past week.

According to Howard County Health Officer Dr. Peter Beilenson, there do not appear to be any other cases among residents at this time.

The Howard County Health Department is working in conjunction with the Maryland Department of Health and Mental Hygiene (DHMH) and Lighthouse Senior Living to assure the safety of other residents at the facility and ensure that appropriate remediation takes place.

Lighthouse Senior Living is an assisted living community with two Maryland locations – Ellicott City in Howard County and Middle River in Baltimore County.

For more information about Legionnaires’ Disease visit the Centers for Disease Control & Prevention (CDC) at www.cdc.gov

Original article on Fox Baltimore

Legionnaire’s Disease Kills 1, 2 More Sickened

PLANT CITY, Fla. (AP) – The health department says one person has died and two others were sickened by Legionnaire’s disease at a mobile home park near Tampa.

The Hillsborough County Health Department says the death occurred Saturday. All three people were residents of a 55-and-older mobile home park in Plant City, a rural town east of Tampa. The health department didn’t release any more information about them except to say they were not relatives and did not live together.

The respiratory disease is spread through water and a water vapor. As a precaution, two swimming pools and two hot tubs at the mobile home complex were closed.

People most at risk for getting the disease are 65 and older, as well as smokers and those who have chronic lung disease.

Original article at WikiNews

OCEAN CITY: Three guests at Plim Plaza develop Legionnaires Disease

OCEAN CITY–The Plim Plaza Hotel in Ocean City closed for the season after three people who had been guests at the hotel developed legionellosis.

It has not been confirmed that the guests developed legionellosis, commonly known as Legionnaires disease, while registered as guests at hotel. The Plim Plaza, located on the Boardwalk at Second Street, voluntarily relocated guests and closed the hotel.

Samples have been taken from water sources in the building are being cultured at a Maryland Department of Health and Mental Hygiene lab. Preliminary results do suggest the presence of Legionella bacteria in the hotel water but final culture results are not expected until the end of next week, according to the DHMH.

Symptoms of Legionnaires disease, which typically show up between two and 14 days after exposure to the bacteria, include a high fever, cough and shortness of breath. People who visited the Plim Plaza Hotel after Sept. 1, 2011, and have these symptoms should contact their health care provider, according to the DHMH.

Original article from: delmarvanow.com

Athens County has two cases of Legionnaire’s disease

September 20, 2011 – An Athens County health official on Tuesday confirmed that within the last week, two cases of Legionnaire’s disease have been diagnosed at O’Bleness Memorial Hospital in Athens.

One case reportedly involves a graduate student at Ohio University; the other, an out-of-county resident who apparently just came to O’Bleness as the nearest available hospital.

“We’re looking at this very closely,” said Chuck Hammer, administrator of the Athens City-County Health Department. “We’ve been aware of this since late last week.”

OU spokeswoman Jennifer Krisch confirmed Tuesday morning that “Yes, we have a graduate student with a confirmed case of Legionnaire’s disease.” She referred questions about the case to the Health Department.

In an internal OU e-mail obtained by The Athens NEWS, Steven Ross, director of the university’s School of Film, advised people in his department Sunday that a graduate student in that department had been taken ill the previous week and diagnosed with Legionnaire’s Disease at O’Bleness.

According to the email message, the graduate student, who is from New York, was transferred to a Columbus hospital.

Calls to the Columbus hospital seeking information on the student’s condition were not returned by the time this story was posted Tuesday.

Legionnaire’s disease is an acute respiratory infection caused by the Legionella bacteria.

According to Hammer of the Health Department, it is typically spread not from person to person, but though an infected shared water supply such as a hot tub, sprinkler system or air conditioner.

Hammer stressed that the disease poses a threat mainly to vulnerable populations such as the elderly or people with compromised immune systems.

“Generally speaking, Legionnaire’s disease can be quite mild,” he said.

Hammer said that state health officials have been informed of the two recent Athens County cases, and that investigators are working to try to find out if the two people diagnosed with the disease have any overlapping recent history, to suggest where they might have picked up the bacterium.

“There’s a little detective work that goes on,” he explained. Just because the two cases were both diagnosed in Athens County, he said, does not necessarily mean the source of the infection is here.

“There are a couple of cases of Legionella (locally), but we don’t know where they originated,” he said.

Hammer said he has heard from state health officials that there has been a “small uptick” in reports of Legionnaire’s disease across Ohio recently.

Ohio Department of Health spokesperson Tessie Pollock confirmed that a number of cases of Legionnaire’s disease are currently under investigation statewide, but added that these do not appear to be connected.

“So far, there is no indication of there being an outbreak,” Pollock said.

Original article from Athens News

Second Pa. care home hit by Legionnaires’ disease

TURTLE CREEK, Pa. (AP) — Health officials now say at least 10 cases of Legionnaires’ disease have been discovered at a pair of care facilities in western Pennsylvania.

The Allegheny County Health Department said Wednesday at least two people have been sickened at the Hamilton Hills Personal Care Facility in Turtle Creek. That’s in addition to eight cases at the nearby LGAR Health & Rehabilitation Center.

No fatalities have been reported related to the outbreak but three people had to be hospitalized with pneumonia-like symptoms. Health officials say they’re treating the water supplies at both facilities, although the cause of the outbreak remains unknown.

The health department said previously the bacteria can sometimes occur when facilities install systems that prevent hot water from scalding people.

Original article at: FortWayne.com

Agency closes building after Legionnaire’s case

ALBANY — A state facility in Broome County used for programs for the disabled has been closed after a state worker came down with Legionnaire’s Disease, officials confirmed Tuesday.

The Office of Persons with Developmental Disabilities closed its Tracy Creek Center in Vestal after an administrative employee came down with the illness last month; officials said the person did not come in contact with clients who attended day programs there.

Problems with the site have not been positively implicated in the illness. Civil Service Employees Association spokesman Stephen Madarasz noted the building had developed mold problems after trouble with the roof led to water in the ventilation system.

The union alerted OPWDD, which called in the Department of Labor to investigate, leading to the closure.

Madarasz said the administration moved quickly to address the problem.

It wasn’t immediately clear when the building could be reopened.

Original article at TimesUnion.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