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.

Lake County Couple Suing Over Son’s Death at UCSF Hospital

A Lake County couple whose infant son was recovering from a rare, life-threatening condition only to be killed by a bacteria that lurks in water pipes is suing the hospital where the child underwent a bone marrow transplant.

“We need to let others know. They need to fix it so it doesn’t happen to anyone else,” said Kellie Joseph, a Lake County Sheriff’s detective and mother of Ryland Joseph, who died at the UC San Francisco’s Benioff Children’s Hospital May 16 at the age of 7 months. She and husband Rodd Joseph, a Clearlake Police sergeant, filed a wrongful death lawsuit Oct. 23 against the University of California regents.

The grieving couple contends Ryland was infected with Legionnaires’ disease while recovering from a successful bone marrow transplant at Benioff Children’s Hospital. He’d been in the hospital for more than three weeks when he contracted a fatal case of pneumonia that later was confirmed to be Legionnaires’ disease.

The time between exposure to the bacteria and symptoms is two- to 14 days, according to the Centers for Disease Control and Prevention.

“It’s just impossible he could have caught it anywhere else,” said Steve Heisler, a personal injury attorney based in Baltimore. He’s one of two lawyers representing the Josephs.

Hospital officials said they cannot comment on the lawsuit but confirmed an ongoing investigation into the death.

“At this point, there is not a clear explanation for the child’s infection,” the hospital’s chief medical officer, Dr. Josh Adler, said in a written response to the Press Democrat’s inquiries.

The California Department of Public Health on Tuesday confirmed it also has conducted an investigation into the death and said its findings should be available “soon.”

The lawsuit alleges hospital officials had “actual knowledge” that the building’s water system was contaminated with Legionella bacteria.

At least two other children have died of the disease at the hospital, one in 1992 and one in 1998, according to the lawsuit.

Adler’s statement said only that there have been no Legionella infections at UCSF in the past two years. Hospital officials did not provide information about cases prior to that and state health officials said they do not keep track of infections by facility.

Adler also said that tests conducted following the child’s death found no Legionella bacteria in the water supply. Legionella bacteria are found in all man-made water systems, he said. Most municipal water companies treat the water with monochloramine to kill the bacteria, he said. The hospital tests monochloramine levels in water at its entry point to the UCSF campus and heats water to 140 degrees Fahrenheit to mitigate exposure to the bacteria, Adler said.

The hospital did not respond to a question asking whether the bacteria was found in any of its pipes, rather than the water.

Legionella bacteria is spread when contaminated water is aerosolized, then inhaled, according to the CDC. It is not spread from person to person.

The 1976 outbreak at a Philadelphia Legionnaires’ convention that gave the disease its name was spread through an air conditioning system. Hot tubs, hot water tanks, decorative fountains and water misters also are believed to have been responsible for outbreaks, according to the CDC.

An estimated 8,000 to 18,000 people in the United States are hospitalized with the disease each year, according to the CDC.

Many people who are exposed do not become ill, but patients with compromised immune systems are particularly susceptible.

Ryland Joseph had Wiskott-Aldrich syndrome, a rare genetic immunodeficiency disorder that required that he have a bone marrow transplant.

Before he could receive the transplant from his sister, Brooklynn, 2, the boy had to undergo chemotherapy, further weakening his immune system. Anyone going into the room was required to follow strict procedures to prevent exposing him to disease, his parents said.

Ryland’s new marrow cells were growing and the procedure was deemed a success just days before he took a turn for the worse, Kellie Joseph said.

“Everything just went downhill from there,” she said between sobs.

Original article at: www.pressdemocrat.com/article/20131112/articles/131119857

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

Belton Man Dies from Legionnaires’ Disease

A former ship’s captain died from Legionnaires’ disease after becoming ill on a Caribbean cruise with his wife and daughter, an inquest heard.

Tore Myhra, 57, from Belton, near Great Yarmouth, died just a month after a woman who stayed on the same deck of the ship ‘Liberty of the Seas’ passed away from an identical strain of the disease.

But yesterday’s Norwich inquest heard that it was impossible to say for certain whether Mr Myhra had contracted the disease on the ship.

The inquest heard that an outbreak of the disease had occurred at the same time at the Epic hotel in Miami where Mr Myhra and family had stayed before they boarded the ship.

Legionnaires’ disease causes a serious pneumonia (lung infection), which you contract by breathing in droplets of water which contain Legionella bacteria.

Mr Myhra, wife Sue and daughter Layna had stayed for two nights at the Epic hotel before the Royal Caribbean cruise lines ship sailed on October 24, 2009.

The inquest heard that Mr Myhra started feeling unwell on October 29 and was hospitalised on the ship.

When it disembarked at the end of the cruise, he was taken as an emergency to the Jackson Memorial Hospital in Miami, where he was diagnosed with pneumonia and subsequently legionella.

His condition deteriorated and he died on November 1 while his wife and daughter were at the departures lounge at the airport, where the girl was due to fly home while Mrs Myhra stayed with her husband at the hospital.

A post mortem examination was carried out and the cause of death was given as legionella pneumophila pneumonia…

Original article at:

Case of Legionnaires’ Disease Reported at Olsen Middle School in Dania Beach

A robo call message was sent to Olsen Middle School parents after a case of Legionnaires’ disease was reported at the Dania Beach school, a Broward County schools spokeswoman said.

“We are working with the Health Department and the school district staff regarding this issue and are taking every precaution to ensure that our school remains a safe learning environment for our students and staff,” the message said.

Spokeswoman Nadine Drew confirmed the person affected was not a student but gave no other information on the victim.

People get Legionnaires’ disease when they breathe in a mist or vapor that has been contaminated with the bacteria, which are not spread from one person to another, the message said.

Signs and symptoms of the disease include high fever, chills, coughing, muscle aches and headaches. A child who exhibits any of those symptoms should be taken immediately to a health care provider, the district told parents.

The district provided bottled water for students and staff as a safety precaution, Drew said in a statement.

Original article at: nbcmiami.com

Legionnaires’ Disease Outbreak in Quebec City

MONTREAL — The regional director of the public health department was categoric in her condemnation in the wake of last summer’s explosion of Legionnaires’ disease in Quebec City.

“There were insufficient practices in place,” said François Desbiens, of the epidemic that saw 181 people fall sick and 13 die of the bacteria found in the cooling towers of buildings in the provincial capital.

The provincial health department got involved in examining the cause of the deadly respiratory disease that comes from bacteria that thrive in aquatic environments.

A report of their findings was made public on Thursday.

Cooling towers, containing water used in building air-conditioning systems, were found to be the source of the bacteria in Quebec City.

The bacteria was found in 24 per cent of the buildings visited by health inspectors after the outbreak was first declared.

In the report, Desbiens calls for more stringent maintenance protocols and cleaning and disinfecting procedures, as well as better official surveillance of these practices.

Original article at: montrealgazette.com

Third Vet’s Death Tied to Legionnaires’

His wife blames water from VA hospital in Oakland

The wife of a Vietnam War Army veteran who died Oct. 23 in Erie believes her husband may have died after contracting Legionnaires’ disease from the water system at the VA hospital in Oakland.

If John McChesney, 63, did die after contracting the pneumonia-like disease at the University Drive facility, that potentially makes him the third patient in the past two years to die after getting Legionnaires’ disease there.

It also makes Mr. McChesney part of an expanding investigation into the Legionnaires’ outbreak at the hospital that has caught national attention in part because the hospital used to be home to researcher Victor Yu, who in 1982 first confirmed the connection between the spread of the disease and water systems.

Part of that expanding inquiry is looking into whether Legionnnaires’ cases also originated at the VA’s H.J. Heinz campus near Aspinwall, a site that contains a nursing home for veterans.

VA spokesman David Cowgill on Monday confirmed the VA has detected Legionella, the bacterium that causes the disease, in the water system at Heinz, and that facility still has water restrictions in effect while the water system is being treated with chlorine. Water restrictions were finally lifted at University Drive on Friday after two weeks of cleaning.

Mr. Cowgill said in an email that one of the five cases of Legionnaires’ disease that originated at the VA may have originated at Heinz, though there is a “high probability” that it began at University Drive for that patient.

Mr. Cowgill said he could not comment on Mr. McChesney’s case, though Mr. McChesney’s wife, Evelyn, said she has been contacted three times in the past five days by officials from the VA about her husband’s death and requests to test the water in her Columbus, Warren County, home to see if that was the source of the Legionnaires’ disease he contracted.

“I think he got it at the VA,” she said Monday. “I don’t believe there’s anything wrong with my water.”

Mr. McChesney had suffered from kidney and heart trouble that resulted from contact with the chemical defoliant Agent Orange during his 18-month stint in the infantry in Vietnam.

He died after his wife of 18 years took him to St. Vincent Health Center in Erie on Oct. 1 because he was coughing and wheezing badly. She said an emergency room doctor there said Mr. McChesney tested positive for Legionnaires’ disease.

That was less than 14 days after he had spent six days over two visits to the University Drive facility in late September, where he was being seen for heart problems. Legionnaires’ disease typically has up to a 14-day incubation period.

Mrs. McChesney, who has been following the stories about the outbreak over the past two weeks, was incensed by what she has read.

“Whoever was responsible for this, they should be held accountable,” she said. “I mean, the suffering my husband went through for 3 1/2 weeks [before he died] was needless and it was because they just neglected things.”

“I feel my husband and other soldiers served their country and they deserve the best care possible,” she added.

The outbreak was first revealed by the VA Pittsburgh Healthcare System on Nov. 16, when it said that it had confirmed just four cases of the disease linked to the University Drive hospital, and it said all four patients had recovered.

It later said on Nov. 22 that a fifth person had contracted the disease from the hospital, though it omitted from the news release that the fifth patient had died. It wasn’t until Friday that the VA told the Allegheny County Health Department that that person — whom the VA refuses to identify — had died after contracting the disease.

In addition, the children of a second veteran, John Ciarolla, 83, told the Pittsburgh Post-Gazette that he died last year after contracting the disease following stays at both University Drive and the VA’s H.J. Heinz nursing home.

The U.S. Centers for Disease Control and Prevention is investigating how the outbreak occurred, and U.S. Sen. Bob Casey, D-Pa., has asked Veterans Affairs Secretary Eric Shinseki for a report on why the outbreak occurred.

Dr. Yu and his research colleague, Janet Stout, who both left the VA after a dispute with management in 2006 and 2007, respectively, believe that the outbreak is due to the VA’s failure to properly manage and maintain the water treatment system they first installed at the hospital in 1993. The VA believes the treatment system is what failed.

U.S. Rep. Brad Miller, D-N.C., was chairman of the House Investigations and Oversight Subcommittee in 2008 when it held a hearing into the way that Dr. Yu and Dr. Stout were pushed out of the hospital, and how the VA destroyed 30 years worth of frozen isolates of Legionnaires’ disease that the researchers had collected.

Mr. Miller believed then that the VA seriously erred in forcing Dr. Yu and Dr. Stout out and destroying their isolate collection. Now the actions look even worse, he said, since it was Dr. Stout who oversaw the water treatment system at the hospital.

“At the very least, [losing Dr. Yu and Dr. Stout] compromised that hospital’s ability to deal” with the outbreak, Mr. Miller said Monday. “And they may have lost the people who were best at handling [the water treatment] system.”

Another part of the story that has bothered Mrs. McChesney and others is that the VA knew as early as June that it had a problem with the water treatment system — known as a copper-silver ionization system. The VA called in a consultant then, who recommended in July a series of steps to make it work properly.

But the VA did not do anything in response to the recommendations until sometime in October, when it called the consultant back in and asked the consultant to adjust the copper-silver system to work properly.

“I mean, for them to be that negligent,” Mrs. McChesney said. “They never even warned their patients.”

Because the Legionella bacterium must get into a patient’s lungs, one of the most common ways it infects a person is while taking a shower, when the moist mist from a shower is inhaled. Mrs. McChesney believes her husband took at least two showers during a four-day stay at the hospital from Sept. 18 to Sept. 21. He returned for a two-day visit at the VA Sept. 26 and 27 and then went home after a procedure.

About 8,000 to 10,000 people each year are hospitalized with the disease. But the Centers for Disease Control and other experts believe many more cases occur each year that go undiagnosed as simple pneumonia or other afflictions. Legionnaires’ disease can be fatal in 5 percent to 30 percent of cases, depending on who it strikes and where it is acquired.

After Mr. McChesney was admitted to St. Vincent on Oct. 1, his condition got worse, and it was the heart and kidney conditions he had suffered from for much of his life that were the official causes of death on Oct. 23. But his wife said his doctors acknowledged to her that it was the Legionnaires’ disease that exacerbated them, leading to his death.

Mrs. McChesney said VA officials told her in late October that they would send bottles to her to collect samples of her home water to test.

But she never got the bottles and no one followed up until the past five days, after the outbreak had been publicly revealed.

On Thursday, a VA official called and asked if she could send Mrs. McChesney a kit to test her home’s water. Then, on Friday, Robert Muder, director of the infectious disease section at University Drive, called her and left a message that he wanted to talk to her. And finally, on Monday, another VA official called and asked if the VA could send a social worker to her home to test her water.

“I’m not sure I want them to come, or if I want to talk to them,” Mrs. McChesney said.

Now, she said, she’s focused on getting to the bottom of what caused her husband’s death, to honor his memory.

“I do know that he would not want me to just let this go,” she said.

Original article at: post-gazette.com

Legionnaires’ Disease Deaths At 3 In Outbreak Traced To JW Marriott Chicago Hotel

The JW Marriott hotel in Chicago. Three deaths have now been traced back to a Legionnaires’ outbreak at the hotel.

A third death has been reported in the Legionnaires’ disease outbreak at a high-end hotel in downtown Chicago.

The Chicago Tribune reports that, according to an Irish newspaper, Thomas Keane, 66, was visiting Chicago from his native Ireland when he dined at the JW Marriott, 151 W. Adams St., with his wife in July.

Keane, a retired plumber, and his wife were celebrating their 40th wedding anniversary on the trip.

Health officials on Friday also announced two new confirmed cases of the illness, which victims thus far identified in the outbreak contracted while staying at the hotel between July 16 and Aug. 15, according to the Chicago Sun-Times.

Health officials also identified the source of the bacterial disease’s outbreak: the decorative fountain located in the hotel’s lobby, according to ABC Chicago.

The fountain has since been removed from the hotel’s lobby and other areas found to have contained the same bacteria — including the hotel’s pool, spa whirlpool and men’s and women’s locker rooms — have been “disabled or made inaccessible to the public,” the Tribune reports.

Last month, the city announced three cases of the fast-spreading, sometimes fatal Legionnaire’s disease. The bacteria spread through the inhalation of contaminated water vapor, causing a severe form of pneumonia.

In response to the news, the hotel issued a warning to all recent guests, and began the complicated process of notifying the 8,500 guests who stayed there in recent months.

The outbreak was previously responsible for two deaths of guests of the hotel.

Health officials noted that there “is no ongoing public health risk” at the hotel, according to CBS Chicago.

Symptoms of the disease include headache, chills, chest pain and fever. A hotline has been set up by Chicago Department of Public Health to answer questions from people who may have been exposed at (312) 746-4835.

Original article at: The Huffington Post

Italian Woman Dies from Legionnaires Disease at Dental Practice

A recent death of an Italian woman from Legionnaires Disease is a timely reminder that dental surgeries should be constantly checked for cleanliness and bacterial infection.

It has been found that the 82-year-old woman died from bacteria found in the water line used by her dentist, which shows the need to ensure that patients are not at risk.

Legionnaires Disease causes severe pneumonia, which even healthy people can succumb to. The lady although in her early 80s was apparently very healthy and visited her dentist on 2 occasions. As such, when the cause of death was realised, the only place where they could find the bacterium was at the practice.

Samples were taken from water supplies in the lady’s home but the L pneumophila was not found there. However, samples taken from water supplies at the dental practice showed high levels of the bacterium with the highest levels found in the output from the high-speed turbine.

Legionnaires Disease comes in 2 forms – Legion Fever and Pontiac Fever. The former is more severe and causes pneumonia. The latter is a milder illness that is less likely to be fatal.

Speaking with reporters, Peter Bacon, technical director at a company that supplies a product that helps reduce contamination in dental surgeries said: “We have long understood the risks associated with infections caused by the presence of biofilm in dental unit water lines and have worked to provide an easy to use solution for dentists.”

He added: “This case underpins the duty of care dentists need to demonstrate to patients as well as to the regulatory bodies, to ensure they are minimising risk. This is exactly the reason we offer free, reliable dental unit water assessments to dentists.”

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