Legionnaires’ Disease Linked to Aria

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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

Legionella Outbreak at Ohio Nursing Home

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CLEVELAND, Ohio – Three residents of a Cuyahoga County nursing home have been treated for Legionella, a bacterial infection related to Legionnaire’s Disease.

MetroHealth confirms the patients were living at the Elizabeth Severance Prentiss Center for Skilled Nursing on Scranton Road in Cleveland. Two have been treated and released, one is still hospitalized at MetroHealth Medical Center.

County officials are taking precautions recommended by the Centers for Disease Control. They are sterilizing the building and the water supply, switching to bottled water, and suspending showers for residents.

Legionella bacteria is usually transmitted through drinking water, air conditioning units and water sprays often found in cooling stations and produce sprays at grocery stores. It is not spread from person to person.

Symptoms include headache, fever, muscle aches. In severe cases, Legionella can lead to pneumonia. It is treated with antibiotics.

From WEWS 5

Richmond Health Center Employee Dies of Legionnaires’ Disease

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Experts are testing the water system at the Richmond Health Center after an employee there died of Legionnaires’ disease.

The center remains open and no other cases of the disease have been identified, said William Walker, director of Contra Costa Health Services.

Test results are expected this week.

Legionnaires’ disease is a pneumonia-like infection that is spread when people breathe in water mist contaminated with Legionella bacteria.

The bacteria, which occur naturally in the environment, live in water and can sometimes be found in hot tubs, air conditioning units in large buildings, decorative fountains, and water systems in cruise ships, hotels and hospitals.

Some people get it from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected.
The disease is not contagious.

Contra Costa County typically has three to 10 cases per year. Nationally, 8,000 to 18,000 people are hospitalized annually with the disease.

It may never be known where the medical records technician at the Richmond Health Center came in contact with the bacteria, Walker said.

But in 2008, after another Richmond Health Center employee became ill with Legionnaires’ disease, tests indicated that water in the health center’s cooling tower may have contained the bacteria.

Since then, the county has disinfected the heating and cooling system in the building regularly, Walker said.

The employee who fell ill in 2008 recovered, as do most people who contract the disease, which can be treated with antibiotics. Some people never have symptoms.

But Legionnaires’ can be fatal in 5 to 30 percent of cases, according to the national Centers for Disease Control and Prevention.

Those who are at greatest risk include smokers, people who have a weakened immune system, those with chronic lung disease, and the elderly.

Legionnaires’ disease can be difficult to diagnose initially because symptoms can be similar to the flu. About two to 10 days after becoming infected, people may develop a fever, chills, cough, muscle aches and headache.

Walker advises anyone with such symptoms to see a doctor.

In the latest round of testing at the Richmond Health Center, Walker said it is likely that some of the water samples will contain the Legionella bacteria because it is commonly found wherever tests occur.

But he stressed that county leaders will take steps to eliminate it and he noted that there have been no other cases of Legionnaires’ disease in the county this year.

“We consider the health center to be safe for both staff and patients,” Walker said.

The health center, which has served West Contra Costa residents since 1967 and sees about 7,000 patients monthly, will soon be replaced by a new, state-of-the-art facility.

On Friday, Rep. George Miller will join county leaders in a groundbreaking ceremony for a $45 million center in San Pablo. The 53,000-square-foot building is expected to be completed by July 2012.

County leaders say the current building, the only one of eight county health centers that has never been replaced, has outlived its usefulness.

From Inside Bay Area

Overview of the Dangers of Legionnaire’s Disease

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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 outbreak, 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 can lead to 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.

From Avvo

Spokane hospital fighting Legionnaires Disease

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SPOKANE, Wash. —

Patients at Sacred Heart Medical Center in Spokane are being given bottled water to drink while the hospital cleans its water system to remove the bacteria that causes Legionnaires Disease.

Three patients have come down with the disease since January and one has died, although the hospital says the bacteria likely weren’t the cause of the death.

Sacred Heart called in the Centers for Disease Control and Prevention. Testing confirmed Wednesday that Legionella is in the water supply.

The hospital has been cleaning its water tanks and is adding extra chlorine.

—

Information from: KXLY-TV, http://www.kxly.com

Playboy Mansion Illness; Hot Tub Bacteria caused Legionnaires Disease

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The Los Angeles County Health Officials have established that the bacteria which caused scores of people to suffer from Legionnaires Disease were traced to a hot tub at the Playboy Mansion where they attended a fundraiser in February.

The Health Officials from Los Angeles County presented the evidence at an annual conference at the Centers for Disease Control in Atlanta. This legionella bacterium not only causes Legionnaires Disease but also Pontiac Fever, a milder illness that has fever and headache as its symptoms.

The people who attended the fundraiser at Playboy Mansion reported respiratory illness after the famous Domainfest conference which was held in February this year.

The Health Officials contacted 439 people and their finding reveal that out of these 439 people 123 people suffered fever and some other related symptoms while 69 of them fell ill on the same day.

We just hope that this finding is not going to affect the upcoming marriage of Playboy founder Hugh Hefner who is ready to tie the knot with his third wife this summer.

From 05 News

Dubai Hotel Faces $16.7 Million Legionnaires’ Disease Lawsuit

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Travel Daily News reports that the suit claims that Thomas Boyle, from Britain, and Elodie Nogues, from France, contracted Legionnaires’ disease after staying at the Dubai Westin Mina Seyahi in January and February of 2009. The health of the pair deteriorated rapidly and resulted in hospital stays. A third guest, BBC radio commentator Bill Frindall, 69, passed away as a result of contracting the disease.

The legionella bacterion that causes Legionnaires’ (a form of pneumonia) can be found in natural water sources such as lakes and rivers, but also on occasion in man-made water systems such as cooling towers, whirlpool spas, and also in air-conditioning units. People become infected by inhaling water droplets containing the bacterium. Since the disease was first identified in 1976 – at a meeting of retired US military personnel, or legionnaires – outbreaks have been linked to hotels, cruise ships, and other types of holiday accommodation. About 5-15% of cases prove fatal, with elderly people most at risk.

Boyle arrived at the Westin with his family on December, 2008, and left several days later, on January 6, 2009. On his return to the UK, the suit says he developed flu-like symptoms and his health deteriorated rapidly. He then spent a fortnight in a UK hospital having been diagnosed with the disease.

Nogues started to feel weak and feverish two days after checking into the hotel with her son and a friend on February 14. With her health deteriorating, she returned to France on February 21 where she was also diagnosed with Legionnaires’ disease.

Frindall, a highly-regarded cricket scorer and broadcaster, returned to the UK on 20 January from a tour to Dubai with his charity cricket team, the Lord’s Taverners. His condition quickly deteriorated and he was not able to recover after one of his lungs collapsed. He passed away in Swindon Hospital on January 30. The team said no other members were showing symptoms of Legionnaires’ disease.

Following these incidents, Amalie Craig, a spokeswoman for Starwood said in a written statement that the company was “continuing to conduct a thorough investigation with independent assessors, including leading European and US based experts, to investigate whether legionella is present in the hotel.” The investigation was being conducted in co-operation with Dubai Municipality and Dubai Health Authorities.

A later statement by Starwood said that “no evidence of legionella has been found to date at the hotel based on initial testing by an independent accredited laboratory and the hotel’s systematic and regular audits,” and continued “although recent monitoring and testing has not revealed the presence of legionella at the property, hotel management is continuing to monitor the situation and has begun contacting guests and associates to advise them of the circumstances. The ongoing monitoring is intended to ensure that the hotel satisfies all requirements regarding the health, safety and welfare of hotel guests and associates.”

According to the lawsuit, both plaintiffs were unable to return to their normal lives having suffered from depression and anxiety. The New York Supreme Court is deciding whether the case can go to trial, a decision that could take up to a year to make.

Hotel in Dubai Faces $16.7 Million Lawsuit after Guests Contract Legionnaires’ Disease

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Starwood Hotels and Resorts Worldwide is facing a $16.7 million lawsuit in the U.S. after two guests staying at the Westin Mina Seyahi in Dubai claim they caught Legionnaires’ disease at the property, reports Arabian Business.

The suit claims that Thomas Boyle, from Britain, and Elodie Nogues, from France, contracted the disease after staying at the Westin in January and February of 2009. It claims the health of the pair deteriorated rapidly and resulted in hospital stays. The disease is a form of pneumonia spread through airborne water droplets, which thrives in water and air-conditioning systems.

Boyle arrived at the Westin with his family in late December 2008, and left several days later, in January 2009. On his return to the UK, the suit says he developed flu-like symptoms and his health deteriorated rapidly. He then spent a fortnight in a UK hospital having been diagnosed with Legionnaires’ disease.

The paper reported that Nogues started to feel weak and feverish two days after checking into the hotel with her son and a friend on February 14. With her health deteriorating, she returned to France on February 21 where she was also diagnosed with Legionnaires’ disease.

According to the lawsuit, both plaintiffs were unable to return to their normal lives having suffered from depression and anxiety. The New York Supreme Court is deciding whether the case can go to trial, a decision that could take up to a year to make.

Legionella Found in Hot Water System at Dayton, Ohio Hospital

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DAYTON – Tests have found the bacteria that cause Legionnaire’s disease were present in the hot water system at a new part of an Ohio hospital where 11 patients got sick.

According to the Associated Press, fficials at Miami Valley Hospital in Dayton say the test results released Monday also show that superheating the water system and treating it with large amounts of chlorine killed the bacteria.

President and chief executive Bobbie Gerhart says in a statement that steps have been taken to make sure the water in the hospital’s new 12-story addition is safe for drinking, bathing and washing.
The hospital’s 11 cases of Legionnaire’s include a 73-year-old man who died Feb. 22, though the Dayton Daily News reports the death certificate does not specifically mention Legionnaires’ disease.

Seventh Legionnaires Disease Case in Miami Valley Hospital Confirmed

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DAYTON — A seventh Miami Valley Hospital patient has contracted Legionnaires’ disease, a hospital spokeswoman said Wednesday.

Hospital and Montgomery County public health officials on Tuesday had confirmed that one patient diagnosed with Legionnaires’ disease — a Dayton man in his 70s — had died Feb. 21, and that two additional patients had contracted the disease, raising the total number of cases at the time to six.

The hospital announced the seventh case Wednesday afternoon.

The hospital said Legionella bacteria did not cause the man’s death. But the hospital declined to say if the disease was a contributing factor in the death, citing privacy concerns.

The hospital also said the physician filling out the man’s death certificate is not an employee of the hospital or its parent, Premier Health Partners.

The hospital said it has not yet received confirmation that Legionella bacteria had been present in the water system of its new patient tower. Another week could pass before those results are available.

Miami Valley instituted water restrictions in the new tower for three days last week after identifying the initial cluster of Legionnaires’ disease cases.

Legionnaires’ disease got its name in 1976, when high numbers of people attending an American Legion convention contracted the lung infection. Each year, 8,000 to 18,000 people are hospitalized with the disease in the U.S. It can cause death in 
5 percent to 30 percent of cases, but often is treated successfully with antibiotics.

From Dayton Daily News