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

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:

Lack of Legionnaire’s Alert Upsets Guests; Woman Files Suit Against Another Hotel

Man says group wasn’t told of risk; suit filed against different hotel

ALBANY — Guests to one area hotel claim they weren’t warned about the presence of a potentially dangerous bacterial contamination on a visit this week, while a woman who fell ill last year after attending a conference at a different establishment is filing a lawsuit seeking damages.

Ken Cooper, a state canteen operator from Buffalo, checked in to Best Western Sovereign on Tuesday, one day after state tests confirmed the hotel’s water system was contaminated with legionnella bacteria.

Nobody at the front desk told him, Cooper said.

Cooper, who is legally blind, said he went to his room and noticed a white paper taped to the bathroom mirror. He couldn’t read it because of his vision impairment and almost ignored it, but Cooper said he decided to ask a hotel worker to read it to him.

The worker informed him about the bacteria risk at the hotel and told him the water temperature had been raised to help eliminate the bacteria, he said.

“We were pretty appalled that nobody was forthcoming with the information at the front desk,” Cooper said. “I felt I was done wrong.”

Cooper, who runs the canteen at Roswell Park Cancer Institute, was attending a meeting at the hotel for State Committee of Blind Vendors, whose members operate the numerous convenience stores located in state buildings throughout New York. The group talked over the situation but decided to remain at the hotel for the two-day meeting, he said.

Mansoor Mustafa, general manager of Best Western Sovereign, 1228 Western Ave., said in a statement: “My understanding is that someone in the group who was not sight impaired informed members of the group about the issue at the property.”

He would not comment on whether the group was told before they checked in.

Six cases of Legionnaires’ disease between September and December have been linked to the Western Avenue hotel. All of the people have recovered and hotel is taking steps to eliminate the bacteria from its aging water system. The hotel will flush out its water system on Sunday, according to the Albany County Health Department.

Legionnaires’ is a severe form of pneumonia. The disease is transmitted on water droplets that can come from shower mist, steam from a hot tub and air conditioners. Legionnella, a naturally occurring bacteria that is present in many bodies of water, is harmless at lower levels.

County health officials said the hotel is under orders to inform hotel guests about the elevated bacteria at the hotel.

On Friday, an Albany lawyer announced that he is filing a lawsuit on behalf of a woman who nearly died after allegedly contracting Legionnaires’ disease at another area hotel.

Lori Clark, 48, of Nassau, an associate project manager for the New York State Energy Research and Development Authority, attended a three-day training session at the Comfort Inn in East Greenbush in early January 2011. Clark did not stay overnight, but ate several meals and used the hotel’s restrooms.

Clark’s lawyer, Michael Conway, of the Albany law firm Harris, Conway & Donovan, said the hotel never informed Clark that there were elevated levels of legionnella despite tests done a month earlier that showed abnormal results. Days after her visit to the hotel, Clark said she and several coworkers developed flu-like symptoms. Clark, who suffers from rheumatoid arthritis and lupus, became critically ill. She went into septic shock and organ failure. Clark eventually recovered and has returned to work, though she mostly works from home and only has 50 percent lung function.

“They were negligent in cleaning up their mess and they had a lack of concern for the public,” Clark said about the hotel.

Nicole Nykorchuk, general manager at the Comfort Inn, said the hotel has no comment.

Conway said the hotel shut down their hot tub for a couple days and cleaned it.

“They appeared to have done nothing to clean the air system,” he said. “And they said nothing to folks staying there or visiting for conferences.”

Original article at: timesunion.com

Guest Who Stayed at Luxor Dies of Legionnaires’ Disease

Three guests at the Luxor have contracted Legionnaires’ disease since last spring, including one who recently died as a result, the Southern Nevada Health District announced today.

The other two cases were not fatal, health district officials said. The Centers for Disease Control and Prevention contacted the health district about each case of the disease, which causes respiratory illness.

The first two cases occurred in spring 2011, prompting the health district to collect bulk water samples from the Luxor for an environmental assessment, officials said.

The water samples did not detect Legionella bacteria, indicating the resort’s water did not pose an increased risk to guests for contracting the disease, officials said. Both patients fully recovered.

The CDC reported the third case, which was fatal, to the health district Jan. 6, officials said. The patient stayed at the Luxor in December and contracted the disease later that month, said Brian Labus, a senior epidemiologist at the health district.

The CDC has not released the patient’s name or when he or she died, Labus said.

The health district began another environmental investigation after the death, that found Luxor water samples positive for Legionella bacteria, officials said.

Gordon Absher, vice president of public affairs for MGM Resorts International, said authorities immediately began remediation — super-heating and super-chlorinating water to kill the bacteria — when health district officials notified the resort last week.

Luxor completed remediation for a 400-room water loop, where the deceased guest had stayed, within a day, Absher said. A voluntary remediation for the rest of the hotel will be completed within 10 days, he said.

“We take this very seriously,” Absher said. “Health of our guests and our employees is of paramount importance to MGM Resorts.”

The Luxor also formed a monitoring plan to prevent another cluster from occurring, Labus said, calling the resort very cooperative in the process.

Chlorine and other water treatments typically kill Legionella bacteria, a common form found in water, but large buildings are at risk for the bacteria becoming established in the pipe system and growing, Labus said.

No other cases have been reported so far, authorities said.

Legionnaires’ disease, a form of pneumonia, can cause high fever, chills, cough and occasional muscle aches and headaches, officials said. Symptoms typically occur two to 14 days after being exposed to the bacteria.

Health officials said most people exposed to the bacteria do not get sick, but people who are elderly, have chronic illnesses, a compromised immune system or respiratory disease are at higher risk.

Luxor guests possibly experiencing symptoms should contact their doctors, health officials said. MGM officials also created a website (luxorfacts.com) for more information.

Last year, health officials linked six cases of Legionnaires’ disease to Aria, where all the patients had stayed as guests. All six people fully recovered.

Aria officials alerted guests who stayed there from June 21 to July 4 of their possible exposure to the bacteria. Water tests had detected elevated levels of the bacteria in several guest rooms.

“Legionnaires’ is something we have to live with,” Absher said. “It’s in everyone’s homes. It’s here…We feel we are industry leaders in the way we go after this issue.”

MGM Resorts has started installing secondary water treatment systems in all its hotels, Absher said. The first one is installed and operating at Aria, he said.

“It’s yet another investment in how we protect guest safety,” Absher said.

Original article at: lasvegassun.com

CHP Investigates a Legionnaires’ Disease Case

The Centre for Health Protection (CHP) of the Department of Health is today (December 21) investigating a case of Legionnaires’ Disease involving a 67-year-old man.

The patient, with underlying illnesses, presented with fever, cough, shortness of breath and malaise since December 16. He was admitted to Queen Mary Hospital on December 18 and was transferred to Intensive Care Unit the next day. He is in stable condition now.

Test on his nasopharyngeal aspirate specimen revealed that the patient was infected with Legionella bacteria.

He had travelled to the Mainland between December 10 and 11. His close contacts were asymptomatic. Investigation is in progress.

Information on Legionnaires’ Disease and advice on prevention can be found at the CHP’s website, www.chp.gov.hk.

Original article at: flutrackers.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

Eight in Turtle Creek get Legionnaires’ disease

UPDATE on Turtle Creek Legionnaires’ Disease Outbreak.

Eight people living at the LGAR Health & Rehabilitation Center in Turtle Creek contracted Legionnaires’ disease, an Allegheny County Health Department official said Tuesday.

Legionnaires’ disease, caused by a bacteria called Legionella, mimics pneumonia and can cause a high fever, chills, a cough, muscle aches and headaches, according to the Centers for Disease Control and Prevention.

Bruce Dixon, director of the Allegheny County Health Department, said no one has died and the center is taking extra precautions to prevent it from spreading.

Dr. Dixon said the center has switched to using bottled water and is using a heavy metal iron system hospitals employ to prevent the spread of the bacteria.

He said Legionella often spreads when facilities install systems to prevent water from scalding people, causing it to lower in temperature and sometimes become tepid. He said he did not know what caused the Legionella to appear in the LGAR facility.

Representatives for LGAR could not be reached for comment Tuesday evening.

Original article at: post-gazette.com

Redstone Arsenal officials hold town hall on Legionnaires’ disease

Huntsville, AL (WAFF) – Redstone Arsenal officials are conducting testing in one building for Legionnaires’ disease after a man who worked on base died.

They held a town hall meeting Tuesday for workers who want answers to any questions about Legionnaires’ disease.

A Huntsville man who worked on Redstone Arsenal in the PEO Aviation building died of the disease on August 4th. Several viewers contacted WAFF 48 News after learning the cause of the man’s death.

Legionnaires’ disease can have symptoms like many other forms of pneumonia, so it can be difficult to diagnose.

[Find out more about Legionnaires’ disease from CDC]

Because Legionnaires’ is an airborne illness, Redstone officials are testing at the PEO Aviation building. They have not found any traces of the disease in the building so far. They are still waiting on results from a lab.

At a news conference Monday afternoon, officials said that civilian employees can take off work if they don’t feel it’s safe to be in the building.

Officials are also testing several people who are exhibiting upper respiratory problems. So far, there are no positive results for Legionnaires’ among these people.

A Redstone Arsenal spokesman said they are doing everything possible to get the word out to employees about the possible health risk.

WAFF 48 News will continue to track new developments in this story.

Original article at: WAFF.com

Elevated levels of Legionella found at Parma General ICU

Parma — A routine water test in the intensive care unit at Parma Community General Hospital on Tuesday revealed elevated levels of Legionella, the bacterium that causes Legionnaire’s disease.

As of Friday afternoon, no cases of Legionnaire’s had been reported.

Hospital officials confirmed unusually high levels of the bacteria were found in faucet water from the ICU, although other areas of the hospital remained unaffected. Legionella is naturally occurring in water, but certain conditions, such as warm, stagnant water, can cause flare-ups.

According to the Centers for Disease Control and Prevention’s website, hospital buildings are at particular risk because of their complex water systems and the fact that many patients have illnesses that increase their risk for infection.

Legionnaire’s disease is contracted by inhaling contaminated water vapor. Common symptoms include a high fever, chills and a cough. Signs of illness usually begin two to 14 days after exposure.

Infection can lead to a form of pneumonia and even death in 5 percent to 30 percent of cases, according to the CDC.

Smokers, the elderly and people with lowered immune systems are more at risk of developing symptoms. Most patients can be treated successfully with antibiotics.

Since the discovery of the high bacteria levels, the hospital has relocated two ICU patients who were considered vulnerable and released a third. Parma will continue selected admissions to the ICU, said hospital marketing director Mark White. Patients and staff have been alerted.

White said that the hospital has already started eliminating the Legionella colonies by replacing the ICU faucets and flushing out the pipes with hot water.

“We’re erring on the side of caution,” White said. “There hasn’t been any outbreak. It’s a manageable situation.”

This is not the first time Legionella has been an issue at Parma General. Since a single case of Legionnaire’s disease occurred in 2002, the hospital has been voluntarily testing its water supply every quarter. White said there have been other instances of positive Legionella levels since testing began but no additional cases of Legionnaire’s.

Cuyahoga County Board of Health Commissioner Terry Allan said that hospital officials had alerted his staff to the current situation. He applauded them for their continued testing regimen and reporting.

“It’s a very good practice to prevent cases among patients,” Allan said.

Last year, 33 cases of Legionnaire’s were reported in Cuyahoga County. There have been 22 cases so far this year.

Original article at: Cleveland.com