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An outbreak of Legionnaires’ disease that sickened three, killing one, over a 12-month span at a Wisconsin resort has sparked an investigation by health officials.

Sauk County Health Department (SCHD) director Tara Hayes confirmed that Legionella bacteria, which causes Legionnaires’ disease, were found at Christmas Mountain Village, a golf and ski resort in Wisconsin Dells. Legionnaires’ disease is a severe type of bacterial pneumonia  that is contracted by inhaling microscopic water droplets in the form of mist or vapor containing Legionella.

“There is no determination tying the death or illness to the presence of Legionella at Christmas Mountain,” Hayes told Capital Newspapers.

The only commonality between the three people who were sickened, however, was that they all visited the resort.

“We had received a report that some individuals contracted Legionnaires’ disease, so that prompted us to do an investigation with Christmas Mountain,” Hayes said. “During that investigation with the sampling of the water, there have been some units that have tested positive for the Legionella bacteria.”

The first case was reported to the SCHD in November 2017, and the health department identified Christmas Mountain Village as a possible source since the patient had recently visited the site. The facility tested positive for Legionella at that time, according to Hayes.

More recently, two more cases with ties to Christmas Mountain Village were recorded within two weeks of one another in October of last year.

No additional information regarding any of the three patients was released, so neither the timing of the death nor the condition of last October’s victims is known.

Why is this an outbreak?
The terms “outbreak” and “cluster” are used when multiple cases are reported in or around the same proximity and within a designated period. The term “community-acquired” is used when there are no commonalities; these kinds of cases are the most common.

The Centers for Disease Control and Prevention (CDC) would classify these illnesses as an “outbreak” because two or more cases of Legionnaires’ disease was reported within weeks of each other and occurred in a more limited geographic area – meaning officials were able to identify Christmas Mountain Village as a possible source.

“It was our understanding (via the health department) that there have been multiple cases reported across the region, in which only three cases reported to the health department are from guests that have stayed at the property within the last 24 months,” according to a statement released by a spokesperson for Bluegreen Management, the management company for the property. “There is no conclusive evidence that they contracted the Legionella bacteria during their stay at the property.”

Remediation efforts are underway at the facility and include installing “point of use” filters on every fixture at the resort. Those filters are believed to be 99 percent effective in eliminating exposure to harmful bacteria.

“Our guests’ safety is our number one concern,” the Bluegreen statement read. “We are working closely with the Sauk County Health Department and implemented a recommended risk-reduction measure in addition to ongoing water management and remediation.”

Bacteria problem for Wisconsin resorts?
Christmas Mountain Village wasn’t the only resort in Wisconsin to have Legionnaires issues in 2018. Four people were diagnosed with the disease at The Osthoff Resort in Elkhart Lake between March and August last year. After learning of those illnesses, two locations on the property were tested in September and came up positive for elevated levels of Legionella.

According to Anna Kocharian, an epidemiologist with the Bureau of Communicable Disease of the Wisconsin Department of Health Services (DHS), the five-year average of confirmed Legionnaires cases in Wisconsin is 135, and the DHS conducts about five Legionella public health investigations every year.

About Legionnaires

According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States every year. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

  • air-conditioning system cooling towers
  • large plumbing systems
  • water systems of large buildings (hospitals, nursing homes, hotels, etc.)
  • hot-water heaters and tanks
  • bathroom showers and faucets
  • swimming pools
  • whirlpools and hot tubs
  • physical therapy equipment
  • mist machines and hand-held sprayers
  • decorative fountains.

Legionnaires complications
Anyone can get the disease, but those at the greatest risk of infection include:

  • people 50 or older
  • smokers (current or former)
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • people with weakened immune systems.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: this can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Legionnaires symptoms
Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following signs and symptoms:

  • headache
  • muscle pain
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other signs and symptoms develop, including:

  • cough, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pain
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

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Water restrictions instituted after two patients contracted Legionnaires’ disease at a Brooklyn hospital still are being enforced months later, and there does not appear to be an end in sight, patients told Patch.com.

Soon after the illnesses were revealed during the final two months of last year, tests showed Legionella bacteria in the water system at Park Slope’s New York-Presbyterian Brooklyn Methodist Hospital. Hospital officials subsequently required the use of body wipes by patients instead of showers, and bottled water for drinking was supplied to patients, staff, and visitors.

Routine water safety testing at the hospital in December returned positive results for the bacteria in specific inpatient units, and the New York State Department of Health (NYSDH) was enlisted to assist with the investigation of the legionellosis, which is the collective term for diseases caused by Legionella.

The two cases of Legionnaires’ disease still are being investigated by state health officials, although no additional information regarding the patients was released.

Large buildings problematic

According to the Centers for Disease Control and Prevention (CDC), Legionella are found naturally in freshwater environments, such as lakes and streams. The bacteria can become a health concern when they grow and spread in human-made water systems, including:

  • large water and plumbing systems, like those in hospitals
  • hot water tanks and heaters
  • showerheads and sink faucets
  • hot tubs that aren’t drained after each use
  • cooling towers (structures that contain water and a fan as part of centralized air cooling systems for building or industrial processes
  • decorative fountains and similar water features.

“The water supply of many large buildings and hospitals often contains small amounts of Legionella bacteria, and most people who are exposed to Legionella will not become ill,” a hospital spokesperson said in December. “If Legionella does cause an infection, it is treatable with antibiotics and does not generally pose a threat to the public.”

Frustrated patients

Patients are understandably frustrated by the restrictions.

“No brushing teeth, washing face, or showering — even hand washing is discouraged,” Rebecca Lentjes, an inpatient being treated for migraines, told Patch.com. “It’s frustrating because … once I finally got moved from the ER upstairs to a bed, all I wanted to do was wash up — but then I found out I wouldn’t be able to.”

She said she tried to wash her hair with bottled water but found it too difficult with an IV attached to her arm.

A hospital spokesperson told Patch.com that the hospital has “taken steps to disinfect” the water, reiterating the statement officials made in December when they said, “We work with the state and city departments of health to maintain a clean water supply and have already taken steps to disinfect our water sources.”

Hospital officials, however, did not respond to Patch.com’s more specific questions about hygiene concerns, or how long resolving the issue will take.

Brooklyn dilemma

The water restrictions can be lifted once more testing is completed after “remediation of the water system,” NYSDH spokesperson Jill Montag said.

New York-Presbyterian Brooklyn Methodist Hospital is not the only hospital in Brooklyn dealing with Legionella. SUNY Downstate’s University Hospital of Brooklyn, which is less than three miles away, was found to have elevated levels of Legionella in late January. Remediation efforts and water restrictions also were enacted.

Legionnaires basics

Legionnaires’ disease – also called Legionella pneumonia – is a severe type of pneumonia or lung infection caused by Legionella infection. The pathogen is contracted by inhaling microscopic water droplets, usually in the form of mist or vapor, which is why the hospital is restricting the use of showers and sinks. The disease is treatable with antibiotics, although if it is not diagnosed early, it can lead to severe complications and even can become deadly.

A 2015 study by the CDC stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

High-risk demographics

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk. Other people more susceptible to infection include:

  • anyone with a compromised immune system
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.
About 25,000 annual cases

According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (scientific name: Legionella pneumophila) occur in the United States every year. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and they can even resemble those of influenza (flu):

Sick with Legionnaires’ disease?
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Legionnaires lawyer Elliot Olsen has regained millions of dollars for clients. If you or a family member contracted Legionnaires at the Hastings hospital in Michigan, you might have cause to file a lawsuit. Please call (612) 337-6126 for a free consultation.


The Barry-Eaton District Health Department (BEDHD) and Spectrum Health Pennock Hospital announced that efforts to remove Legionella bacteria from the Hastings hospital’s water system in Hastings, Michigan, have been successful.

The Hastings hospital’s water system tested positive for Legionella in late December after an outbreak of Legionnaires’ disease sickened two in three months, and resulted in the death of a 92-year-old man.

Legionnaires – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection caused by Legionella infection. The bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. If it is not diagnosed early, it can lead to severe complications and even become deadly.

Remediation underway

The Hastings hospital’s water system was tested twice a month for the first two months of the year, and all results have been clear of Legionella (there is one more test scheduled for March). Monthly tests will be performed in April, May, and June as well, and the BEDHD will continue to monitor those results.

The man who passed away was diagnosed with Legionnaires in November, treated for the disease, and then discharged to a rehab center, where he died from “chronic aspiration pneumonia,” according to Dr. J. Daniel Woodall, medical director of BEDHD, who said at that time that it’s “not possible to determine if (the patient’s death) was linked to Legionnaires’ disease.”

The other patient sickened by the disease was treated for Legionnaires in September and recovered. It’s unknown whether their illness was hospital-acquired.

Bottled water dispensed

After the initial discovery of the bacteria in the water system, bottled water was supplied to patients, staff and visitors, and hospital officials installed filters on faucets and showers.

In addition, a monochloramine water treatment unit – which is a disinfecting system combining chlorine and ammonia (known as “chloramine”) and commonly used as an alternative to free chlorine for disinfecting drinking water – was installed as a long-term solution for the facility’s private water system.

Spectrum Health Pennock is working with the Michigan Department of Environmental Quality (MDEQ) to obtain the required permits and approvals to operate the secondary treatment system, according to health officials.

“The health and safety of our patients, community, and employees is of utmost importance to us,” said Angie Ditmar, Spectrum Health Pennock president, to MLive.com. “We acted quickly when we learned of the problem, and we are committed to making sure the water remains safe and clean.”

BEDHD officials say they do not believe the City of Hastings water supply was the source of the Legionella. According to BEDHD’s press release: “Routine daily required bacteriological sampling within the city’s water system is being performed. Nothing of concern has been reported or is currently being reported in the Hastings municipal supply.”

Legionnaires info

A 2015 study by the Centers for Disease Control and Prevention (CDC) stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk. Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

This list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.
About 25,000 annual cases

According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (scientific name: Legionella pneumophila) occur in the United States every year. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

  • air-conditioning system cooling towers
  • large plumbing systems
  • water systems of large buildings (hospitals, nursing homes, hotels, etc.)
  • hot-water heaters and tanks
  • bathroom showers and faucets
  • swimming pools
  • whirlpools and hot tubs
  • physical therapy equipment
  • mist machines and hand-held sprayers
  • decorative fountains.
Disease complications

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: this can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and in other parts of the body, including the heart.

Sick with Legionnaires’ disease?
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Elliot Olsen has regained millions of dollars for people harmed by Legionnaires’ disease. If you or a family member contracted Legionnaires at the Waco Family YMCA, please call (612) 337-6126 for a free consultation.


Health authorities in Waco, Texas, are investigating two cases of Legionnaires’ disease believed to be connected to the Waco Family YMCA.

Legionnaires’ disease is a severe type of pneumonia or lung infection caused by Legionella bacteria, which are contracted by inhaling microscopic water droplets in the form of mist or vapor.

“Exposure to the Legionella bacteria may have occurred at the Waco Family YMCA,” Rodney Martin, president and CEO of the YMCA of Central Texas, was quoted in a notice to visitors.

While the facility remains open to members and guests – after consultation with the Waco-McLennan County Public Health District (WMCPHD) – officials closed the whirlpool area, which is adjacent to an indoor pool.

“The Waco Family YMCA will remain open to members, guests and program participants as all other areas of the Y are accessible, including the pool, gym, fitness, group exercise spaces and more,” the organization said. “The restricted area will not affect the operations of the Y or its ability to serve its guests.”

The source of the bacteria has not been identified.

“We have been in contact with both the Waco-McLennan County Public Health District as well as the Center for Disease Control and are following their recommendations,” Martin wrote in an e-mail. “We have also contacted an outside expert to complete testing of the Y’s water.”

Health officials work backward
Kelly Craine, public information officer for the WMCPHD, said once the department was notified of the cases, its staff began “working backward” to discover a common denominator between the patients and pinpoint a possible source of their infection.

“The hot tub has been closed, and it is the only area that’s been closed,” she said. “Because of the mist, you always want to look at the hot tub as a possible suspect.”

YMCA visitors may need to take action
Health district officials said they believe the two patients contracted the Legionella between Feb. 4 and Feb. 21.

If you are a member, visitor or employee of the YMCA, located at 6800 Harvey Road, and you used the whirlpool, swam in the pool or traveled through the whirlpool or pool area this month and are feeling pneumonia- or flu-like symptoms, you should seek care from your health-care provider, according to Craine.

Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and they even can resemble those of the flu, including:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

This list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: This can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the strength of the organ to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. Pericarditis can also affect the ability of the heart to circulate blood throughout the body.

Waco has seen outbreaks before
Last July, the Fairfield Inn & Suites by Marriott Waco North in Lucy Lakeview was investigated for the second time in less than 12 months when two of its hotel guests were confirmed with Legionnaires. Four cases of the disease were connected to the facility between October 2016 and August 2017.

The Waco Family YMCA and Fairfield Inn & Suites by Marriott Waco North are fewer than 9 miles apart.

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The North Dakota Department of Health (NDDoH) and Fargo Cass Public Health are investigating three cases of Legionnaires’ disease connected to a hotel water park in Casselton, a town of about 2,300 in Cass County 25 miles west of Fargo.

All three people who became ill reported spending time at the Days Inn of Casselton, but none were overnight guests. All of them, however, reported using the hotel’s spa.

Spas often are associated with outbreaks of Legionnaires’ disease because of their propensity to aerosolize Legionella bacteria in small water droplets, which are then inhaled into the lungs. (Legionnaires’ disease – sometimes called legionellosis or Legionella pneumonia – is a severe type of pneumonia or lung infection caused by Legionella, or Legionella pneumophila.)

Environmental samples, including water and sand filter samples, were collected from the hotel on Jan. 8-9, and one sample from the spa filter tested positive for Legionella. After the spa was cleaned and disinfected, a second sample collected Jan. 31 was clear of the bacteria, but a third sample collected Feb. 13 showed that Legionella had returned.

Officials of the hotel, located at 2050 Governors Drive, closed the spa until further notice, and they are continuing remediation efforts. The hotel’s pool remains open.

Exhibiting symptoms?
If you were a hotel guest, work at the hotel, or visited the facility this month and are feeling ill, you may have been exposed to Legionella. The illness typically develops within two to 10 days after exposure, and symptoms can resemble the common flu, which is why the NDDoH urges you to seek medical care.

“If you spent time at the hotel, especially in the water park area, between Feb. 7 and 21 and are ill with undiagnosed pneumonia or you develop symptoms in the two weeks following your visit, please see a health-care provider to be evaluated for possible Legionnaires’ disease,” Laura Cronquist, epidemiologist with the NDDoH, told the Bismarck Tribune. “There are no recommendations to prevent illness once people have been exposed to Legionella bacteria. Instead, the focus is on rapid diagnosis and treatment, if people develop symptoms after a possible exposure.”

Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and they can resemble symptoms of influenza (flu), including:

  • people 50 years of age or older
  • smokers, both current and former
  • people with chronic lung disease
  • people with compromised immune systems
  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

How are Legionella spread?
The outbreak at the Days Inn of Casselton is the second this month for a hotel in the Red River Valley. Four people who visited the Crookston Inn and Convention Center in Crookston, Minnesota – about 85 miles northeast of Casselton – also were confirmed with the disease.

Legionella is naturally found in water, especially warm water. Hot tubs or spas that are not cleaned and disinfected often enough can become contaminated with Legionella. A person can get infected by the bacteria when they breathe in steam or mist from a contaminated hot tub or spa.

Warm, stagnant water provides ideal conditions for growth, according to the Occupational Safety and Health Administration (OSHA). The organism can multiply at temperatures between 68 degrees and 122 degrees Fahrenheit, and temps of 90 degrees to 105 degrees are optimal for that to occur.

How can you avoid it?
If you are going to stay at a facility with a hot tub or spa, here are some questions the Centers for Disease Control and Prevention (CDC) recommends that you ask before your visit to ensure your safety and the safety of your family and friends:

  • What was the most recent health inspection score for the hot tub/spa?
  • Are disinfectant and pH levels checked at least twice per day?
  • Are disinfectant and pH levels checked more often when the hot tub/spa is being used by a lot of people?
  • Are the following maintenance activities performed regularly:
    • Removal of the slime or biofilm layer by scrubbing and cleaning?
    • Replacement of the hot tub water filter according to the manufacturer’s recommendations?
    • Replacement of hot tub water?

Where else do Legionella live?
The bacteria are found primarily in human-made environments, such as swimming pools, whirlpools, and hot tubs, but they also can be found in:

  • water systems of large buildings (hotels, hospitals, nursing homes, etc.)
  • bathroom showers and faucets
  • air-conditioning system cooling towers
  • large plumbing systems
  • hot-water heaters and tanks
  • physical-therapy equipment
  • mist machines and hand-held sprayers
  • decorative fountains.

Sick with Legionnaires’ disease?
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Elliot Olsen has regained millions of dollars for people harmed by Legionnaires’ disease. If you or a family member contracted Legionnaires at Promenade at University Place, please call (612) 337-6126 for a free consultation.


Legionnaires’ disease claimed the life of one person and sickened another at an assisted living facility in suburban Albany, New York, that had issues with Legionnaires when it was a hotel.

The Albany County Department of Health confirmed that two people were infected by Legionella – the bacteria that causes the lung disease – at Promenade at University Place, located on Route 20 at 1228 Western Avenue in Guilderland. The facility opened in late December after previously being the site of a Best Western Sovereign Hotel.

When the facility was a hotel, it battled issues with Legionnaires’ disease from 2010-12, during which time 19 people contracted the disease. In 2012, the hotel’s remediation efforts included replacing a 40-year-old water heater, installing new water pipes, and replacing shower heads.

County health officials, who learned of the outbreak about a week ago, are working with the New York State Department of Health (NYSDOH), to determine the cause of the illnesses in the 200-bed assisted living facility, which currently has 23 residents. Preliminary environmental water testing returned “positive results for Legionella,” according to county officials.

“The testing was done the same day we became aware of the second case,” Dr. Elizabeth Whalen, county health commissioner, told the Albany Times Union. “The facility has been responsible. They have been proactive in installing new shower filters and providing bottled water for drinking and assistance with any bathing methods to really make sure they aren’t putting additional residents at risk.”

Staff at the facility notified residents and their families of the confirmed cases. “We’ve taken immediate action to address the matter and make sure that we stay at the forefront of the safety of our residents,” said facility CFO Paul Belitsis, who would not confirm a death had taken place, according to the Times Union. “We’re openly communicating with them.”

Area familiar with disease

Legionnaires’ disease outbreaks have affected the region in recent years. In 2016, 18 people in the Saratoga Springs area were sickened by the disease, including two who died. Many of those who took ill were connected to the Wesley Health Care Center, where five Legionella-contaminated sources were discovered. There were no other local sources identified, even though several of the individuals sickened had not visited or been connected to the facility in any way.

About Legionnaires

An estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States every year, according to the Centers for Disease Control and Prevention (CDC). However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms. A 2015 CDC study stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk.

Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

This list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe Legionnaires cases, complications can include respiratory failure, kidney failure, septic shock, or even death.

Possible bacteria sources

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

  • water systems of large buildings (hospitals, nursing homes, hotels, etc.)
  • large plumbing systems
  • air-conditioning system cooling towers
  • hot-water heaters and tanks
  • bathroom showers and faucets
  • swimming pools
  • whirlpools and hot tubs
  • physical-therapy equipment
  • mist machines and hand-held sprayers
  • decorative fountains.

Warm, stagnant water provides ideal conditions for growth, according to the Occupational Safety and Health Administration (OSHA). At temperatures between 68 degrees and 122 degrees Fahrenheit, the organism can multiply. Temperatures of 90 degrees to 105 degrees are ideal for growth.

Disease symptoms

Legionnaires’ disease usually develops two to 10 days after exposure to Legionella bacteria. It frequently begins with the following signs and symptoms:

  • headache
  • muscle pain
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, other signs and symptoms develop, including:

  • cough, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pain
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

A mild form of Legionnaires’ disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headache and muscle aches. Pontiac fever doesn’t infect your lungs, and symptoms usually manifest within two to five days.

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Staff at a hotel in Crookston, Minnesota, is working with the Minnesota Department of Health (MDH) to investigate the illnesses of four visitors who were diagnosed with Legionnaires’ disease.

Crookston is a town of about 8,000 in northwestern Minnesota, about 25 miles southeast of Grand Forks, North Dakota.

None of the four were guests at the Crookston Inn and Convention Center (2200 University Avenue), but all visited the facility before taking ill between Jan. 22 and Jan. 27. The individuals either attended an event or visited the hotel’s restaurant, University Station.

Legionnaires’ disease is a severe type of pneumonia or lung infection caused by Legionella bacteria, which is contracted by inhaling microscopic water droplets in the form of mist or vapor.

It’s unknown at this time if the hotel is the source of the illnesses, but MDH investigators are working with hotel staff to determine if Legionella is present at the facility. Early indications point to the hotel’s pool and spa area as a possible source, since whirlpool jets can cause infected water to aerosolize.

Out of an abundance of caution, hotel management has temporarily closed the pool and spa area while it is being remediated, which includes cleaning and decontaminating the entire area.

Health officials said it’s possible other cases associated to the hotel could emerge.

Kris Ehresmann, director of infectious disease epidemiology, prevention and control at MDH, told the Crookston Times: “If you spent time at the hotel between Jan. 14 and Feb. 13 and are ill with undiagnosed pneumonia, or you develop symptoms in the two weeks following your visit, please see a health-care provider to be evaluated for possible Legionnaire’s disease.”

Visited the facility and feeling ill?
Hotel staff is contacting all guests who were at the hotel between Jan. 14 and Feb. 13 to alert them that they may have been exposed to Legionella. The illness typically develops within two to 10 days after exposure, and symptoms can resemble the common flu, which is why it’s important to seek medical care.

Legionnaires’ disease frequently begins with the following symptoms:

  • headaches
  • muscle pains
  • chills
  • fever, which can be 104 degrees Fahrenheit or higher.

By the second or third day, symptoms can worsen to include:

  • coughing, which can bring up mucus and sometimes blood
  • shortness of breath
  • chest pains
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea
  • confusion and other mental changes.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and other parts of the body, including the heart.

A mild form of Legionnaires’ disease — known as Pontiac fever — may produce signs and symptoms including a fever, chills, headaches and muscle aches. Pontiac fever doesn’t infect the lungs, however, and symptoms usually manifest within two to five days.

Health-care providers alerted
Area health-care providers have been warned by the MDH to watch for patients presenting Legionnaires symptoms. Legionnaires’ disease can be severe and even deadly, so timely diagnosis and treatment are imperative. The illness is not spread from person to person, but it is easily treatable with antibiotics if caught early.

According to the MDH, Minnesota had more than 150 cases in 2018. The department is currently investigating two cases of Legionnaires diagnosed between November and January at Alomere Health in Alexandria.

Most people exposed to Legionella bacteria do not develop Legionnaires’ disease. People over the age of 50, smokers, or those with certain medical conditions – weakened immune systems, diabetes, chronic lung disease or other chronic health conditions – are at increased risk of developing the disease. If you have concerns about possible exposure, you should contact your health-care provider.

Multiple complications
After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur, including:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the ability of the heart to maintain adequate blood flow throughout the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This also can affect the ability of the heart to circulate blood throughout the body.

If you have any questions, please contact the MDH by calling (651) 201-5414 or toll-free at (877) 676-5414.

Sick with
Legionnaires’ disease?
Call (612) 337-6126
Legionnaires lawyer Elliot Olsen has regained millions for his clients. If you or a family member contracted Legionnaires’ disease in Washington Heights, please call (612) 337-6126 for a free consultation.


Attorneys Elliot Olsen of Minneapolis and Scott Harford of Manhattan have filed a lawsuit on behalf of a Manhattan woman who was sickened during last year’s second Legionnaires’ disease outbreak in Washington Heights.

The lawsuit is the first concerning the two Washington Heights outbreaks, which claimed two lives, sickened almost 60, and hospitalized more than 50.

Mr. Harford’s office filed the complaint Thursday Feb. 14 in the Supreme Court of the State of New York, County of New York, naming three defendants:

  • Broadway Housing Communities, Inc.
  • Broadway Housing Development Fund Company, Inc.
  • Broadway Sugar Hill Housing Development Fund Company, Inc.

According to the complaint, Vivian Weeks was infected with Legionella bacteria in late September while visiting the Church of the Intercession (550 West 155th Street). In early October, Ms. Weeks developed symptoms that included shortness of breath, fatigue, dizziness, nausea, difficulty breathing, body aches, and fever, and on Oct. 5, she was admitted to St. Luke’s Hospital. During her extended stay, she was diagnosed with Legionella pneumonia (Legionnaires’ disease), and she continues to experience complications from the disease.

Washington Heights outbreaks:
Sugar Hill Project pinpointed

In early October, the New York City Department of Health and Mental Hygiene (DOHMH) began investigating an outbreak of Legionnaires’ disease cases in the lower Washington Heights neighborhood of Manhattan – the second outbreak to affect the area in 2018. That outbreak produced 32 illnesses; 30 victims were hospitalized, and one died.

The DOHMH investigation found that clinical specimens of Legionella from patients matched the strain of Legionella found in the cooling tower at the Sugar Hill Project (898 St. Nicholas Avenue), which is less than a quarter-mile from the Church of the Intercession.

“After a comprehensive investigation, the Health Department has identified the cooling tower at the Sugar Hill Project as the likely source,” said Dr. Oxiris Barbot, who was then-acting health commissioner of the DOHMH. (Dr. Barbot has since been elevated to commissioner.)

The complaint filed by Olsen and Harford states that the defendants “did not warn area residents and visitors of the risk of contracting Legionnaires’ disease by exposure to the building’s cooling tower.”

The DOHMH started monitoring the Sugar Hill Project after the first outbreak last July and August, when 27 area residents were sickened, 25 were hospitalized, and one died. The DOHMH investigation also pinpointed the Sugar Hill Project cooling tower as the “most likely” source for that outbreak.

It was the first time that one cooling tower had been linked to two separate outbreaks in the same year, health officials said at the time.

“DOHMH needs to move immediately to put in place better protocols to prevent this kind of repeat contamination,” NYC City Council member Mark Levine said.

Washington Heights outbreaks:
Legionnaires information

Legionnaires’ disease – sometimes called legionellosis or Legionella pneumonia – is a severe type of pneumonia or lung infection caused by Legionella bacteria, or Legionella pneumophila.

The Centers for Disease Control and Prevention (CDC) estimate that about 25,000 Americans are sickened yearly with Legionnaires, and about 2,500 victims will die. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

Legionella bacteria are usually contracted by inhaling microscopic water droplets (mist or vapor). Legionella grow best in warm water, and are primarily found in human-made environments.

Multiple sources have been proven to be conducive to the growth of Legionella:

  • hot tubs and whirlpools
  • swimming pools
  • showers and faucets
  • equipment used in physical therapy
  • hot-water tanks and heaters
  • mist machines
  • hand-held sprayers
  • cooling towers used in air conditioning systems
  • plumbing systems used in large buildings
  • water systems, such as those in hospitals, nursing homes, and hotels
  • decorative fountains.

Disease symptoms
Legionnaires’ disease is similar to other types of pneumonia, and symptoms can even resemble those of influenza (flu), which is why it often goes under-reported. Early symptoms generally include:

  • severe headaches
  • muscle aches
  • suppressed appetite
  • fever (104 degrees or higher) and chills.

Symptoms can then worsen to include:

  • pleuritic chest pain (pain caused by inflamed lungs)
  • dyspnea (difficulty breathing)
  • cough, which can produce blood and mucus
  • gastrointestinal problems such as diarrhea, nausea, and vomiting (about one-third of Legionnaires cases produce these symptoms)
  • mental agitation and confusion.

About 10 percent of people infected with Legionella will die from the infection.

People at greatest risk
Anyone can develop Legionnaires’ disease, but people who are most susceptible include:

  • people 50 years old or older
  • smokers, current and former
  • people with suppressed immune systems
  • heavy drinkers of alcoholic beverages
  • people with chronic lung disease
  • organ-transplant recipients
  • people on specific drug protocols (corticosteroids, for example).

Sick with Legionnaires’ disease?
Call (612) 337-6126
Elliot Olsen has regained millions of dollars for people harmed by Legionnaires’ disease. If you or a family member contracted Legionnaires at Bronx River Houses, please call (612) 337-6126 for a free consultation.


The New York City Department of Health and Mental Hygiene (NYC Health) confirmed that two cases of Legionnaires’ disease occurred at the Bronx River Houses within the past year.

“The risk to residents of contracting Legionnaires’ disease remains very low,” according to a statement posted by NYC Health on every floor of the low-income public housing project.

Despite the health department’s reassurance, tenants fear exposure to the potentially deadly bacterial disease.

“The Department of Health and NYCHA (New York City Housing Authority) wanted to speak about it,” Norma Saunders, the Bronx River Houses resident leader, told News 12 The Bronx. “We have 11 buildings. Two of the buildings are NYCHA senior buildings. We have a community center which houses seniors and youth programs, so we really need to know if we’re in danger of getting this disease.”

“I haven’t heard anything about that,” resident Eric Webb said to WNBC 4 New York, adding that it is a concern “ ’cause I drink the water.”

Legionnaires’ disease is a severe type of pneumonia or lung infection caused by Legionella bacteria, which are contracted by inhaling microscopic water droplets in the form of mist or vapor. According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur in the United States on a yearly basis. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

Bronx River Houses consists of 10 14-story high-rise buildings and one 6-story low-rise building with more than 1,250 apartments and 3,000-plus residents in the Soundview section of The Bronx. The 13.94-acre development, which opened in 1951, is bordered by East 174th Street, Harrod, and Bronx River avenues.

Tenants received written notification from NYC Health informing them that water testing would be performed. Health and NYCHA officials met with tenants at 1571 and 1575 East 174th Street in late January to discuss the situation and answer questions.

No information was provided on the timing of the two tenants’ illnesses or what their current conditions were.

If you’re sick, get checked

NYC Health urges residents or employees of Bronx Rivers Houses, visitors to the housing project, or individuals traveling through the immediate area who are feeling pneumonia- or flu-like symptoms to seek “immediate medical attention.” Those symptoms:

  • cough
  • shortness of breath
  • fever
  • muscle aches
  • headaches
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

Elsewhere in New York City

Legionella found at UHB

Water testing at University Hospital of Brooklyn (UHB) uncovered a high percentage of Legionella bacteria in the building’s water supply, causing the water taps to be temporarily shut down in the 342-bed teaching hospital.

Officials for the hospital, which is part of the SUNY Downstate campus, announced that staff and patients would use only bottled water for drinking and brushing their teeth, and to avoid showering until the system can be remediated. “Bath in a bag” products are being provided instead of showers.

“While we understand that these actions may cause concern, we want to assure the UHB community that we are taking all appropriate actions to address the matter,” Dawn Skeete-Walker, associate vice president of communications and marketing at SUNY Downstate, said in a statement.

The restrictions will be enforced until showerhead replacements, and the installation of a filtration system in ice machines have been completed, and the state Department of Health has reviewed and approved the institution’s remediation, according to Skeete-Walker.

“It’s important to stress that Legionnaires’ disease is not spread from person-to-person,” Skeete-Walker said. “The hospital is open and safe for patients, staff, and visitors.”

“According to an internal memo, a patient at the hospital was recently diagnosed with the disease, but was most likely already infected before coming to the hospital,” the New York Daily News reported. “It is unclear if there is any connection between that patient and the bacterial strain behind the new precautions.”

Legionella also was discovered at Park Slope’s New York-Presbyterian Brooklyn Methodist Hospital in December.

Upgrade for NYC Health + Hospitals/Lincoln

NYC Health + Hospitals/Lincoln completed installation of a “state-of-art, antimicrobial” cooling tower. The towers include antimicrobial features that will reduce the growth of dangerous bacterias, including Legionella. The primary function of the towers will be to support the heating, ventilation, and air-conditioning system.

Engineers believe the modern towers will reduce energy consumption by about 40 percent.

The new towers replace towers that had reached the end of their lifespan, not because of any health concerns they had caused. Improved safety to the community was a significant factor in their selection.

Sick with Legionnaires’ disease?
Call (612) 337-6126
Legionnaires lawyer Elliot Olsen has regained millions of dollars for clients. If you or a family member contracted Legionnaires’ disease at Alomere Health in Alexandria, Minnesota, you might have cause to file a lawsuit. Call (612) 337-6126 for a free consultation.


Two cases of Legionnaires’ disease since November have prompted officials at Alomere Health hospital in Alexandria, Minnesota, to work with the Minnesota Department of Health (MDH) to try and identify possible sources of Legionella bacteria.

The first patient was sickened at Alomere Health, located at 111 17th Avenue East, in late November; that patient recovered. The most recent patient infected with the sometimes-deadly respiratory illness developed Legionnaires’ disease symptoms in late January and remains hospitalized.

Legionnaires’ disease is a severe type of pneumonia or lung infection contracted by inhaling microscopic water droplets in the form of mist or vapor containing Legionella bacteria (Legionella pneumophila). According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella occur in the United States yearly. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

According to the MDH, Minnesota had more than 150 cases reported around the state in 2018.

Consultant hired
Alomere Health has contracted an independent environmental consultant to “conduct a complete assessment and testing of the facility’s water system and address potential sources for the bacteria,” according to an MDH news release.

Additionally, the hospital has implemented the following recommendations from the MDH in an attempt to minimize the risk of exposure to patients and employees:

  • Restricted the use of showers; patients can use bathtubs without using water jets.
  • Restricted the use of hand sprayers.
  • Bottled water must be used by patients on medical/surgical and ICU units for drinking, brushing teeth, and other oral care.

The MDH stated that the “recommendations only apply to patients and employees at Alomere Health. Alexandria’s municipal water supply meets water-quality standards.”

Hospital staff also has begun notifying patients and families about the outbreak, as well as informing them of the steps being taken by the hospital.

The MDH is contacting area health-care providers to be on alert for additional patients with possible Legionnaires symptoms.

Watch for symptoms
If you are a patient, employee or visitor to Alomere Health and you are experiencing pneumonia- or flu-like symptoms, you should seek care from your health-care provider out of an abundance of caution. Those symptoms include:

If you have any questions, concerns or are experiencing any of the above symptoms, contact Alomere Health at 320-762-6019 and ask for Bonnie Freudenberg, the hospital’s director of quality, or Margaret Kalina, VP of patient-care services. In addition, you can call the MDH at 651-201-5414.

More on Legionnaires’ disease

A 2015 study by the CDC stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk of developing Legionnaires’ disease.

Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

This list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: This can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the strength of the organ to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Possible Legionella sources
Legionella bacteria, which thrive in warm water, are found primarily in human-made environments, such as:

  • water systems of large buildings (hospitals, nursing homes, hotels, etc.)
  • bathroom showers and faucets
  • physical-therapy equipment
  • whirlpools and hot tubs
  • swimming pools
  • air-conditioning system cooling towers
  • large plumbing systems
  • hot-water heaters and tanks
  • decorative fountains
  • mist machines and hand-held sprayers.

Temps from 90 to 105 ideal
Warm, stagnant water provides ideal conditions for Legionella growth, according to the Occupational Safety and Health Administration (OSHA). Temperatures between 68 degrees and 122 degrees Fahrenheit provide ideal conditions for Legionella to multiply. Temperatures between 90 degrees and 105 degrees provide conditions that are ideal for Legionella to grow.