One case of Legionnaires’ disease has been diagnosed on the island of Oahu and is being investigated by the Queen’s Medical Center in Honolulu and the Hawaii State Department of Health (DOH), according to KHON2 TV.

Dr. Leslie Chu, chief medical officer at Queen’s Medical Center, confirmed that the patient is being treated there but did release the age or gender of the patient, or their current condition. Chu told KHON2 that the hospital is investigating potential sources of the disease.

Residents or visitors to Oahu exhibiting pneumonia- or flu-like symptoms (see the list of symptoms below) should seek immediate medical attention from their health-care provider.

Oahu is the third-largest of the 140 islands that make up the state of Hawaii (tourists visit only the six largest islands: Hawaii, Maui, Oahu, Kauai, Molokai, and Lanai). Oahu is home to the city of Honolulu, Waikiki Beach, Pearl Harbor, Diamond Head and the Polynesian Cultural Center, which are among the most popular destinations in the state.

Locating the source of the Legionella bacteria, which causes Legionnaires’ disease, is of extreme importance, because Legionnaires’ disease, which is a potentially fatal type of pneumonia, often presents in clusters or outbreaks. Being able to identify the cause of the patient’s illness could eliminate the threat for others.

Outbreak or cluster?
Clusters and outbreaks are where multiple cases are reported in or around the same proximity and within a designated period. Multiple illnesses reported within days or weeks, rather than months, are identified as an outbreak and occur in a more limited geographic area. When multiple diseases occur in the same general vicinity within a period of three to 12 months, a cluster is suspected.

Climate change

Legionnaires’ disease cases in Hawaii have increased each of the past two years (12 in 2016 and 14 in 2017), after a slight decrease in 2015 (7 cases), according to the DOH. Nine cases were reported in both 2013 and 2014.

The most recent Hawaiian outbreak occurred in June 2016, when two confirmed cases and a third suspected case forced the temporary closure of the WorldMark Kapaa Shore Resort in Kapaa, Kauai.

Legionnaires’ disease outbreaks have made headlines across the United States nearly annually since the disease was discovered in 1976. That was the year more than 200 attendees at an American Legion Convention in Philadelphia were sickened, and 34 of them died.

Legionnaires’ disease is “an emerging disease in the sense that the number of recorded cases of Legionnaires’ in the United States continues to increase,” said Laura Cooley, MD, MPH from the Respiratory Diseases Branch of the Centers for Disease Control and Prevention (CDC). Cooley said the increase is due to a rise in the susceptibility of the population, with more and more people on immunosuppressive medications.

In addition, there could be more Legionella in the environment, with warmer temperatures creating the right conditions for bacterial growth. The previous three years have been the hottest years on record, with NASA ranking 2016 as the warmest and 2017 second-warmest.

Legionnaires’ 101

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of lung infection. According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur yearly in the U.S. Only 5,000 cases are reported, however, because of its nonspecific signs and symptoms.

Ten percent of people who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Where do Legionella live?
Outbreaks have been linked to a number of sources:

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

Legionnaires’ symptoms
Legionnaires’ disease is similar to other types of pneumonia. Symptoms can even resemble those of flu, which is why it often goes under-reported.

Symptoms include:

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

Who is most at risk?
Anyone can become ill from Legionella, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, both current and former
  • heavy drinkers of alcoholic beverages
  • 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).

Three campus cooling towers and three bathrooms have tested positive for Legionella bacteria on the Wayne State University campus in Detroit, according to a university communique released this week. Legionella is the bacteria that causes Legionnaires’ disease.

The university began conducting tests after an employee who works in the Faculty Administration Building was diagnosed with Legionnaires’ disease on May 29. The employee, whose age and gender have not been disclosed, has been under the care of a physician since becoming ill. Their current condition is not known.

Preliminary results identified Legionella in cooling towers of the Towers Residential Suites, Purdy/Kresge Library and the College of Education Building. Remediation in the three towers has begun using the “prescribed disinfection process,” according to the university’s statement.

A private bathroom in the Faculty Administration Building, a first-floor men’s bathroom in Scott Hall, and a men’s bathroom in the Cohn Building also tested positive for Legionella. The bathrooms will be closed until they can be further assessed.

“As a result of these findings, the university will continue comprehensive testing of the campus, including potable water, to ensure all water sources are safe,” the university’s release stated. “The expert consultants will return to campus this weekend to continue sampling.

“Moving forward, we will work with the experts to re-evaluate our water treatment and monitoring protocols and make any necessary adjustments to ensure that this problem does not occur in the future.”

The university has notified the Detroit Health Department about the findings, and health department officials said they will assist WSU closely with the investigation moving forward.

Officials are unaware of any additional Legionnaires’ cases connected to the campus.

Students, employees or visitors to any of the buildings or bathrooms where Legionella was found and who have recently suffered from or are currently suffering from pneumonia- or flu-like symptoms (see below) should seek immediate medical attention from their health-care provider.

For updates on the university’s investigation, visit http://go.wayne.edu/fab-health.

Legionnaires’ 101

Legionnaires’ disease – also known as legionellosis and Legionella pneumonia – is similar to other types of pneumonia, which is an infection of the air sacs in one or both lungs that might produce fluid in the lungs. Symptoms can resemble flu-like symptoms in the following forms:

  • coughing
  • difficulty breathing
  • high fever
  • muscle aches and pains
  • headaches
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

Who is most at risk for illness?
Anyone can get Legionnaires’ disease, but people most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of its nonspecific signs and symptoms. Ten percent of those who become infected with Legionnaires’ disease will die from the infection.

How does Legionella infect a person?
Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a number of sources, such as:

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

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs. That, however, is a very rare occurrence.

A Wayne State University (WSU) employee was diagnosed with Legionnaires’ disease, and university officials said they will respond by conducting water tests, according to news reports.

WSU is a public research university located in Detroit, with more than 27,000 graduate and undergraduate students.

The employee, who works in the faculty administration building, is under the care of a doctor, according to a letter written by Michael Wright, WSU’s chief of staff.

“While it is very unlikely that this person contracted the disease from a campus source,” Wright wrote, “through an abundance of caution we will check the building for a potential source.”

The water tests will be performed to see if Legionella bacteria is present in the system. Legionella is the bacteria that causes Legionnaires’ disease.

The university also plans to review the building’s heating and cooling system to see if additional actions are required.

Students, employees or visitors to the administration building who have recently suffered from or are currently suffering from pneumonia- or flu-like symptoms (see below) should seek immediate medical attention from their health-care provider.

For updates on the university’s investigation, visit http://go.wayne.edu/fab-health.

WSU prof leads Flint investigation
Coincidentally, Shawn McElmurry, an associate professor of civil and environmental engineering at WSU, is heading a team of researchers that has been investigating the 2016 Legionnaires’ outbreak in Flint, MI. The Flint water crisis, which occurred in 2014-15, resulted in 12 deaths and more than 90 people contracting Legionnaires’ disease.

McElmurry’s team consists of Flint residents, WSU students, and students from other universities. The team is receiving funding from the state of Michigan but is working independently. The team expects to have a significant portion of research completed by the end of the year.

Legionnaires’ information

Legionnaires’ disease – also known as legionellosis and Legionella pneumonia – is similar to other types of pneumonia, which is an infection of the air sacs in one or both lungs that might produce fluid in the lungs. Symptoms can resemble flu-like symptoms in the following forms:

  • coughing
  • difficulty breathing
  • high fever
  • muscle aches and pains
  • headaches
  • gastrointestinal symptoms, such as nausea, vomiting, and diarrhea.

Who is most at risk?
Anyone can get Legionnaires’ disease, but people most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of its nonspecific signs and symptoms. Ten percent of those who become infected with Legionnaires’ disease will die from the infection.

How does one become ill?
Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a number of sources, such as:

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

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs. That, however, is a very rare occurrence.

A patient has contracted Legionnaires’ disease while undergoing treatment for cancer at the University of Washington Medical Center (UWMC), the third consecutive year that the deadly respiratory illness has hit the hospital.

The news comes less than a year after the death of a woman in her 20s who contracted Legionnaires’ while a patient at the Seattle hospital. She was one of three patients sickened with the disease in August of last year, although one patient became ill in the community, not at the hospital.

Five people were sickened with the severe type of pneumonia in 2016, and two victims died. All seven of those sickened at the hospital in the past two years took ill while at the UWMC building called Cascade Tower.

The latest illness occurred while the patient was being treated at the hospital’s Seattle Cancer Care Alliance (SCCA) unit. The patient is recovering and in satisfactory condition, hospital officials said. The patient’s age and gender were not reported.

An investigation is underway to identify the location of Legionella, the bacteria that causes Legionnaires’ disease, and if or to what extent the bacteria remains at the hospital. All patient respiratory specimens are being tested for the existence of Legionella, and patients with pneumonia are being tested as well.

Hospital staff has talked to patients being cared for at the SCCA and their family members. In addition, two rooms in which the ill patient received care have been closed, and an ice machine has been replaced, according to a UWMC spokesperson. Environmental testing is being conducted to try to pinpoint exactly where and when the person contracted the disease.

UWMC is investigating this latest illness with Public Health – Seattle & King County and the state Department of Health.

UWMC implemented intensive water management since the previous cases, which includes testing and monitoring of water temperature, chlorine levels and tests for the presence of Legionella. Special filters were installed on all showers and sinks in the in-patient rooms in the Cascade Tower.

UWMC and SCCA officials said the case is believed to be isolated and reiterated that “Legionella bacteria are rarely if ever transmitted from person to person.”

What is Legionnaires’ disease?

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia (lung infection). According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur yearly in the United States. Only 5,000 cases are reported, however, because of its nonspecific signs and symptoms.

Ten percent of people who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Where do Legionella live?
Outbreaks have been linked to a number of sources, such as:

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

Who is most at risk?
Anyone can become ill from Legionella, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

Legionnaires’ symptoms
Legionnaires’ disease is similar to other types of pneumonia. Symptoms can even resemble those of flu, which is why Legionnaires’ often goes under-reported.

Symptoms include:

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

Elliot Olsen has been retained by the second victim of the Water Oak Legionnaires’ disease outbreak in Florida.

Dennis Nedza – a 69-year-old resident of Waterford, WI, who spends winters at Water Oak Country Club, a 55-plus retirement community in Lady Lake – first started feeling ill about April 1. He was hospitalized on April 12, and was diagnosed with Legionnaires’ disease a couple of days later.

Nedza, who was discharged April 17, lost 30 pounds during his illness. He has regained 10 pounds since but is still experiencing shortness of breath and fatigue.

The Florida Department of Health in Lake County confirmed the two Legionnaires’ cases at Water Oak in late April. Testing confirmed the existence of Legionella – the bacteria that causes Legionnaires’ disease – in the club’s hot tub, which Nedza said he used daily.

Nedza joins a 61-year-old woman from the Chicago area in retaining Olsen’s services in separate lawsuits against Water Oak Country Club. The woman, who wishes to remain anonymous, told Olsen she became ill after visiting her brother at Water Oak in late March and using the hot tub at least five times.

The Chicago-area woman started feeling sick March 27. She said she figured she had flu as she and her husband drove home on the 28th and 29th. On April 2, her husband took her to the E.R. at Palos Hospital in suburban Palos Heights, and she was hospitalized for the next 11 days.

Olsen confident

Olsen, a Minneapolis-based attorney who is one of the country’s leading Legionnaires’ lawyers, said he is confident both clients have strong cases.

“Mr. Nedza lost a lot of weight while he was ill, and he is still suffering the effects of his illness seven weeks later,” Olsen said. “My other client is no longer hospitalized, but she is also still very weak. … Nobody using the Water Oak hot tub should suffer the way they have, and I intend to extract whatever justice I can.”

Gated community

Water Oak Country Club is an active, gated-community near The Villages, between Leesburg and Ocala, about 55 miles northwest of Orlando. Amenities include: golf course, tennis courts, horseshoe pit, bocce ball court, an Olympic-size swimming pool, and a fitness center that has both a Jacuzzi and sauna.

Legionnaires' disease

Legionella info

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.

“Outbreak” definition
The CDC classifies a “Legionnaires’ disease outbreak” as happening when two or more people are exposed to Legionella bacteria and become ill in the same vicinity at about the same time.

Disease symptoms
Legionnaires’ disease symptoms are similar to those of other types of pneumonia, and include:

  • coughing
  • difficulty breathing
  • fever
  • muscle aches and pains
  • severe headaches
  • gastrointestinal distress, which includes nausea, vomiting, and diarrhea.

People at greatest risk
Anyone can become sick with Legionnaires’, 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).

New York City Department of Health and Mental Hygiene (DOHMH) officials met with tenants of the Co-Op City complex last week to inform them that no new cases of Legionnaires’ disease have been found and the risk of contracting the disease is very low, according to a story posted on Bronx.News12.com.

The community meeting comes weeks after the residents were alerted that a cluster of three Legionnaires’ cases had been confirmed at Co-Op City’s Building 11 within the past 12 months, including the death of an elderly tenant.

The three cases occurred in Building 11, which is actually three smaller, connected buildings at the complex, which share a water supply. They do not, however, have a cooling tower, which is a common breeding ground for Legionella bacteria, the bacteria that causes Legionnaires’ disease.

The first case was reported last year, while two others have occurred within the past 60 days. Had the illnesses occurred within a six-month period, health officials would categorize it as an “outbreak” instead of a cluster.

The notification took place as part of the DOHMH’s public notification protocol for Legionnaires’ disease, which requires management to notify tenants when there are two or more cases reported at a single building in a 12-month period.

Riverbay Corporation, Co-Op City’s property management company, installed a copper-silver ionization system last week to proactively disinfect the water supply. Copper-silver ionization is a disinfection process, primarily used to control Legionella. The technology is recognized by the World Health Organization (WHO) and the Environmental Protection Agency (EPA) to control Legionella within potable water distribution systems found in hospitals, hotels and other large facilities.

No information was released by health officials or the management company regarding the results of the water testing performed in late April. Results typically take 2-3 weeks to become available.

Residents, visitors to, and employees of Co-Op City who have recently suffered from or are currently suffering from pneumonia- or flu-like symptoms should seek immediate medical attention from their primary health-care provider. They should also contact the DOHMH to report the illness.

Co-Op City, located in the Baychester section of the borough, is the largest cooperative housing development in the world. It has 15,372 apartments in 35 high-rise buildings and seven townhouse groups with approximately 50,000 residents. It is situated at the intersection of I-95 and the Hutchinson River Parkway and is part of Bronx Community District 10.

The three buildings in Co-Op City are located at 100, 120, and 140 Carver Loop in zip code 10475 in the north Bronx.

Congressmen concerned

Robert R. Redfield, director of the Centers for Disease Control and Prevention (CDC), wrote to Congressmen Eliot Engel recently that the DOHMH is heading up the investigation into the Legionnaires’ cases at Co-Op City. They’re “checking the internal plumbing of the building affected, and out of an abundance of caution sampling the building’s internal water supply,” Redfield wrote.

Congressmen Eliot Engel
Congressmen Eliot Engel

“An abundance of caution is the only way to handle something like this,” Congressman Engel wrote on his website, “so I am encouraged to hear that’s the track being taken with this very serious issue.

“Though the CDC has made clear that DOHMH is carrying out the investigation, they have assured me that they are in close communication with the city, and stand ready to assist if needed,” he added. “I will remain in contact with officials at both the federal and local level to ensure this is handled quickly and appropriately.”

Redfield’s reply was in response to an April 26 letter from Engel, which requested the CDC’s assistance. “I am extremely alarmed by these cases and ask that the Centers for Disease Control and Prevention work with the New York City Department of Health and Mental Hygiene to investigate the cause of these cases without delay,” Engel wrote.

Legionnaires’ timeline

In 2012 and 2013, two residents in Building 27 of Co-Op City were sickened with Legionnaires’, which they were believed to have contracted through contaminated shower heads. Tenants did not learn of those illnesses until early 2014, angering many residents. Officials of Riverbay Corp., Co-Op City’s management company, said testing did not find Legionella, which is why residents were never told.

Between December 2014 and January 2015, there were eight cases of Legionnaires’ disease at Co-Op City. Those illnesses were linked to a cooling tower infected with Legionella bacteria. Riverbay paid a chemical treatment company $200,000 to disinfect that water with chlorine and clean the tower to eliminate Legionella from the system.

Legionnaires’ 101

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia (lung infection). According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur yearly in the U.S. Only 5,000 cases are reported, however, because of its nonspecific signs and symptoms.

Ten percent of people who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Where do Legionella live?
Outbreaks have been linked to a number of sources, such as:

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

Who is most at risk?
Anyone can become ill from Legionella, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

Legionnaires’ symptoms
Legionnaires’ disease is similar to other types of pneumonia. Symptoms can even resemble those of flu, which is why it often goes under-reported. Symptoms include:

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

Several employees at the Jerry L. Pettis Memorial V.A. Medical Center in Loma Linda, CA, have filed a federal whistleblower complaint against hospital officials alleging that they are covering up a Legionella bacteria outbreak, the Orange County Register (OCR) recently reported. The complaint says that officials put patients, hospital visitors, and staff at risk for catching Legionnaires’ disease.

A five-page, redacted complaint was submitted to the U.S. Office of Special Counsel Robert Wilkes, acting Secretary of Veterans Affairs. The complaint, which was obtained by the Southern California News Group, claims “gross mismanagement, abuse of authority, gross waste of funds, and substantial and specific danger to public health and safety.”

“We have an administration not following Veterans Administration directives to protect the welfare of employees, patients, and visitors from exposure to Legionella,” said Dr. Linda Hyder Ferry, chief of preventive medicine at Pettis Medical Center and among more than a dozen whistleblowers (physicians and nurses).

Ferry told the OCR that federal officials visited the hospital and collected hundreds of pages of patients’ records after the whistleblowers filed their complaint.

Officials deny problems exist

Wade J. Habshey, a spokesperson for Pettis Medical Center, dismissed there was a Legionella issue at the facility.

“(The) V.A. takes Legionella prevention very seriously,” Habshey said in an email to the OCR. “V.A. directives on Legionella are among the most stringent in the country. The V.A. Legionella prevention program addresses the education of staff on how to prevent Legionella, reduction of conditions for Legionella growth, (and) monitoring and remediation if found.”

Water quality is monitored quarterly at the Pettis Medical Center, according to Habshey, and the facility has a prevention team to deal with any Legionella problems.

“We have been very successful and have a zero history of hospital-acquired Legionella cases,” he said.

Administration failed to communicate

The complaint alleges that the hospital’s administration knew of the Legionella issue in 2017 but failed to notify the medical staff, failed to correct the problem, and denied that bacteria existed at the facility.

“There are many employees and patients who could have been exposed from August-September to November from the sporadic growth of Legionella in the water system,” the complaint reads.

The whistleblowers specifically cite Melissa Lloyd, the hospital’s associate director for patient care services, for her lack of communication with the medical staff, after she learned of a positive Legionella test. “None of the physicians were informed of the presence of Legionella,” states the complaint.

The whistleblowers also state that Pettis Medical Center officials have not been forthcoming with the California Department of Public Health. “Public health investigators were told by Loma Linda V.A. officials that there was no Legionella exposure to report, there was no verified index case, and that the water testing was negative,” according to the complaint.

State health officials said they had no reports of a Legionella outbreak. One whistleblower – who asked to remain anonymous out of fear of retribution – said they are unconvinced and concerned Legionella is widespread.

“We don’t know how many patients may have died from Legionnaires’ pneumonia,” the whistleblower said. “If they don’t tell doctors (about the existence of Legionella), we don’t do testing.”

Legionella: A V.A. problem

There have been many instances of Legionella contamination or disease cases plaguing V.A. hospitals across the country the past few years. Some examples:

  • February 2018: Four residents at the Illinois Veterans Home in Quincy were confirmed with Legionnaires’ disease, marking the fourth consecutive year the facility has battled an outbreak. There have been 68 people infected and 13 deaths since the first outbreak in 2015.
  • January 2018: A resident of the Fresno, CA, Veterans Home tested positive for Legionnaires’ disease. It’s unknown whether the illness was caught at the facility.
  • January 2017: Testing discovered the existence of Legionella at the V.A. Pittsburgh Healthcare campus. There were no reports of hospital-acquired Legionnaires’ disease after the discovery. The same facility was not as lucky during a Legionnaires’ outbreak in 2011-12, when 22 patients were infected and six of them died.
  • August 2016: Two residents contracted Legionnaires’ while living at the Ussery Roan Veterans Home in Amarillo, TX.
  • November 2015: Water samples at the Minneapolis, MN, Veterans Medical Center tested positive for Legionella, although no illnesses were reported.
  • August 2015: The V.A. Hospital in Phoenix, AZ, relocated 20 patients after routine testing indicated “unacceptable levels” of Legionella in the water system of one building. None of the patients contracted Legionnaires’ disease.
  • October 2014: Legionella were discovered in nine positive tests at the Prescott, AZ, V.A. hospital. It was caught before any illnesses were reported.
  • August 2014: Six buildings on the campuses of New Jersey V.A. Hospitals in East Orange and Lyons were found to be contaminated with Legionella.
  • February 2014: Hospital-acquired Legionnaires’ disease claimed the life of a patient at Bay Pines V.A. Medical Center in Bay Pines, FL. In September 2014, testing returned positive results for Legionella in nine of 19 sites in Building 1. Follow-up testing in December showed the bacteria was even more prevalent, with 11 of 20 sites testing positive.
  • June 2013: An 80-year-old veteran died from Legionnaires’ disease contracted at the Castle Point veterans campus of the Hudson Valley, NY, Health Care System.

What is Legionnaires’?

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia (lung infection). According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur annually in the United States. Only 5,000 of those cases are reported, however, because of the disease’s nonspecific signs and symptoms.

Ten percent of people who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are most commonly found in human-made environments.

Where do Legionella live?
Outbreaks have been linked to a number of sources:

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

The state of Michigan and Governor Rick Snyder have ended the free bottled water distribution program to Flint residents, according to news reports. The 2-year-old program began in January 2016 as part of a $450 million state and federal aid package that was put in place after lead-tainted water plagued the city during the Flint water crisis, which started in 2014, sickening thousands of children, seniors, and pets.

It’s also believed that the tainted water is responsible for a 2015 Legionnaires’ disease outbreak in which 12 people died and nearly 90 sickened. In addition, the area experienced a decrease in fertility and increase in infant deaths and miscarriages.

Gov. Rick Snyder
Michigan Gov. Rick Snyder

“I have said all along that ensuring the quality of the water in Flint and helping the people and the city move forward were a top priority for me and my team,” Gov. Snyder said in a news release. “.We have worked diligently to restore the water quality, and the scientific data now proves the water system is stable and the need for bottled water has ended.”

State testing has shown Flint’s water supply has passed federal standards for nearly two years. Recent results put the lead levels at 4 parts per billion (ppb), which is below the federal action level of 15 ppb, according to state officials.

The Points of Delivery (POD) – where the bottled water distribution took place – were officially closed April 10, after the last of the free water was distributed, according to the Michigan Department of Environmental Quality (MDEQ). The state said the program cost an average of $22,000 a day this year.

“One of the things we said right from the beginning [was] that those PODs stay open until we got through the lead service line replacements,” Flint Mayor Dr. Karen Weaver said in a news conference. “We’re not through that yet … that was very insensitive to the people when you look at everything we’ve been through.”

Mayor Dr. Karen Weaver
Flint Mayor Dr. Karen Weaver

Weaver said she will lobby Gov. Snyder for an extension of the water distribution program until the state has replaced all residential lead and galvanized steel water service lines, which is expected to be completed by the end of 2019. A spokesperson said the governor would meet with Weaver “when his schedule allows.”

Water crisis started in 2014

The Flint water crisis began in April 2014 after the city switched its public water source from Lake Huron to the Flint River to cut costs. The switch introduced lead, iron and organic matter into Flint’s water supply, leading to the Legionnaires’ outbreak and other medical issues.

Soon after the switch, residents complained that the water started to look, smell and taste funny. Tests by the Environmental Protection Agency (EPA) and scientists at Virginia Tech University showed alarming levels of lead in the residents’ water.

A class-action lawsuit charged that the state wasn’t treating the Flint River water with an anti-corrosive agent, a violation of federal law. The improperly treated water was eroding the iron water mains, turning the water brown. Additionally, about half of the service lines to Flint homes are made of lead, and because treatment of the water wasn’t adequate, lead also began leaching into the water supply.

More than a dozen lawsuits, including several class-action suits, were filed against the state of Michigan and the city of Flint, as well as various state and city officials, and employees involved in the decision to switch the water source.

Free water filters and replacement cartridges will continue to be made available for residents who have water line work in progress – which could cause short-term spikes of lead into the water – or who feel more comfortable using a filter until their confidence in the water quality is restored. Residents can find them at City Hall or by calling the Community Outreach Resident Education Program (CORE) at 810-238-6700. The CORE program was established to ensure Flint residents are correctly installing, using and maintaining the water filters.

Non-profit groups also have been distributing free bottled water at Flint churches, and that will likely continue, although with the discontinuation of the city program, it could affect how they administer the distribution. “Normally, we give out whatever a family wants,” Bill Quarles, a deacon at the First Trinity Missionary Baptist Church in Flint, told NBC News. “But now we may have to limit that until more supplies come in.”

What is Legionnaires’ disease? 

Legionnaires’ disease – also called Legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (CDC), about 25,000 cases of pneumonia due to the Legionella bacteria (Legionella pneumophila) occur each year. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms, and 10 percent of those illnesses will end in death.

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

Outbreaks have been linked to a range of sources:

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

The New York City Department of Health and Mental Hygiene (DOHMH) is investigating a cluster of Legionnaires’ disease illnesses at Co-Op City in the Bronx, including the death of an elderly resident.

Co-Op City, located in the Baychester section of the borough, is the largest cooperative housing development in the world. It has 15,372 apartments in 35 high-rise buildings and seven townhouse groups with approximately 50,000 residents. It is situated at the intersection of Interstate 95 and the Hutchinson River Parkway and is part of Bronx Community District 10.

The three cases occurred in three connected buildings at the complex within the past year; the first case was reported last year, while two others occurred within the past 60 days. Had the illnesses occurred within a six-month period, health officials would categorize it as an “outbreak” instead of a cluster.

All three people who became ill had conditions that increased their prospects of catching Legionnaires’ disease. The two residents who survived their illnesses have been released from the hospital, according to the health department.

Neither the name of the deceased has been released, nor when their illness occurred.

“Residents of this building who are over 50 or have underlying medical conditions should avoid showering until the investigation is completed,” the DOHMH warned in a statement. The statement included information that said tap water is safe to drink.

The DOHMH will test the building’s plumbing to see if a common source of Legionella bacteria can be located. (Legionella is the bacteria that causes Legionnaires’ disease.) The three buildings where the illnesses occurred do not have a cooling tower but share the same plumbing system.

A history of Legionnaires’

Between December 2014 and January 2015, there were eight cases of Legionnaires’ disease at Co-Op City. Those illnesses were linked to a cooling tower infected with Legionella bacteria. Seven of the eight people infected lived in different buildings.

At that time, Co-Op City’s management company, Riverbay Corporation, paid a chemical treatment company $200,000 to disinfect that water with chlorine and clean the tower to eliminate Legionella from the system.

In 2012 and 2013, two residents in Building 27 of the housing development were sickened with Legionnaires’, which they were believed to have contracted through contaminated shower heads. Tenants did not learn of those illnesses until early 2014, angering many of the residents. Testing, however, did not indicate the existence of Legionella, which is why residents were never told, according to Riverbay officials.

In 2015, cooling towers were responsible for an outbreak in the Bronx that sickened 133 people and killed 16, making it the largest outbreak of Legionnaires’ disease in New York City history.

Residents, visitors to, and employees of Co-Op City who have recently suffered from or are currently exhibiting pneumonia- or flu-like symptoms (see below) should seek immediate medical attention from their primary health-care provider. They should also contact the DOHMH to report the illness.

Legionnaires’ info

Legionnaires’ disease is similar to other types of pneumonia. Symptoms can resemble those of flu, such as:

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

Who is most at risk?
Anyone can become ill from Legionella, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

What exactly is Legionnaires’?
Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia (lung infection). 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 U.S. annually. However, only 5,000 cases are reported because of its nonspecific signs and symptoms.

Ten percent of those who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Where do Legionella live?
Outbreaks have been linked to a number of sources, such as:

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

The Florida Department of Health in Lake County has confirmed two Legionnaires’ disease cases at a 55-plus community in Lady Lake, FL, according to Villages-News.com.

Two sickened with Legionnaires' disease at Water Oak Country Club.
Hot tub sickens two with Legionnaires’ disease at Water Oak Country Club, FL, community.

Laboratory testing determined that the hot tub at the Water Oak Country Club clubhouse was the source of the illnesses. No further information was available on the current condition of the victims, or whether they required hospitalization.

Residents, visitors and employees who have used the hot tub since Feb. 1 and who have had or are currently exhibiting pneumonia- or flu-like symptoms (see below) should seek immediate medical attention from their primary health-care provider. They should also contact the Department of Health at (352) 771-5573 to report their illness.

The 300-acre, active gated-community is located near The Villages, off U.S. 27/441 between Leesburg and Ocala, approximately one hour north of Orlando. Amenities include an 18-hole golf course, four tennis courts, bocce ball court, horseshoe pit, an Olympic-size swimming pool, and fitness center, equipped with a Jacuzzi and sauna.

Water Oak Country Club is part of Sun Communities, Inc., a real-estate investment trust with more than 300 manufactured home communities and RV resorts located in 29 states throughout the United States and Ontario, Canada. Sun Communities offers all-age communities, Sun RV resorts, and active 55-plus communities. Water Oak is one of Sun’s 100 active 55-plus communities in 71 cities.

A rough 2017 for Orlando

There were 21 confirmed cases of Legionnaires’ disease last year in Orange County, for which Orlando is the county seat. Some of the more high-profile incidents included:

  • Seven guests at three LA Fitness clubs in the metropolitan area were infected with Legionnaires’ between April and June. In April, three guests of the LA Fitness in Ocoee (1560 E. Silver Star Road) contracted the disease, although tests for Legionella at that facility were negative. And last June, four members of the Metro West area LA Fitness (4792 Kirkman Road) and the Hunter’s Creek LA Fitness (12700 S. Orange Blossom Trail) were sickened.
  • In July, two residents at Summit Greens, a 55-and-older living community in suburban Orlando, were infected with Legionnaires’ disease.

Legionnaires’ 101

Legionnaires’ disease – also called legionellosis and Legionella pneumonia – is a severe type of pneumonia or lung infection. According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella bacteria (Legionella pneumophila) occur each year, but only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

Ten percent of those who become infected with Legionnaires’ disease will die from the infection.

Legionella bacteria are contracted by inhaling microscopic water droplets, usually in the form of mist or vapor. The bacteria, which grow best in warm water, are found primarily in human-made environments.

Outbreaks have been linked to a number of sources, such as:

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

People also can contract Legionnaires’ disease when they “aspirate” contaminated drinking water – that is, choking or coughing while drinking can cause water to go down the wrong pipe into the lungs. It is also possible to contract the disease from home plumbing systems. Both of these, however, happen very rarely.

What is an outbreak?
A Legionnaires’ disease outbreak occurs when two or more people are exposed to Legionella bacteria and get sick in the same vicinity around the same time, according to the CDC.

Who is at risk?
Anyone can get Legionnaires’ disease, but those most susceptible to infection include:

  • people 50 years of age or older
  • smokers, current and former
  • heavy drinkers of alcoholic beverages
  • 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).

What are the symptoms?
Legionnaires’ disease is similar to other types of pneumonia. Symptoms can resemble those of the flu in the following forms:

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