Two cases of Legionnaires’ disease at James Square Health and Rehabilitation Centre in Syracuse, NY, have caused the New York State Department of Health (NYSDH) to recommend a water restriction on one of the facilities’ two buildings, according to news reports.

Drinking water in the 918 James Street building was found to contain Legionella, the bacteria that causes Legionnaires’ disease.

The NYSDH, which is currently investigating the facility, recommended a water restriction last month after water samples detected low levels of Legionella in the tap water in the first of its two buildings at 918 James Street. Testing was required after two cases of Legionnaires’ disease were reported between March and July 24. Testing at the second building at 906 James Street showed no reportable levels of the bacteria.

James Square hired a remediation expert, who hyperchlorinated (disinfected) the water system and installed filters on shower heads and faucets. Officials also installed a system that filters the water supply to both buildings.

According to a NYSDH spokesperson, James Square violated state regulations by not promptly reporting elevated Legionella water levels to the health department earlier this summer. Nursing homes are required to immediately notify the NYSDH whenever at least 30 percent of water samples test positive for Legionella. The NYSDH said the nursing home received elevated test results in early June but did not report the results until June 27.

An attorney representing the nursing home disputed the health department’s claim, stating the nursing home did not receive the June test results until August 1.

Alternate water supplies, including bottled water, are being provided to residents until additional testing shows the eradication of the bacteria from the water supply.

Both individuals who were sickened are doing well, according to a nursing home administrator.

South Bronx outbreak in 2015 prompted state regulations

The state adopted regulations designed to protect nursing home and hospital patients from Legionnaires’ disease after a 2015 outbreak in the South Bronx linked to cooling towers sickened 120 people, 12 of whom died, the largest outbreak in New York state history. Under those regulations, nursing homes and hospitals were required to submit water sampling and management plans to the state by Dec. 1, 2016. James Square has yet to submit a plan, according to the NYSDH.

The Legionnaires’ scare is the latest black eye for James Square, which has a history of poor quality and is currently under investigation by the state Attorney General’s office for patient care.

A busy summer for Legionnaires’ disease in NY

The Syracuse outbreak is the most recent for the state of New York. In June, one person died and another seven were hospitalized after contracting Legionnaires’ disease in the Lenox Hill neighborhood on the Upper East Side of Manhattan. Cooling towers were believed to be the cause after 24 of the 116 towers in the area tested positive for traces of Legionella.

Also in June, two New York City police officers took ill with Legionnaires’ disease at the 23rd Precinct in Harlem. An infected water system is believed to be responsible for those illnesses.

Complications of Legionnaires’ disease

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

Anyone can get the disease, but those at the greatest risk include:

  • people 50 or older
  • smokers, both current or former
  • heavy drinkers of alcohol
  • individuals who suffer chronic lung disease
  • people with suppressed immune systems.

For the second time in two years, patients at the University of Washington Medical Center (UWMC) in Seattle, WA, have been diagnosed with Legionnaires’ disease, according to multiple news reports.

In this latest outbreak, three patients were diagnosed with Legionnaires’ disease, including a woman in her 20s who died. Her case was reported to Seattle & King County Public Health, but the cause of her death has yet to be determined because she was “very ill [and] had multiple underlying conditions,” according to a statement by the health department.

The other two cases involve a man in his 40s, who has been discharged from the hospital, and a man in his 60s, who remains hospitalized. The latter patient appears to have caught the disease in the community and not at UWMC.

Between August and September of last year, an outbreak of Legionnaires’ disease at the hospital sickened five patients, two of whom – both in their 50s – died.

Hospital officials are limiting exposure to water sources – including tap and shower water – of patients, visitors and employees until the origin of the Legionella bacteria, which causes Legionnaires’, can be identified. The latest illnesses affected patients in the hospital’s Cascade Tower, the same tower affected last year.

Water samples tested as recently as July did not show the existence of Legionella within the hospital.

After last year’s incidents, the water system was flushed, and filters were installed to prevent the spread of Legionella, according to UW medical officials. The bacteria was found in sinks and ice machines during that occurrence. All known facility-based risk factors were corrected at that time.

Recent patients, visitors or employees of the hospital who are exhibiting pneumonia- or flu-like symptoms, such as a cough, fever or shortness of breath, should contact Public Health by calling 206-296-4600. They should also seek immediate medical attention from their care providers.

According to the Centers for Disease Control and Prevention (CDC), Legionnaires’ disease is often under-reported, so the full extent of the outbreak may not be known if people don’t report their condition.

Legionnaires’ disease on the rise in health-care facilities

In June, the CDC released information from a new study of the U.S. health-care industry and found that 76 percent of the facilities studied in 2015 reported cases of Legionnaires’ disease.

The findings are especially alarming for residents living at, or patients admitted to the facilities, as 1 in 4 people infected in a health-care facility will die. The death rate is higher than for people who get the infection elsewhere; 1 in 10 are estimated to succumb to the disease overall.

According to the CDC’s analysis, among the Legionnaires’ disease cases associated with health-care facilities:

  • 80 percent were linked to long-term facilities; 18 percent with hospitals, and 2 percent with both
  • Cases were reported from 72 unique facilities, with the number of cases ranging from 1 to 6 per facility
  • 88 percent were in people 60 years of age or older.


Complications of Legionnaires’ disease

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

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

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

AUGUST 23
A fourth case of Legionnaires’ disease since October 2016 has prompted the Waco-McLennan County Public Health District to issue a control order against the Fairfield Inn and Suites by Marriott Waco North in Lacy Lakeview, TX, according to numerous news reports.

The latest illness spurred the health district to more fully investigate the facility. “What we need to determine is: Is this an issue with a pool or spa; is it an issue to do with the A/C, or is it potable water and has it spread?” said Kelly Craine, Public Health Information Specialist at Waco-McLennan County Public Health District. “Is it really isolated in one area, or are we seeing something that’s really large where it covers a large area? We don’t know that yet, and that is why an independent consultant is so important.”

Two hotel guests were sickened with Legionnaires in October 2016, and a third took ill in May. That triggered hotel officials to temporarily shut down the hotel pool.

Tests after the May incident, however, returned negative findings for Legionella bacteria. The second round of testing has been completed and results are expected back before the end of the month.

In cooperation with the Centers for Disease Control and Prevention (CDC) and the Texas Department of State Health Services, the health district is requiring the Fairfield Inn to implement the following three actions immediately in order to comply with the control order:

  • Hire a qualified consultant to assist with the development and implementation of a water maintenance plan
  • Maintain water temperature at 140 degrees Fahrenheit
  • Notify all guest of the risks of Legionnaires’ disease.

A hotel representative said the hotel would cooperate, and that “safety was the priority.”

The hotel is located at 4257 N. Interstate 35 in a suburb of Waco.

CDC: About 25,000 cases of Legionnaires’ annually

Legionnaires’ disease is a severe type of pneumonia or lung infection. According to the CDC, an estimated 25,000 cases of pneumonia caused by Legionella bacteria (Legionella pneumophila) occur in the United States yearly. However, only 5,000 cases are reported because of its nonspecific signs and symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria are found primarily in human-made environments, such as cooling towers, air-conditioning systems, hot tubs, and spas, to name a few.

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.

Complications of Legionnaires’ disease

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

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.

Legionnaires' disease affects two workers at Brooke Army Medical Center in Texas.Two hundred employees in an administrative building next to the military hospital at Brooke Army Medical Center (BAMC) in Fort Sam Houston, TX, have been relocated to a temporary workspace after two coworkers were hospitalized and treated for Legionnaires’ disease this summer, according to numerous news reports. In addition, test results are pending on a possible third case.

The two cases involve workers on post, not patients registered in the hospitals. Because the illnesses affected two people working in the same building within one year, it’s considered an outbreak, according to the Emerging and Acute Infectious Disease Guidelines.

Finding the source

By relocating the employees to a temporary workplace, the BAMC is taking an over-abundance of caution as it looks for the origin of the Legionella bacteria. The investigation seeks to determine if the cases are associated with the building or if the inffected pair has another commonality that could be the source.

Extensive testing will be conducted to “determine if the building is the source of the bacteria,” a BAMC spokesman said.

BAMC is the U.S. Army’s largest and busiest medical center, and the Army’s only military Level I trauma center. It also operates the Department of Defense’s only burn treatment facility.

CDC: About 25,000 cases of Legionnaires’ annually

Legionnaires’ disease 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 in the United States yearly. Only 5,000 cases are reported, however, because of the disease’s non-specific signs and symptoms.

Legionella bacteria are contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are generally found in human-made environments, such as cooling towers, air-conditioning systems, hot tubs, and spas, to name a few.

Complications of Legionnaires’ disease

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

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 a second reported case of Legionnaires’ disease at a Flushing apartment complex in Queens, NY, within a year period, the city is performing tests to the water distribution system, according to multiple news reports.

Two residents of Building 3 at Latimer Gardens – one of four buildings in the complex, located at 34-20 137th Street – were diagnosed with Legionnaires’ disease 10 months apart, according to the NYC Department of Health and Mental Hygiene.

The building does not have a cooling tower, which has been a common breeding ground for Legionella bacteria in many incidents throughout New York in recent years.

The health department confirmed that the latest incident occurred within the past two months. That individual remains hospitalized. The first patient also was hospitalized but recovered and was discharged from the hospital. Health officials are required to notify tenants when there are multiple cases reported at a single address within a one-year period.

The New York City Housing Authority said “out of an abundance of caution” it is installing a copper silver ionization system to disinfect the water.

A busy year for Legionnaires’ disease in NYC

In June, one person died and another six were hospitalized after contracting Legionnaires’ disease in the Lenox Hill neighborhood on the Upper East Side of Manhattan. Cooling towers were believed to be the cause after 24 of the 116 towers in the area tested positive for traces of Legionella bacteria.

Also in June, two New York City police officers took ill with Legionnaires’ disease at the 23rd Precinct in Harlem. An infected water system is believed to be responsible for those illnesses.

New York City’s largest outbreak killed 12 in 2015

The largest outbreak in New York City history occurred just two years ago. Contaminated cooling towers were blamed for producing Legionnaires’ disease that killed 12 people and sickened more than 120 others in the South Bronx.

The hot tubs at the Gold’s Gym in Kennewick, WA, tested positive for Legionella bacteria, Benton-Franklin Health District (BFHD) officials announced.

Testing occurred after two members, both women, were infected with Legionnaires’ disease in July. A third woman took ill after the initial reports. All three have since recovered.

“The only commonality that we were able to identify between the women who got sick was the spa and pool area at Gold’s Gym in Kennewick,” Rick Dawson, BFHD senior manager for surveillance and investigation, said in a statement. “The positive results for Legionella tell us that the spa was the source of the bacteria.”

Health officials required gym management to temporarily close the pool and spa areas during the investigation. (The pool and sauna/steam room have been reopened.) Only the hot tubs will remain off limits until decontamination of the equipment and follow-up testing determines that the bacteria has been eradicated.

Members or visitors to the Kennewick Gold’s Gym who have used the hot tubs and are exhibiting pneumonia- or flu-like symptoms should contact the Health District by calling 509-460-4200. They also should seek immediate medical attention.

Legionnaires’ disease complications can be severe

Legionella bacteria are generally contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria, which thrive in warm water, are primarily found in human-made environments, such as hot tubs, spas, cooling towers, and air-conditioning systems, to name a few.

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

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.

CDC: About 25,000 Legionnaires’ cases yearly

According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia caused by Legionella bacteria (Legionella pneumophila) occur in the United States annually.

Two residents of The Manor at Whitehall, OH, tested positive for Legionella bacteria in July, according to officials at the Franklin County Public Health Department. The Manor is a short-term rehabilitation or extended-stay skilled nursing facility in a suburb of Columbus.

Additional medical testing is needed to determine whether the two men – both in their mid-60s and hospitalized with respiratory infections – have contracted full-blown Legionnaires’ disease. Results will not be known for at least a week.

An inspection of all plumbing, heating and cooling systems, along with all pipes and water systems, will attempt to identify whether the facility is the source of the bacteria.

Franklin County Public Health has planned town hall forums for today and tomorrow for residents and staff. For more information, contact the hotline at 614-525-3097.

In June, two inmates at Ohio’s prison hospital, the Franklin Medical Center in Columbus, were diagnosed with Legionnaires’ disease. A cause of their illnesses has yet to be released.

In 2013, the largest Legionnaires’ disease outbreak in Ohio history occurred when six people died and 39 others were sickened at the Wesley Ridge Retirement Community in Reynoldsburg, a suburb of Columbus. A cooling tower and potable water were the sources for that outbreak.

Two members of the Gold’s Gym in Kennewick, WA, were sickened with Legionnaires’ disease, according to the Benton Franklin Health District (BFHD) in a statement.

The two senior women, who are in their 70s and 80s, are recovering after being discharged from the hospital. The only commonality between the two is that they are members of the Kennewick Gold’s Gym, leading the district to investigate the facility.

The gym has temporarily closed its pool and hot tub as a precautionary measure, and gym officials are working with the BFHD to ensure that both are cleaned and sanitized before reopening. Water samples have been submitted for testing, and results are expected back within two weeks.

Members or visitors to the Kennewick Gold’s Gym who are exhibiting pneumonia- or flu-like symptoms should contact the Health District by calling 509-460-4200. They should also seek immediate medical attention.

More than 4,000 delegates from the Pennsylvania chapter of the American Legion traveled to the Bellevue-Stratford Hotel in Philadelphia on July 21, 1976, for the Legion’s annual three-day convention. It was supposed to be remembered as the bicentennial commemoration of the 200th anniversary of the signing of the Declaration of Independence.

A medical mystery changed all that.

On July 27, three days after the convention ended, Ray Brennan, a 61-year-old retired U.S. Air Force Captain and an American Legion bookkeeper, had died from an apparent heart attack. By August 2, hundreds of Legionnaires had been sickened, and 22 were dead. In all, the case count eventually reached 221 ill and 34 dead.

It was one of the worst U.S. medical tragedies of the 20th century.

Dr. Ernest Campbell, a physician from Bloomsburg, PA, was the first to see a pattern in the outbreak after he realized that three of his patients with similar symptoms had attended the convention. He contacted the Pennsylvania Department of Health to report his findings. Officials at the American Legion also became concerned when notified of the sudden death of numerous members.

The Centers for Disease Control and Prevention (CDC) was called in and mounted one of its largest investigations ever to try to identify the cause. Bioterrorism, foul play, microorganisms, and toxins all were considered.

Five months later, after much speculation and failed tests, CDC microbiologist Joseph McDade finally identified a red, rod-shaped organism as the cause of the illness. It was a bacteria unlike anything scientists had seen before. They called it Legionella.

In April 1977, the CDC coined the name of the disease that had sickened and killed so many and baffled scientists for months as “Legionnaires’ disease.”

Illness caused by Legionella bacteria continues to be detected, now more than ever, according to the CDC. About 6,000 cases were reported in the U.S. in 2015, but because Legionnaires’ disease is underdiagnosed, the actual number of individuals infected each year is unknown.

Four more people have contracted Legionnaires’ disease after visiting The Guest House at Graceland hotel in Memphis, TN, increasing the total to nine, the Shelby County Health Department (SCHD) said in a statement.

The hotel’s hot tub and swimming pool both tested positive for Legionella bacteria, which causes Legionnaires’ disease. The aquatics center, which includes the hot tub and pool, was closed June 26 for remediation but reopened Wednesday after testing returned negative results for Legionella.

Anyone who stayed at or visited the hotel between May 12 and June 26 and has experienced or is still experiencing pneumonia- or flu-like symptoms should contact the SCHD Hotline at (901) 222-9299 and seek immediate medical attention.

In related news, a lawsuit was filed against the hotel’s owner, Elvis Presley Enterprises, Inc., on behalf of one victim. The lawsuit is seeking compensation for Douglas Johnson of Miami Lakes, FL, and his wife, Marisol, whose relationship with her husband was allegedly harmed by the illness.