Feb
23
2018
Share Button

This past Monday, February 19, a Philadelphia-based global molecular solutions company called Invisible Sentinel Inc. announced its first-in-class Legionella species assay had been verified and adopted by a Centers for Disease Control (CDC) ELITE Certified Laboratory called Q Laboratories, Inc.

The CDC ELITE, or Environmental Legionella Isolation Techniques Evaluation, is a CDC designation for labs that have shown proficiency with isolating, growing, and identifying Legionella from samples collected in the environment. Traditional screening methods, however, can often take up to two weeks so a development like the one touted by Invisible Sentinel would certainly mark a significant improvement.

The new first-in-class same day Legionella species assay is called the Veriflow Legionella and can provide results in under 4 hours. In addition, Veriflow also includes a DNA Signature Capturing technology which allows the species assay to differentiate between viable and non-viable organisms, a distinction which can allow individuals responsible more information to act upon when containing an outbreak or even just a sporadic case of Legionnaires’ disease.

According to Invisible Sentinel’s CEO, Dr. Nicholas Siciliano, “(W)e spent several years developing this assay to ensure it would meet the high standards set by ELITE CDC certified testing laboratories and we expect it to be a game-changer for the water testing market,”. On the topic of partnering with Q Laboratories’, Siciliano added that “(W)e’re excited to partner with Q Laboratories, a market leader in assay validation and microbiology testing services, to formally launch our groundbreaking Legionella assay to the entire industry,”.

This kind of technological advance, along with the cube discussed earlier, gives a good deal of encouragement to individuals involved with water distribution systems. Indeed by ensuring that testing can be as quick and efficient as possible, it can allow individuals involved on the ground more alternatives and options for responding to potential Legionella infections and hopefully preventing the contraction of Legionnaires’ disease as a whole.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 10:27 am
Feb
22
2018
Share Button

Over the course of this blog, many subjects have been covered however perhaps as a reminder and as a step back, it is prudent to review exactly how individuals contract Legionnaires’ disease. As mentioned before, Legionnaires’ disease is often contracted by breathing in aerosolized water (and in some cases, soil) that has Legionella bacteria. As such, Legionnaires’ disease cannot be given from one individual to another. The Legionella bacteria grows the best in warm temperatures so can often thrive in locations like cooling towers, evaporative condensers, and hot water tanks.

The Legionella pneumophila causes around 90% of all Legionnaires’ disease cases and can survive within aquatic systems like those listed above however also within humidifiers, showers, ice-making machines, nebulizers, fountains, whirlpool spas, room-air humidifiers, windshield washers, and even misting systems

Perhaps to put it simply, Legionella bacteria can often thrive in locations where there is stagnant, warm water. This Legionella bacteria can become a major problem when it becomes aerosolized, thus allowing individuals to potentially inhale it and ultimately contract Legionnaires disease. While this description is certainly not exhaustive on the subject, this post does simply seek to provide an introduction to the subject.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 9:42 am
Feb
21
2018
Share Button

About a month ago, we began discussing the Quincy, Illinois Veterans Home outbreak. Since then, we have followed legislative attempts as well as the revelation last week that there were in fact 2 new cases found. Now just a week later, it was reported last night that there are, in fact, two additional cases stemming from the Qunicy, Illinois Veterans Home.

The Illinois Department of Public Health made this announcement on Tuesday, just hours after the state’s Senate Democrats had held a series of hearings regarding the outbreaks. This fourth patient is apparently in stable condition and the central issue being discussed by Senate Democrats on Tuesday evening was about a report outlining around $8 million in additional investments that would hopefully prevent such an incident from happening again and would include the partial replacement of older water pipes.

As a review, the Quincy, Illinois Veterans Home outbreak initially began in 2015 and have so far left 13 dead with dozens more ending up sick. Thoughts about these recent revelations are much the same as last week however clearly amplified; what appears to be frustrating about this incident is how new cases are still being discovered. With the initial outbreak happening almost two and a half years ago, one would assume that officials would have discovered all the cases, treated them, and made repairs to the water pipes and infrastructure to ensure this would not happen again.

As such, one would hope that these most recent revelations will encourage state officials and building administrators to implement methods, informed by research, which can reduce the likelihood of anything like this happening in the future, whether it be replacing old pipes, regular testing, regular flushing, or an overhaul to their water distribution management system as a whole.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 9:53 am
Feb
20
2018
Share Button

Last Wednesday, officials with the Illinois’ Department of Human Services made a statement that a patient at the Chester Mental Health Center, a mental health facility in southern Illinois, had tested positive for Legionnaires’ disease. In the statement, the officials also said that the patient from the mental health facility was being treated and is in stable condition.

In response to the incident, the Chester Mental Health Center stated that it would be working with the Illinois’ Department of Public Health to find the source of the bacteria and maintain extensive monitoring other patients.

In a news release earlier this week from State Sen. Paul Schimpf, R-Waterloo, it was stated that the water was turned off to a portion of the facility in order to try and prevent additional cases of Legionnaires’ disease. In an email sent out last Friday, the director of communications at the Illinois Department of Human Services, Meghan Powers, said officials “are waiting for results for our cultures test and will decide the best course of action once we receive those results,”. Powers did not, however, answer any questions regarding how long the tests would take or when water might be turned back on to that wing portion of the Chester Mental Health Center.

Clearly more information will become available as the investigation continues and as a first step, they get the test results back. Yet the recent set of stories involving state run facilities in Illinois and positive tests of Legionnaires disease has been disconcerting. Hopefully all of these incidents will push legislators if not commercial and/or residential building owners to take water distribution systems seriously as a risk concern and as such, to develop routines and procedures to help ensure that Legionella bacteria never has a chance to form in the first place.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 10:00 am
Feb
19
2018
Share Button

Over the course of the past month, we have not only covered various sporadic cases and outbreaks of Legionnaires’ disease, but have also tried to shine light onto other developments within the field. A seemingly simple question, however, has been on my mind as I continue to go through these stories; is there a vaccine that could prevent individuals from being at risk to Legionnaires’ disease? And if there is not a vaccine, then why not?

Well the first question is relatively simple to answer; no, there are currently no vaccines for Legionnaires’ disease. There have certainly been attempts to create a vaccine for Legionnaires’ disease and Legionella bacteria more generally, including most famously in the eighties with a research study which apparently revolved around guinea pigs.

The results of this study found that several forms of vaccination could actually create “moderately high levels of protection”. Yet there appears to be some weaknesses with the vaccine tested as well, including with aerosolized exposure to Legionella bacteria.

It is not the place of this page to try and make a conclusive answer regarding the second question; indeed the previous study which we discuss in detail in this post was done over 30 years ago so it is curious to not see much more attempts regarding the vaccination of Legionnaires’ disease. With that in mind, it perhaps just goes to show how truly important every form of prevention planning can be; for without a working vaccine in wide circulation, effective prevention planning is one of the only methods individuals have for avoiding sporadic and/or outbreaks of Legionnaires’ disease.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 4:25 pm
Feb
16
2018
Share Button

The source of Legionella bacteria and where individuals contract Legionnaires’ disease can often be unexpected. In a study from researchers out of the University of Padua, it was found that two men contracted Legionnaires’ disease after using two separate car washes in Italy. And while the location may seem somewhat surprising, according to microbiologist Dr Tom Makin, a senior consultant at Legionella control in the UK, perhaps it shouldn’t be. Indeed Dr. Makin remarks that, “(C)ar washes are capable of generating the right sized aerosols that can be inhaled into the lungs where the Legionella bacteria cause infection, such as pneumonia.’

The study’s authors, in the report, write that, “(A)ny water source producing aerosols should be considered at risk for transmission of legionella bacteria, including car wash installations used by a large number of customers and where the is poor maintenance.” In regards to the two men who became ill with Legionnaires’ disease, the authors write that it “is unclear how the patients are recovering. Both of their cars have since been disinfected.” These findings were published in the journal Annals of Hygiene.

Now this report isn’t intended to generate fear and suspicion of all car washes everywhere so much as to try and raise awareness, particularly for individuals who run facilities where water is regularly sprayed and can be inhaled by consumers. Indeed many Legionnaires’ disease cases arise simply because individuals accidentally inhale tiny microscopic droplets of water which contain Legionella bacteria. The source can often be systems as simple as a shower or any other system where water is dispersed through a building’s ventilation system or remains stagnant like in a swimming pool.

As such, owners and operators should ensure the safest atmosphere for clients and residents as possible by being aware of any locations in their facility which could serve as a hot spot for generating Legionella bacteria and in addition, any potential uses of the water which might generate aerosols that can be inhaled by individuals.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 9:44 am
Feb
15
2018
Share Button

 

NSF International, a global public health organization that develops standards and tests and certifies products for the water, food, consumer goods and health sciences industries will be hosting the first ever Legionella Conference alongside the National Science Foundation. The conference, specifically entitled the Legionella Conference 2018 – Managing Legionella and Other Pathogens in Building Water Systems, will be occurring from May 9-11, 2018, in Baltimore, Maryland and represents the first time experts with various backgrounds including from academia, medicine, industry, public health and government will come together in order to discuss Legionella along with other related pathogens which can be found in water distribution systems.

Specifically, the conference will feature over 40 speakers and will involve discussing the latest monitoring, treatment and management approaches for preventing the creation and spread of Legionella bacteria. This includes topics such as biofilms, analytical techniques for the detection and perhaps more importantly quantification of Legionella bacteria, technologies for management of water distribution systems, techniques for the prevention of Legionella, along with federal and state guidelines, guidance and requirements on the subject.

According to Dave Purkiss, Vice President of the Global Water Division at NSF International, “Prevention of Legionnaires’ disease is a complex challenge that requires a team-based approach to be successful as no single industry or profession can solve this issue on its own. The goal of the Legionella Conference is to gather together all the different stakeholders and a diverse group of experts and thought leaders to share ideas and discuss ways of detecting, mitigating and preventing Legionella outbreaks,”. This, according to Mr. Purkiss, includes, “bringing together everyone involved in building operations – from building owners and managers to members of the engineering and HVAC communities, along with regulators, specifiers and government officials.”

Overall, this kind of opportunity for all invested and involved parties to speak and share ideas with one another is truly a benefit if done correctly. Yet perhaps the most encouraging element of the conference is that subjects appear to be focused a good deal on the outright prevention of Legionella bacteria in one’s building or potable water distribution system opposed to just on how one might respond to its presence. Indeed, Chris Boyd, General Manager of Building Water Health Programs at NSF International, puts the renewed focus in context by stating that, “(A)s an industry, we need to move from a reactive approach to a proactive model focused on prevention. It should no longer be acceptable to use increases in illness and death as the sentinel data that triggers investigations and response. We must begin responding to building water system risks before an outbreak occurs. With the right approach of hazard assessment, process controls, detection and corrective action, we can stop Legionnaires’ disease outbreaks before they occur and before they take lives.”

If the conference is truly able to encourage the kind of actions and thought processes which Mr. Boyd appears to be highlighting, then it would appear as though the conference will have been a success.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 11:13 am
Feb
14
2018
Share Button

This past weekend, it was reported by WKBW Buffalo that the Buffalo Public Schools were investigating a potential claim of Legionella being found at the Districts office. According to the report, the bacteria was found in a single water sample and furthermore, according to a spokesperson for the Buffalo Public Schools, it is unclear whether this finding is accurate.

Part of the reason for the lack of clarity is due to there not being any current standards for Legionella testing in buildings that are not health related. This is in addition to the fact that individuals associated with the Buffalo Public Schools, at the moment, have no information about the collection technique utilized by the custodial engineer who found the positive result and as such, have had additional questions regarding the accuracy of the testing.

According to the Buffalo Public Schools, local health officials have so far not received any complaints of Legionnaires’ disease or a Legionella related outbreak being associated with any specific building this year. Even so, out of precaution, the District building proceeded to raise the water temperature to 170 degrees with both the hot and cold water systems being flushed. Once the flushing is completed, a sampling protocol will be taken which should bring forward additional information regarding the situation in about 2 weeks.

Now from the news article, it sounds as though it is questionable whether there is, in fact, any Legionella bacterial infection in the Districts office to begin with. Yet the fact that this is so unclear is perhaps the most disconcerting part of this story. The fact that there are apparently no standards for Legionella testing in non health care related buildings is one which can and should be remedied immediately in order to help prevent another record year of Legionnaires’ disease across New York state.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 4:05 pm
Feb
13
2018
Share Button

Over the past few weeks, we have been following the Quincy, Illinois Veterans Home outbreak, one which has so far contributed to the death of 13 residents of the Veterans home while infecting dozens more. Now, as of this morning, officials have come forward and reported that in fact two additional confirmed cases of Legionnaires’ disease among the residents of the veterans’ home have been discovered.

Meanwhile the Illinois Department of Public Health made an announcement Monday evening that it had already removed faucets from residents’ rooms in the veteran’s home and were collecting water samples along with taking other additional steps to try and ensure the safety of the water. As it stands now, the Illinois Department of Public Health states that the two individuals involved with the newly confirmed cases are doing well.

This ongoing case is one which we will certainly continue to follow however it continues to be a somewhat surprising and unsettling incident mainly due to the continuation of cases being discovered. Indeed as a review, this outbreak largely stems back from the fall of 2015; the fact that even now, additional confirmed cases of Legionnaires’ disease are being discovered is not an encouraging sign. Ensuring that there are regular methods for monitoring the safety of the water and water distribution system within state facilities would help all parties involved and would ultimately help ensure the safety of every individual who interacts with these facilities.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 3:19 pm
Feb
12
2018
Share Button

In a previous post, we discussed the origins and very early beginnings of Legionnaires’ disease. In this post, we are hoping to slowly move through time and discuss some significant outbreaks and moments of Legionnaires’ disease history. Perhaps the first major outbreak after the 1976 Philadelphia incident would be with Stafford, England. In April 1985, approximately 175 people were admitted into the Kingsmead Stafford Hospital with pneumonia. Of these cases, around 28 individuals ended up dying with the origin of the infection being discovered to be the Stafford District Hospital.

About a decade later, in March 1999, the Bovenkarspel legionellosis outbreak occurred in the Netherlands. This was during the Westfriese Flora flower exhibit and involved 318 individuals contacting the illness and 32 people dying, making this incident the second-deadliest outbreak since the original 1976 outbreak. The largest outbreak, however, was in July 2001 in Murcia, Spain, where there were in fact over 800 suspected cases although luckily only six individuals passed away.

In September 2005, a nursing home in Canada experienced a large outbreak involving 127 residents at a nursing home. Within a single week, 21 of these residents would pass away with the source of the outbreak eventually being traced back to the cooling towers on the roof of the building. From there, there are a few cases which we have covered on this site over the past few years, including that of Legionella in Portugal, the outbreak in the housing development in the Bronx, as well as clearly the cases which continue to be discovered from the Flint water crisis and the Quincy, Illinois Veterans Home.

It is worth highlighting that in fact, a good portion of cases are not involved with outbreaks but are sporadic cases where an individual becomes infected. In addition, this review of various outbreaks is not and cannot be an exhaustive list of the full history of Legionnaires’ disease. Rather this review simply serves to ideally inform individuals of the long history of Legionnaires’ disease and how it can become present in various situations.

Jules Zacher is an attorney in Philadelphia who has tried Legionnaires’ disease cases across the U.S.  Please visit LegionnaireLawyer.com again for updates.

Posted by jzacher">jzacher at 4:45 pm