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Three important pieces of evidence have been revealed through the media so far about the outbreak at the Sands Resort. The owner did not have a permit for the spa, there was legionella bacteria in numerous places through out the hotel and not just the spa, and numerous people who have been associated with the hotel who have contracted the disease.  These facts are important for the following reasons. Permits are issued to make sure the spa holder complies with all regulatory requirements, e.g. the amount of chlorine in the spa. Finding legionella in two different water systems within the hotel is significant as it shows the prevalence of the bacteria in the hotel and the failure of its management to properly maintain it. Finally, someone dying from the disease, and at least 12 others contracting Legionnaires’ disease, shows just how virulent the strain is at the hotel and how much of a risk the owners placed the public under.

Jules Zacher has been retained by two persons who contend they have contracted Legionnaires disease at the Sands Resort in Hampton New Hampshire. An Order issued by the New Hampshire Department of Health and Human Services indicates that the bacteria that causes the disease has been found in a hot tub, water heater, outdoor shower hose,  and shower heads or sinks. The state Department of health has ordered the Sands Resort to notify all guests of the outbreak and to hire a consultant to remediate. Testing by the CDC  indicates the  legionella bacteria was found in shower heads or sink heads in three guest rooms. According to press reports, fourteen people  have contracted the disease in Hampton, nine of whom stayed at the Sands Resort. What is remarkable about this outbreak is the prevalence of the bacteria in so many water systems. Normally, the water supply for a spa is separate from the water supply for the showers and faucet, let alone the outdoor shower hose. Another aspect of this outbreak that is remarkable is the potency of the bacteria that caused the outbreak. Reportedly, one person has died and thirteen others have confirmed Legionnaires’ disease. For these reasons, this outbreak is distinctly different from most of the cases that Jules Zacher has worked on around the country.

New York City health officials first learned of a cluster of Legionnaires’ Disease cases in Washington Heights in early July. Since then, eight confirmed cases have more than doubled with the current total inching toward two dozen. The outbreak has already proven fatal with one death, and several confirmed cases still hospitalized.

Health Officials have indicated that the “Lower Washington Heights” outbreak stems from an infected cooling tower. The health department has conducted testing on over 20 cooling towers and have affirmed that drinking water is safe despite the rise in cases.

Early reports show that affected individuals are between the ages of 40-80. The first confirmed death was an individual over 50 with underlying health issues. The health department urges anyone in the area experiencing flu-like symptoms to seek medical treatment.

The outbreak has galvanized local politicians and organizers to demand more transparency and harsher penalties for building owners who fail cooling tower inspections. At present fines for failing a cooling tower inspection are $2,000 for first time offenders, and no more than $5,000 for repeat offenders. Owners whose cooling towers cause deadly outbreaks cannot be charged more then $10,000.

Cooling tower cases are known to be deadly because infected water may become aerosolized over large areas. An infected cooling tower in Pas-de-Calais, France, spread mist carrying Legionella bacteria over 3 miles from the tower. In that case, 18 out of the 86 laboratory confirmed cases were fatal.

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

The Southern Nevada Health District has launched an investigation into two reported cases of Legionnaire’s Disease connected to Harrah’s Laughlin Hotel and Casino.  The affected guests stayed at the hotel in November 2017 and March 2018. The normal incubation period for Legionnaire’s Disease is 2 to 10 days after exposure. The Health District is urging any guests who stayed at the hotel and exhibited symptoms of Legionnaire’s Disease as early as October 2017 to report their illness via survey at www.snhd.info/survey2018.

The Health Department conducted testing of Harrah’s at Laughlin confirming the presence of Legionella in various water samples collected on site. The hotel has since completed remediation including hyper chlorination to destroy the bacteria. The hotel has also created new procedures for water management to prevent future outbreaks.

Large plumbing systems, like those in hotels, are a common source of Legionella bacteria. Complex plumbing systems often house pipes with low airflow where water can stagnate. Stagnant water, without proper chlorination, encourages the growth of Legionella.

The outbreak at Harrah’s highlights the need for vigilance in preventing outbreaks. Researchers predict that about 20,000 people will contract Legionnaire’s disease this year. These incidences are frequently fatal.

Two confirmed cases of Legionnaire’s Disease connected to the same source in a 12-month period is considered an outbreak by the Center for Disease Control and Prevention. The recent Nevada outbreak follows an uptick in Legionnaire’s disease cases throughout the country. Recent outbreaks have occurred in Michigan and Hawaii, and Legionella was recently discovered in the Illinois Capitol Complex building.

Legionnaire’s Disease is a rare but serious illness contracted by inhaling water droplets from infected sources. Common sources of exposure include pools, hot tubs, large plumbing systems, and decorative water features. Symptoms of Legionnaire’s disease include shortness of breath, fever, cough, muscle aches, and headaches. Symptoms of Legionnaire’s disease should never be ignored.

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

In a previous post, we discussed an introduction to water system maintenance. More detailed resources, however, can clearly be of great assistance in situations like this. As such, the CDC actually provides a great page to review other significant guidelines and standards that may be applicable.

Resources on the page include everything from ASHRAE to the Cooling Tower Institute however what’s also of interest is that the page provides links to more healthcare-specific guidelines including those from the Centers for Medicare and Medicaid Services as well as, of course, the CDC’s own guidelines on both matters.

Here are some of the more standard and general guidelines the page includes and be sure to review the full page for more information;

• Legionellosis: Risk management for building water systems. ANSI/ASHRAE standard 188–2015. Atlanta, GA: ASHRAE; 2015.
• Minimizing the risk of legionellosis associated with building water systems. ASHRAE guideline 12-2000. Atlanta, GA: ASHRAE; 2000.
• Cooling Tower Institute. Legionellosis guideline: Best practices for control of Legionella.
• Centers for Disease Control and Prevention. Model aquatic health code.
• Centers for Disease Control and Prevention. Disinfection of hot tubs contaminated with Legionella

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

About a month ago, Transparency Market Research estimated that the global legionella testing market was valued at US$180 million in 2016. In addition, Transparency Market Research also estimated that the testing market would reach around US$398.7 million by 2025. Perhaps one of the biggest factors for future growth moving forward is that the incidence rate is increasing globally, particularly in developing regions. With this higher incidence of infectious diseases comes a steady increase in the demand for diagnostic kits and with it the global legionella testing market is expected to substantially grow.

As it stands now, the incidence rate of infectious diseases is relatively minimal within developed countries however transmission of diseases across regions through migration is increasing which will in turn fuel demand for diagnostic tests and kits across the globe. Increasing healthcare spending is also expected to increase demand for better legionella testing and diagnostic methods. The increase in the cost of treatment, lack of reimbursement policies for legionella testing within developing regions, and the side effects associated with legionella treatment are still restraining the growth of the legionella testing market.

The report also notes that the presence of several key players has led to a dominance of the region. In addition, the relatively supportive stance of many European countries such as the UK, France, and Germany towards legionella testing research has allowed the countries to gain an important place in the global legionella testing market. In regards to the Asia Pacific and Latin America, awareness about accessible healthcare has led to early diagnosis along with a rise in investments into the healthcare sector.

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

Assessing plumbing systems can sometime feel like a task which you are going to be inherently blind in. After all, regular testing is important however pinpointing the exact location of clusters can often be difficult. Luckily, there appears to be a new model which may help public health authorities assess water quality.

According to one of the co-authors and civil and environmental engineering professor Wen-Tso Liu, “(P)revious studies have relied on reproducing the conditions of a stagnant plumbing system within a lab setting,” however for this study, the team was “able to collect samples in a real-life situation.”

The team collected water samples from three University of Illinois dormitory buildings while they were closed during a school break. They then took samples from sink taps before the building closure, i.e. while the water was relatively fresh from the city supply, and again after the water stagnated within the interior plumbing for a week.

The lab results suggested that the post-stagnation samples closest to the actual taps actually contained the highest levels of bacteria. In addition, the team also found that bacteria concentrations decreased significantly as one moved away from a tap. Before moving forward, it is important to note that none of the samples contained cells concentrations that present a public health risk.

These results, according to Mr. Liu, “suggest that the increase in bacteria in the post-stagnation samples is a result of something occurring in the interior plumbing, not the outside city source, and in pipe segments closest to the taps,”.

On a more practical level, the model allows a useful tool for public health officials. According to Liu, “We only need two samples – one before stagnation and one after – and we can determine how extensive the microbe growth is inside in-premise pipes, and we can now do so without destroying property,”.

Another interesting finding was that bacterial concentrations are the highest within the first 100 milliliters of tap flow. As such, Mr. Liu recommends people run taps for a little after being away from home for awhile.

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

A Dallas senior living community was required to treat the water in two of their buildings after the country health department detected a case of Legionnaires’ disease. Mr Jeff Getek, Highland Spring Senior Living spokesman, has said that the retirement community was initially notified of the positive Legionnaires’ disease test by the Collin County Department of Health.

In addition, Mr. Getek also added that this was an “isolated situation,” with no other residents at the Far North Dallas community having reported symptoms. One of the residential buildings where the resident with Legionnaires lives will have water restriction until the health department gives approval. The two buildings will also have their hot water systems disinfected with a hyper-chlorination technique.

In the meantime, residents have been provided bottled water for cooking and drink and filters have been installed so residents can still shower, according to Mr. Getek.

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

Over the course of the past few weeks, we have covered cooling towers and how they can serve as potential breeding grounds for Legionella bacteria. This appears to be the case in Long Island as a school district there announced that Legionella bacteria was found in the cooling towers at three of their schools.

According to the Sachem Central School District at Holbrook’s superintendent, James Nolan, the bacteria was detected in the cooling towers at Seneca, Sequoya and East schools after conducting scheduled testing in order to be in compliance with New York state regulations.

Once discovered, the cooling towers were immediately shut off with the disinfection being scheduled at the moment. Once complete, there will be monitoring of the cooling towers including retesting. Superintendent Nolan also noted that there are currently no reports of Legionnaires’ disease from any of the faculty, visitors, students, and/or staff associated with the buildings.

This incident is on top of a separate incident, when the Smithtown Central School District stated that cooling towers at the Smithtown East and West high schools had tested positive for Legionella bacteria. Like this discovery, the cooling towers in this previous discovery were brought offline and decontaminated after being found.

Clearly finding Legionella bacteria at schools is not exactly comforting however this particular example may actually be evidence of the importance and positive impact routine testing can make. Indeed if the testing had never been done, then the disinfection would have never occurred and the bacteria would have simply continued to remain within the cooling towers, potentially causing individuals associated with the school to contract Legionnaires’ disease.

As such, what this particular story may also be highlighting is a separate question; how often should testing occur? With the use of various new technologies and even the potential for smart buildings to do the testing, it is imaginable to foresee testing becoming a far more regular aspect of water system management, a prospect which may end up making everyone that much safer.

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