Jun
24
2016
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Recent guests at a North Carolina hotel have contracted Legionnaires’ disease and hotel managers are taking steps to control exposure.

Three individuals who stayed at the Meadowbrook Inn and Suites in the mountain resort town of Blowing Rock, NC have tested positive for Legionnaires’ disease. All of the affected guests had stayed at the hotel within 10 days before the onset of their symptoms, and all have undergone treatment and are recovering.

The Meadowbrook Inn has a comprehensive water management system in place, including regular testing of water features such as pools and hot tubs. When the disease was reported, managers informed the Department of Health and performed in-house tests to find the source of the disease. These tests were negative, but samples have now been sent to a lab. No source of the bacteria has yet been found. Managers are extending the scope of their investigation to sources outside the hotel, including water infrastructure in the community. The hotel has encouraged all guests who stayed at the hotel in the last three months and developed respiratory symptoms to contact them.

More information, including the hotline that the hotel has set up for those with questions, is available here.

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 9:41 am
Jun
23
2016
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allgenhospital

Testing last week revealed that the water system of a hospital in Pittsburgh, PA has been contaminated with Legionella bacteria.

Allegheny General Hospital conducted tests for Legionella in their water supply after a cancer patient tested positive for Legionnaires’ disease. The patient had been discharged on May 20 for respiratory problems but had been readmitted four days later after a relapse; a urine test revealed that the patient had been infected with Legionella bacteria. Though hospital officials believe that the patient had been exposed to the bacteria outside of the hospital, they tested the hospital’s water supply and discovered Legionella in two of their water tanks.

Testing has yet to reveal whether the specific strain of Legionella that the patient contracted is the same as the one present in the water tanks. Still, the hospital has taken preventative measures against the spread of the disease and has notified the Pennsylvania Department of Health. The affected water tanks, one of which services several floors of the main inpatient facility, have been shut off. Hospital officials have also instructed patients to drink bottled water and to avoid using the showers. Maintenance crews have treated the water tanks with ionization and officials expect the hospital to return to full function soon.

The Allegheny General Hospital conducts regular testing for Legionella, and their quick response to the discovery of bacteria demonstrates the potential benefits of regular, mandatory testing at large-scale facilities. This testing is especially beneficial in hospitals, as individuals with compromised immune systems are at a higher risk of contracting Legionnaires’ disease.

Read more on this story here.

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
Jun
22
2016
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Senior living facilities in Maryland and New York have reported the presence of Legionella bacteria, leading in some cases to Legionnaires’ Disease.

A resident of The Commons, a senior living facility in Auburn, NY, tested positive for Legionnaires’ disease in early June. Officials conducted tests and found that the facility’s drinking water was contaminated with the Legionella bacteria. The facility has taken preventative measures to control the bacteria, following guidelines established by the New York Health Department. No new cases of Legionnaires’ disease have been reported.

The Lutheran Village in Elliot City, MD has reported that two of their residents have contracted Legionnaires’ disease this year. The senior living facility opened in April. Following the second case, officials shut off water to residents; though the source of the disease remains unknown, they are planning to treat their water system with chlorine on Sunday.

The Nottingham, a senior living facility in Jamesville, NY, has also restricted its residents’ water use following tests that revealed the presence of Legionella bacteria in the water system. No cases of Legionnaires’ disease have been reported, but the hospital has advised patients to use bottled water and to use only showers that have been fitted with a filter.

More information is available here.

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

Posted by jzacher">jzacher at 10:50 am
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Jun
21
2016
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The NYC Department of Health has announced a comprehensive plan to reduce the risk of Legionnaires’ disease in New York City. Following the 2015 outbreaks in the South Bronx , Mayor de Blasio passed some of the nation’s toughest regulations on cooling towers. The city is now investing more than $7 million to enforce these regulations.

Local Law 77, which focuses on preventative maintenance of the city’s 5,544 cooling towers, took effect on May 9, 2016. This law requires that cooling towers be registered with the city and that all cooling towers have plans in place to reduce outbreaks of Legionnaires’ disease. In addition, all towers must now be tested for the Legionella bacteria every 90 days and report their results to the Department of Health.

Routine inspections as well as random, unannounced spot inspections will take place across the city; the inspection schedule prioritizes towers in the South and East Bronx, where the most recent outbreaks took place. Inspections will also focus on high-poverty areas, where infrastructure is often older and residents are as a greater risk of susceptibility to the disease.

The Department of Health has also developed procedures to communicate with residents of affected areas. During suspected outbreaks, the Department will notify residents, staff, landlords, and visitors of affected buildings and provide instructions on how to handle the disease.

The plan also increases collaboration between agencies by creating a database of cooling towers that will be shared with the Department of Buildings. Through this collaboration, the Department of Health and the Department of Buildings will be able to track unregistered cooling towers, review monthly reports on tower inspections, and report violations to the public. Violators will face stiff penalties.

To enforce these regulations, the city has invested over $7 million into staff and inspection teams. The number of inspection teams has increased and staffers from other agencies have been trained and will be available to respond to outbreaks of Legionnaires’ disease over the summer. The city has also funded five new lab positions and has made new methods of testing possible.In addition, test results will now be recorded electronically, which will streamline the reporting process.

These preventative regulations are among the toughest in the nation, and response from local officials and and legislators has been positive. The city’s investment comes just in time for summer, when incidence of Legionella infection peaks, and its focus on areas at high risk of infection is commendable. Regulations on cooling towers are a much-needed step toward a comprehensive legislative response to Legionnaires’ disease.

Read more about these regulations, and community response, here.

 

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

Posted by jzacher">jzacher at 10:51 am
Jun
20
2016
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wesleyhospital

 

New water risk management legislation has been passed in Queensland, Australia in the aftermath of a string of outbreaks of Legionnaires’ disease at hospitals.

A string of illnesses and deaths in hospitals has raised awareness of the risks of Legionnaires’ disease in Queensland. A 2013 outbreak of Legionnaires’ disease at The Wesley Hospital, a private hospital in Brisbane, led to the tragic death of one cancer patient and placed another in intensive care. The bacteria was found in the hospital’s hot water system. This outbreak prompted a string of tests and responses, and the hospital put intensified water-testing measures in place at their facility. Despite these measures, in January 2016 another patient at Wesley tested positive for the disease. The bacteria was found to have originated in an ice machine and an investigation was launched. Another hospital, the Hervey Bay Hospital, suffered an outbreak of Legionnaires’ disease in April of 2015. One patient died and several were sickened by the bacteria, which authorities say was growing inside plumbing fixtures and pipes.

Spurred to action by these deaths, Queensland has now passed legislation requiring hospitals, private health facilities, and public assisted living facilities to undergo strict water tests and to have water risk management plans in place. Periodic testing for Legionnaires’ disease must be reported to the Queensland Health’s Public Health Unit, and any facility that tests positive for the disease must appoint a health risk manager. Facilities that fail to comply with this legislation face a hefty fine. The legislation will come into effect soon.

Hospitals and assisted-living facilities are a particular concern for those fighting the spread of Legionnaires’ disease for several reasons. Large buildings with complex water systems allow the bacteria many opportunities to grow and spread, and the source of an outbreak can be difficult to pinpoint. In the absence of frequent testing, bacteria can appear anywhere from showers and pools to drinking fountains and ice machines. In addition, patients and the elderly are groups at highest risk for Legionnaires’ disease, which is especially deadly for those with compromised immune systems. Laws like those recently passed in Queensland are an essential step toward controlling the disease.

To read more about this story, click here or here.

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

Posted by jzacher">jzacher at 11:36 am
Jun
15
2016
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plumbing-sink

Image via http://www.unclejohnshandymanservice.com

     An article from the Wall Street Journal elaborates on some investigations into Legionnaires’ disease outbreaks done by the Center for Disease Control (CDC) in the past 15 years. The results showed that the vast majority of outbreaks were caused by negligence on the part of maintenance employees who did not maintain biocides effectively, repair or change equipment on schedule, or did not adequately maintain the plumbing. These look like easily fixable problems, but it’s more complicated than it seems.

The guidelines for preventing Legionella are not standards, and there are virtually no laws requiring specific Legionella prevention. This means that companies can have a variety of different maintenance practices, and many of them may not include steps to prevent the proliferation of Legionella. Some companies may not have the money to afford a maintenance company whose services include Legionella prevention. This is where problems arise. Only New York has implemented a law regarding the cleaning of cooling towers, and it was only enacted in response to a massive outbreak in the Bronx which infected more than 120 people and killed 12. Clearly more steps need to be taken to ensure than an outbreak like the Bronx outbreak does not occur again.

 

 

 

Posted by jzacher">jzacher at 3:11 pm
Jun
14
2016
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The WorldMark Kapaa Shore Resort, a Wyndham Resorts hotel, was closed this week after two cases of Legionnaires’ disease were confirmed by the health department.

The closure was done as a precaution and guests were moved to nearby hotels.

Wyndham Resorts released a statement saying:

“Recently, the Kapaa Shore Resort received confirmation that the presence of Legionella bacteria was found in two units at the resort,” the resort said, in an emailed statement.

“As a precautionary measure, we are temporarily closing the resort and relocating owners and guests to nearby properties so that we can properly remediate and get the resort back in operation quickly.”

The two Legionnaires’ disease patients associated with the resort recovered from their illnesses after returning to their home states.  A third potential case is still being investigated.

To read more about this story, please click here.

Posted by jzacher">jzacher at 5:29 pm
Jun
10
2016
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The CDC recently released news tools for Legionnaires’ disease investigations.  The CDC online toolkit includes: Environmental Investigation Tools, Laboratory Investigation Tools, and a section to request CDC assistance.  Example questionnaires, fact sheets, protocols, and educational videos to assist with outbreak investigations are also provided as part of the toolkit.

To view this toolkit, please visit the CDC website http://www.cdc.gov/legionella/health-depts/inv-tools-cluster/index.html 

 

Posted by jzacher">jzacher at 2:14 pm
May
31
2016
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A resident at The Commons on St. Anthony, a healthcare facility in Auburn, NY, has tested positive for Legionnaires’ disease.  Testing was conducted at the facility following this finding and low levels of Legionella were detected in the water system.

No other residents have tested positive for Legionella, but the facility is following recommendations provided by the health department.

Water restrictions were put in place until water tests were shown to be normal.

To read more about this story, please click here.

Posted by jzacher">jzacher at 6:02 pm
May
02
2016
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bacteriophage

Photo courtesy of Shutterstock

Treatment of Legionnaires’ disease typically involves a series of antibiotics that seek out and kill the present bacteria in a person’s system. This type of treatment is generally very effective, but as discussed in previous posts on this blog, there is concern about overuse of antibiotics leading to drug-resistant bacteria. However, a new potential treatment method has emerged as a secondary effect of specific cancer drugs.

BH3-mimetic drugs target and switch-off BCL-XL proteins inside cells. This helps with cancer treatment because it prevents the cancer cells from surviving apoptosis – programmed cell death. Coincidentally, the BCL-XL protein is a very important part of the Legionella bacteria and is dubbed the “survival protein” in an article from LaboratoryNews. BCL-XL is the only protein that has the function of keeping the bacteria alive, so when it is switched off by BH3-mimetic drugs, the bacteria in the macrophages and lung epithelial cells die. Macrophages and other cells that do not contain the BCL-XL protein are not affected by the drugs, so this successfully destroys the bacteria without damaging the hosts normal cells.

Of course cancer medications should not be given to someone who is suffering only from Legionnaires’ disease, so there is some work that needs to be done to isolate the specific compounds. However, any breakthrough in the medical field (even accidental ones) are generally considered a success and can lead to the development of more effective medicine.

Posted by jzacher">jzacher at 5:47 pm