Utah assisted living center dealing with Legionnaires’ disease

TAYLORSVILLE — An assisted living facility in Taylorsville implemented a no tap water policy after two of its residents contracted Legionnaires’ disease.

“The last month has been … very unsettling,” said Norma Soderborg Harris, a resident at Legacy House of Taylorsville.

On Thursday, signs hanging in rooms, bathrooms and above drinking fountains warned residents not to use the water. For more than a week the staff has provided water bottles for drinking, washing and bathing.

“We can’t shower,” Harris said. “We can’t do anything that uses water.”

Jeffrey D. Allred, Deseret News

Bottled water is placed on the dining room tables at Legacy House of Taylorsville on Friday, April 26, 2019. The facility has not been using the water as a precaution because two of their residents contracted Legionnaires’ disease.

The Salt Lake County Health Department retested the facility’s water Friday and recommended it continue to use bottled water. Final test results are expected next week.

However, efforts to remediate the bacteria have progressed enough for residents to start using designated shower rooms that have Legionella filters, said Nathan Cluff, the center’s executive director.

“We have showering residents again today safely and we’ll be calling in some extra staff to help us catch up on our shower schedule,” he said Friday.

Cluff said he has appreciated residents’ patience.

 “This is their home,” he said. “This is where they live.”

In early April, one of Legacy House’s 80 residents contracted Legionnaires’ disease. Last Tuesday, the Salt Lake County Health Department notified Cluff that a second resident had the disease and advised the facility to stop all use of tap water.

The disease comes from the bacterium Legionella, which is found in water but can only spread by breathing in mist that’s contaminated with the bacteria, according to the Centers for Disease Control and Prevention. Symptoms include coughing, shortness of breath and fever.

“It basically shuts down your lungs so you can’t breathe,” said Steve Madsen, owner of Legionella Specialties. Legacy House hired the company last week to eradicate the Legionella bacterium.

Jeffrey D. Allred, Deseret News

Megan Picklesiner places bottled water on the dining room tables at Legacy House of Taylorsville on Friday, April 26, 2019. The facility has not been using the water as a precaution because two of their residents contracted Legionnaires’ disease.

“We’re looking for spots where the water would be turned into aerosol, like a shower head, a fountain, a hot tub. It can even be a drinking fountain or a sink in a room,” Madsen said.

Seven other residents have been tested for the disease, but the results have come back negative.

“Out of an abundance of precaution we’re going to implement these water restrictions just to make sure we keep people safe until the problem’s been remediated,” Cluff said.

Until then, it’s an inconvenience that Harris is willing to live with.

“Hope it’s over with soon,” said Harris, who has warmed up water bottles in the microwave in order to take a shower.”

Sources: Source:Matt Rascon Published: April 26, 2019 12:31 pm

IDPH Investigating Legionella Possibly Associated with Chicago Hospital

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The Illinois Department of Public Health (IDPH) is investigating two cases of Legionnaires’ disease in patients possibly exposed at Mercy Hospital & Medical Center in Chicago, and a report of Legionella in the facility’s water system.  The investigation is currently limited to this facility; the general public is not at risk. IDPH, along with the Chicago Department of Public Health (CDPH), were onsite Thursday to evaluate the reported presence of Legionella in the hospital’s water system and collect environmental samples for laboratory testing. Both agencies continue to collect information and investigate. IDPH has provided the facility with information to give to patients and families about Legionella. Additionally, the facility is conducting active surveillance to identify other potential cases and to ensure appropriate testing and clinical management.  Mercy Hospital & Medical Center is working with a water management team, IDPH and CDPH to strengthen its water management practices. The facility has already put protective measures in place like flushing the water system, altering or replacing water fixtures, and placing filters on sinks.  More information about Legionnaires’ disease can be found on the IDPH website and the Centers for Disease Control and Prevention website.

 

Source: Posted by Editor on May 2, 2019

Cooling Water Treatment Program Control (Which Tests Should I Run?)

For any treatment regimen to be successful, the water quality must be monitored and maintained.   This is accomplished through a series of control tests carried out to ensure consistency and to prevent the development of waterside problems.  These are typically done by the facilities’ operating personnel, the WTSC (water treatment service company) or both.  It is an interesting development that some jurisdictions such as NYC now require cooling tower readings be taken three times per week, and bacteria tests weekly (to support Legionella prevention).

Testing frequency should be dependent upon system size, make-up water quality, stress level, and water system complexity.  Some testing needs to be carried out routinely (daily or multiple times per week) with supplemental testing done less frequently.  Routine basic testing should include as a minimum: confirmation of inhibitor reserves, presence of oxidizing biocide (halogen or ORP), and bleed control (conductivity).  Remaining program control activities should be incorporated into a system’s PM regimen at a slightly lower frequency (perhaps weekly).  These could include product inventory management, cooling tower inspections,  bacteria testing, and feed/control equipment maintenance inspections.  Beyond this, a higher plateau of testing at a reduced frequency can add important value and might incorporate material balance detection, metals concentrations, more involved microbiological screening, long-term corrosion studies or data trending.

The importance of effective water treatment cannot be understated.  Although effectiveness is wholly dependent upon implementation, active operator involvement and good data derived from accurate testing.

 

John D. Caloritis, CWT

Technical Director

The Metro Group, Inc.

Cooling Water Treatment Program Control (On-Line Monitoring Options)

Technology has improved all aspects of our existence.  Yes, it has even made its way into the unfamiliar terrain of water treatment.  The water treatment program for most cooling towers today is supported by the use of a “controller.”  These are special devices which collect input signals from either electronic probes or meters and (together with chemical feed pumps) are used to proportionally output/dose treatment chemicals, or to add biocides.  They also serve to regulate the required amount of bleed in order to control scale-forming tendencies.  In recent years however, controllers are getting even smarter.  Now these devices can measure and control the actual concentration of different products in the cooling water, start/stop pumps, detect inventory levels, measure temperature, and even confirm the rate of pumping when activated.  All of this can be accomplished over the internet to your PC or smartphone, putting control literally at one’s fingertips.  The partial trade-off for such an investment of course is to save time and man-hours, by reducing the time needed to administer a water treatment program and allow Facility Managers to aim their staff at more value-adding tasks.  Like all technology, there are a plethora of options to choose from – so be sure to connect with your CWT or WT Specialist for guidance and to make the best choice possible.  While helpful, these are not magic bullets that eliminate human participation.  It is still important to test water, confirm chemistry and get the chemicals from the drum into your towers!

 

John D. Caloritis, CWT

Technical Director

The Metro Group, Inc.

Legionnaires’ Disease Resulted in up to 49 Cases

New Hampshire health officials say last summer’s Legionnaires’ disease outbreak resulted in up to 49 confirmed, probable or suspected cases, and was linked to two deaths.

HAMPTON, N.H. (AP) — New Hampshire health officials say last summer’s Legionnaires’ disease outbreak resulted in up to 49 confirmed, probable or suspected cases, and was linked to two deaths.

The report released last week by the state Department of Health and Human Services, reiterates the state’s finding last year that the Sands Resort on Ashworth Avenue in Hampton was believed to be the primary source of the outbreak.

The report states the inadequate maintenance of the Sands Resort’s hot tub, as well as other conditions within the facility, such as low hot water temperatures, may have fostered the growth of Legionella bacteria.

Legionnaires’ disease is a bacterial pneumonia spread by inhaling droplets of contaminated water.

Source: 2019 The Associated Press.

Under Deposit Corrosion in Cooling Water

Under deposit corrosion in cooling systems have been one of the most prevalent problems in our industry.  It is also one of the least understood problems with field level engineers and clients alike.

Deposits occur in cooling systems due to colloidal sediment, environmental debris, scale, old corrosion deposits re-depositing on metal surfaces and of course biofilm.

When deposits form on metal surfaces, the corrosion inhibitors added to systems simply cannot do their job, since they cannot get to the metal surfaces they are supposed to protect.  Further, a dissimilar surface is set up on the metal providing the makings of a corrosion cell.

Scale formations provide a dissimilar surface and allow for the anode/cathode corrosion cell to start.  Further, scale insulated the metal surface from the corrosion inhibitors from protecting metal surfaces, most likely on the cathode surface.

Environmental debris such as garden variety dirt and organic material also presents a dissimilar metal surface allowing a corrosion cell to start, same as scale formations.  Environmental debris also provides a great start to both scale and biofilm formation.  Cooling system components most in danger from environmental debris are chillers with enhanced tubes.  Enhanced tubes are already prone to corrosion due to their rifled nature.  Cooling tower systems with enhanced tubes should all be filtered through a sand or multimedia filter to protect the rifling of these tubes.

Biofilm:  Causes the same dissimilar metal surfaces as noted above.  An added feature of microbiological corrosion is the acidic nature of the biofilm wastes.  pH’s of the underside of a biofilm has been measured as low as 2!

How to prevent under deposit corrosion?

 Make sure flow rates in all areas of your system are high enough to prevent sediment from settling on piping.

  1. Avoid intermittent flow conditions.
  2. Clean up all existing deposits.
    1. Descale fouled systems
    2. Remove old biofilm
    3. Physical remove old corrosion products where possible
  3. Consider an appropriate filter for your system.
  4. Keep your biocide program up and consider a bio dispersant, especially in chiller systems with enhanced tubes.

These deposits can be virtually eliminated from most systems.  Be sure to evaluate your systems to determine appropriate cures.

Keith Morgan/ CWT/ Upstate division

Legionella exposure sickens 2, causes closure of Waco YMCA

<i>Legionella</i> exposure sickens 2, causes closure of Waco YMCA

Health authorities in Waco, Texas, are investigating two cases of Legionnaires’ disease believed to be connected to the Waco Family YMCA.

Legionnaires’ disease is a severe type of pneumonia or lung infection caused by Legionella bacteria, which are contracted by inhaling microscopic water droplets in the form of mist or vapor.

“Exposure to the Legionella bacteria may have occurred at the Waco Family YMCA,” Rodney Martin, president and CEO of the YMCA of Central Texas, was quoted in a notice to visitors.

While the facility remains open to members and guests – after consultation with the Waco-McLennan County Public Health District (WMCPHD) – officials closed the whirlpool area, which is adjacent to an indoor pool.

“The Waco Family YMCA will remain open to members, guests and program participants as all other areas of the Y are accessible, including the pool, gym, fitness, group exercise spaces and more,” the organization said. “The restricted area will not affect the operations of the Y or its ability to serve its guests.”

The source of the bacteria has not been identified.

“We have been in contact with both the Waco-McLennan County Public Health District as well as the Center for Disease Control and are following their recommendations,” Martin wrote in an e-mail. “We have also contacted an outside expert to complete testing of the Y’s water.”

Health officials work backward
Kelly Craine, public information officer for the WMCPHD, said once the department was notified of the cases, its staff began “working backward” to discover a common denominator between the patients and pinpoint a possible source of their infection.

“The hot tub has been closed, and it is the only area that’s been closed,” she said. “Because of the mist, you always want to look at the hot tub as a possible suspect.”

YMCA visitors may need to take action
Health district officials said they believe the two patients contracted the Legionella between Feb. 4 and Feb. 21.

If you are a member, visitor or employee of the YMCA, located at 6800 Harvey Road, and you used the whirlpool, swam in the pool or traveled through the whirlpool or pool area this month and are feeling pneumonia- or flu-like symptoms, you should seek care from your health-care provider, according to Craine.

Source:https://www.legionnairesdiseasenews.com/category/legionnaires-disease/

Four Legionnaires’ disease cases linked to Crookston hotel

 

CROOKSTON, Minn. — The Minnesota Department of Health is investigating four cases of Legionnaires’ disease linked to a hotel in northwestern Minnesota.

Four people reported getting sick between Jan. 22 and Jan. 27 after staying at the Crookston Inn and Convention Center. None of them stayed in the hotel overnight and visited the hotel for different occasions, the Department of Health said in a news release.

Legionnaires’ disease is a type of pneumonia caused by Legionella bacteria usually spread to humans by inhalation of contaminated water mist — often from sources like plumbing systems, air duct moisture and hot tubs. It is not spread from one person to another under normal circumstances.

State health officials are working with the hotel to find out what may have caused the outbreak. Based on existing evidence and past outbreaks, the Department of Health currently believes the outbreak may have originated in the hotel’s spa, which is currently closed pending lab test results.

The hotel is notifying people who stayed there between Jan. 14 and Feb. 13 that they may have been exposed.

Symptoms of Legionnaires’ disease include fever, muscle aches, shortness of breath and loss of appetite.

Closed Loop Systems Treated With Glycol

Closed Loop Systems Treated With Glycol

A variety of heat transfer fluids are used to provide freeze protection for industrial equipment and HVAC closed-loop heating and cooling systems.  These fluids may be used in systems that operate anywhere between -60°F to 300°F.

Many heat transfer fluids are glycol-based, containing either ethylene glycol or propylene glycol.  Additives may include corrosion inhibitors (high concentrations of phosphate or nitrite), alkalinity stabilizers, and in some cases – fluorescent dyes – where leak detection is desired.

Operators of these closed-loop systems can often experience long-term and difficult-to-reverse problems resulting from misapplication of these glycol-based solutions.  Glycol degradation and system deterioration can result if the wrong glycol is used or if low concentrations are present.  Problems associated with glycol degradation are:  runaway corrosion, persistent microbiological fouling and deposition.

 Terminology:

Ethylene Glycol:  Most common for general industrial use,  Can be toxic.  Lowe viscosity (less energy required for pumping) and better heat transfer properties than propylene glycol.

Propylene Glycol:  Used in quick-freezing of wrapped foods and in hospitals where there is potential for contamination of potable water systems.  More environmentally friendly than ethylene glycol because of its lower toxicity.  Higher viscosity (less energy efficient) than ethylene glycol.

 Automotive Antifreeze:  Not suitable for HVAC and industrial applications because they contain silicate corrosion inhibitors which may cause fouling and pump seal failures.

Inhibited vs. Uninhibited Glycol:  Only inhibited glycols are recommended for use in closed systems.  Manufacturers and water treatment professionals add inhibitors (phosphate or nitrite and alkalinity) to minimize corrosion and to prevent glycol degradation.  Over time, uninhibited glycol will form acids, making the solution very corrosive (4 ½ times more corrosive than plain water).

 Glycol Stability:  When properly maintained, inhibited glycol solutions can last 20 years or more.  Uninhibited glycol solutions can be expected to break down in 2-3 years.

 Refractometer:  Measures percent glycol.  Accurate and portable method for both ethylene and propylene glycol.

Glycol quality should be monitored annually.  This testing is done to detect any symptoms of glycol degradation – such as:

  • pH depression (as low as 5.0) caused by production of organic acids
  • Formation of formaldehyde, ethanol, methanol and CO2.
  • Presence of a strong septic odor
  • Severe corrosion of mild steel and copper components (resulting soluble copper will cause galvanic corrosion on steel).
  • MB infestation particularly in stagnant areas.

Methods For Handling Degraded Glycol:  Based on manufacturers’ recommendations, the system should be drained, thoroughly flushed with untreated water, and recharged with inhibited glycol.  Salvaging degraded glycol is not recommended.  If microbiological activity is detected, biocides can be used after the flushing process and PRIOR to recharging with fresh glycol.

 Disposal Regulations: Ethylene glycol is classified as an extremely hazardous substance.  The POTW or wastewater treatment plant receiving the discharge should be contacted and written permission should be obtained before discharging water containing ethylene glycol.  Possible alternatives are:  disposal through a waste contactor or recycling through a solvent recovery vendor.

There are no requirements, as defined by SARA, for disposal of propylene glycol; however, you should check with the local municipality prior to disposal.

Recommended Treatment Practices:

 Maintain a minimum concentration of 30% inhibited glycol.  This concentration will ensure adequate corrosion and biological protection.  Supplemental treatment is not required.

  1. Monitor yearly by having the glycol provider test the glycol integrity and inhibitor concentration.  This testing will allow for any corrective actions to be initiated.
  2. If uninhibited glycol is used, you can apply a corrosion inhibited such as Metro DuBoth NB35 at recommended treatment levels.  Also, maintain close vigilance on pH, microbiological activity, iron and copper concentrations and corrosion rates.
  3. Manufacturers specify water impurities be limited to these maximum values:
    1. Chlorides……………..25 ppm
    2. Sulfates……………….25 ppm
    3. Calcium………………50 ppm
    4. Magnesium……………50 ppm

Pre-diluted glycol solutions can be purchased from manufacturers – if acceptable water quality is not available.

  1. Monitor yearly by having the glycol provider test the glycol integrity and inhibitor concentration.  This testing will allow for any corrective actions to be initiated.
  2. If uninhibited glycol is used, you can apply a corrosion inhibited such as Metro DuBoth NB35 at recommended treatment levels.  Also, maintain close vigilance on pH, microbiological activity, iron and copper concentrations and corrosion rates.
  3. Manufacturers specify water impurities be limited to these maximum values:
    1. Chlorides……………..25 ppm
    2. Sulfates……………….25 ppm
    3. Calcium………………50 ppm
    4. Magnesium……………50 ppm

Written by: Mark Botsford

First 2019 outbreak results in death in Pennsylvania By News Services 


The year’s first Legionnaires’ disease outbreak has claimed a life after two patients at a Richlandtown, Pennsylvania, care center were confirmed with the deadly respiratory illness, according to WFMZ-TV.

The two individuals, who came to Phoebe Richland Health Care Center from two area hospitals, were diagnosed on Jan. 2 and Jan. 5. The patient who passed away died due to multiple contributing health factors, according to a statement released by Phoebe Richland officials. The other resident is in stable condition and undergoing treatment.

No information was provided on either patient.

“The health and well-being of our residents and staff are Phoebe’s top priorities,” the Phoebe Richland statement read. “In the last few days, two residents who were recently admitted to Phoebe Richland Health Care Center were diagnosed with Legionnaires’ disease.”

Legionnaires’ disease is a severe form of pneumonia — that is, lung inflammation usually caused by infection – according to the Mayo Clinic. The disease is caused by Legionella bacteria, and most people are infected by inhaling the bacteria in the form of microscopic water droplets, usually in the form of mist or vapor.

Legionnaires’ disease is not contagious – that is, it cannot be passed from person to person. If it is caught early enough, it can be treated with antibiotics.

Phoebe Richland is working with the Bucks County Health Department to identify whether the facility is the possible source of the Legionella that infected the residents.

“We have engaged an outside vendor to conduct specialized water testing beyond our annual testing, which is performed in accordance to our water-management policies,” the statement read. “In the event that our campus is determined to be the source of the Legionella bacteria, we are taking measures to locate and eliminate any potential source of Legionella.”

Phoebe Richland is located at 108 S. Main Street in Richlandtown, about 50 miles north of Philadelphia. The facility offers long-term care, short-term rehab, memory support services, and respite care.

A mild form of Legionnaires’ disease — known as Pontiac fever — can produce signs and symptoms including a fever, chills, headaches and muscle pains. Pontiac fever, however, doesn’t infect the lungs, and symptoms usually manifest within two to five days.