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.

Legionella bacteria found at University Hospital of Brooklyn

 PROSPECT-LEFFERTS GARDENS –

A bacteria known to cause Legionnaires’ disease was found at the University Hospital of Brooklyn, according to multiple tests.

The Prospect Lefferts Garden hospital, which is part of the SUNY Downstate campus, says that testing revealed a high percentage of legionella pneumophila in the building’s water.

The hospital announced that staff and patients will only use bottled water for drinking and brushing their teeth.

They added in a statement, “While we understand that these actions may cause concern, we want to assure the UHB community that we are taking all appropriate actions to address the matter. It’s important to stress that Legionnaires’ disease is not spread from person-to-person.”

SUNY Downstate also released a statement on Friday announcing water restrictions for patients and staff.

People who are 50 and older, smokers, those with chronic lung diseases or weakened immune systems are most at risk of getting Legionnaires’ disease.

The hospital says it is open and safe for patients, staff and visitors.

Source: News 12

Alexandria’s Alomere Health investigating outbreak

By News Services on February 2nd, 2019

Alomere Health is a general medical and surgical hospital in Alexandria, MN.

to file a lawsuit. Call (612) 337-6126 for a free consultation.


Two cases of Legionnaires’ disease since November have prompted officials at Alomere Health hospital in Alexandria, Minnesota, to work with the Minnesota Department of Health (MDH) to try and identify possible sources of Legionellabacteria.

The first patient was sickened at Alomere Health, located at 111 17th Avenue East, in late November; that patient recovered. The most recent patient infected with the sometimes-deadly respiratory illness developed Legionnaires’ disease symptoms in late January and remains hospitalized.

Legionnaires’ disease is a severe type of pneumonia or lung infection contracted by inhaling microscopic water droplets in the form of mist or vapor containing Legionella bacteria (Legionella pneumophila). According to the Centers for Disease Control and Prevention (CDC), an estimated 25,000 cases of pneumonia due to Legionella occur in the United States yearly. However, only 5,000 cases are reported because of the disease’s nonspecific signs and symptoms.

According to the MDH, Minnesota had more than 150 cases reported around the state in 2018.

Consultant hired
Alomere Health has contracted an independent environmental consultant to “conduct a complete assessment and testing of the facility’s water system and address potential sources for the bacteria,” according to an MDH news release.

Additionally, the hospital has implemented the following recommendations from the MDH in an attempt to minimize the risk of exposure to patients and employees:

  • Restricted the use of showers; patients can use bathtubs without using water jets.
  • Restricted the use of hand sprayers.
  • Bottled water must be used by patients on medical/surgical and ICU units for drinking, brushing teeth, and other oral care.

The MDH stated that the “recommendations only apply to patients and employees at Alomere Health. Alexandria’s municipal water supply meets water-quality standards.”

Hospital staff also has begun notifying patients and families about the outbreak, as well as informing them of the steps being taken by the hospital.

The MDH is contacting area health-care providers to be on alert for additional patients with possible Legionnaires symptoms.

Watch for symptoms
If you are a patient, employee or visitor to Alomere Health and you are experiencing pneumonia- or flu-like symptoms, you should seek care from your health-care provider out of an abundance of caution. Those symptoms include:

If you have any questions, concerns or are experiencing any of the above symptoms, contact Alomere Health at 320-762-6019 and ask for Bonnie Freudenberg, the hospital’s director of quality, or Margaret Kalina, VP of patient-care services. In addition, you can call the MDH at 651-201-5414.

More on Legionnaires’ disease

A 2015 study by the CDC stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Most people exposed to Legionella do not get sick, but people 50 years old and older – especially those who smoke or have chronic lung conditions – are at a higher risk of developing Legionnaires’ disease.

Other people more susceptible to infection include:

  • recipients of organ transplants
  • individuals who are on specific drug protocols (corticosteroids, to name one)
  • heavy drinkers of alcoholic beverages.

This list also includes anyone with an immune system weakened by:

  • frequent and recurrent pneumonia, bronchitis, sinus infections, ear infections, meningitis, or skin infections
  • organ inflammation and infection
  • blood disorders, such as low platelet counts or anemia
  • digestive problems, such as cramping, appetite loss, diarrhea, and nausea
  • delayed growth and development.

After Legionnaires’ disease has been diagnosed, hospitalization is often necessary. In the most severe cases, complications can occur; they include:

  • respiratory failure: caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
  • septic shock: This can occur when Legionella produce toxins that enter the bloodstream and cause a drop in blood pressure, leading to the loss of adequate blood supply to the organs.
  • kidney failure: those same Legionella toxins can damage the kidneys’ ability to eliminate waste from the blood, resulting in kidney failure.
  • endocarditis: an infection of the inner lining of the heart that can affect the strength of the organ to maintain adequate blood flow through the body.
  • pericarditis: swelling of the pericardium, which is the primary membrane around the heart. This can also affect the ability of the heart to circulate blood throughout the body.

Erosion Corrosion

There are multiple factors which can contribute to corrosion within a closed loop system. For this blog we will concentrate on erosion corrosion. This is caused by particulate in the system sand blasting the piping, causing leaks typically in elbows and threaded sections of the piping. This can also be damaging to small areas of newer high efficiency boilers. There are many factors that can lead to this particulate, including improper cleaning of a hydronic system after installation, improper chemistry used in the system, or a complete lack of chemistry. Routine checks of system iron and copper (both dissolved and total) should be performed to monitor against this. The American Boiler Manufacturer Association sets limits of less than one ppm of iron and less than 1/2 ppm of copper. If a higher level of these metals is found within the system from routine testing, your water treatment partner may recommend flushing the system to remove the debris or installing a filter to clean up the undissolved iron/copper and protect the rest of the system.

Legionnaire’s disease bacteria found in water supply at Hastings hospital

This story has been updated on 12/28/2018.

Recent testing of the water supply at Spectrum Health Pennock Hospital in Hastings found positive results for Legionella bacteria.

Legionella is the bacteria that causes Legionnaire’s disease.

The results were reported to the Barry-Eaton District Health Department on Wednesday.

The testing was done after a second case of Legionnaire’s disease in patients at the hospital was identified in November.

It’s “unknown if the two recent cases at the hospital are directly connected to the Legionella found in the water supply,” according to the release. The hospital is providing alternative water sources, using water filtration and testing additional patients for Legionnaire’s disease.

Spectrum Health Pennock’s water supply comes from a private water plumbing system. The health department does not believe the city of Hastings’ municipal water supply is affected. According to a press release, the city’s water system is receiving its “(r)outine daily required bacteriological sampling.” Nothing of concern has been found currently.

Legionnaire’s disease is a kind of lung infection. Symptoms include cough, shortness of breath, muscle aches, headache and fever. It is treatable with antibiotics and cannot be spread from person to person.

The infection can happen when a person breathes in water droplets containing the bacteria.

The health department is working with Spectrum Health Pennock to monitor the water supply and protect patients.

Patients or visitors of the hospital concerned about Legionella can call (844) 689-2875 or (616) 391-9986.

More information about Legionnaire’s disease can be found on the CDC’s website at www.cdc.gov/legionella/fastfacts.html.

2017 CDC report Update

By  on 

A 2017 report from the Centers for Disease Control and Prevention (CDC) said Legionnaires’ disease is widespread in long-term care facilities – and 75 percent of cases could be prevented with better water management.

The most recent example of this is happening currently at University Hospital in Madison, Wisconsin, where an outbreak of Legionnaires’ disease has resulted in 14 patients being sickened – and three of them dying. The primary suspect in the outbreak: a change in the hospital’s hot-water system, which was adjusted to save water.

“The flow was altered in the system,” Nasia Safdar, medical director of infection control for UW Health, said on Nov. 28, when the outbreak was first reported. “So, instead of being at a consistent high flow, it was altered to be more flexible to be on demand.”

Data from 2015 cases
The 2017 CDC report, using data from 2015, showed that Legionnaires’ disease kills 10 percent of those who are diagnosed from the general population. In a long-term care facility, such as University Hospital, that rate increases to 25 percent.

There were 2,809 cases of Legionnaires’ disease confirmed in the U.S. in 2015, including 85 (3 percent) considered “definite” and 468 (17 percent) considered “possible” health-care-associated cases. The study used information only from long-term-care patients, or anyone who had been in a health-care facility for 10 days or longer.

“In health-care facilities, people are more vulnerable and more likely to get sick if they are exposed to the pathogen,” Anne Schuchat, then-acting director of the CDC, said during a 2017 media telebriefing on the report. “Everything from shower heads, to decorative fountains, to respiratory equipment, could house Legionella.”

Patients vulnerable
The three patients who died at University Hospital all had “serious, life-limiting health conditions,” UW Health officials said, underscoring the vulnerability of bed-ridden hospital patients.

UW Health officials reported that test results from three patients showed the strain of Legionella was identical to that found in University Hospital’s water system. Samples were not taken from the other 11 patients.

Chlorine successful
University Hospital officials said the water system had been flushed with high levels of chlorine to eliminate Legionella, and the procedure has worked. “Testing completed so far continues to show the expected reduction in the bacteria,” officials said in a statement. “UW Health will continue intensive monitoring of its water system to ensure patient safety.”

University Hospital officials also said they have been working with the CDC, and a review and analysis from the federal organization are expected in about three months.

A disease on the rise
Legionnaires’ disease is “an emerging disease in the sense that the number of recorded cases of Legionnaires in the United States continues to increase,” according to Laura Cooley from the Respiratory Diseases Branch of the CDC.

Cooley said she believes that increase is due to the susceptibility of the general population, as well as the likelihood that there is more Legionella in the environment since warmer temperatures are creating the optimal conditions for bacterial growth.

Seventeen of the 18 warmest years since modern record-keeping began have happened since 2001, according to both the National Aeronautics and Space Administration (NASA) and the National Oceanic and Atmospheric Administration (NOAA). The four warmest years all have occurred since 2014, with 2017 being the warmest non-El Niño year ever.

This year is shaping up to be the fourth-hottest year on record. The only years hotter were 2015, 2016 and 2017.

Legionnaires information

The CDC estimates that there are about 25,000 yearly cases in the United States, although only 5,000 are reported because of the disease’s nonspecific symptoms.

Those symptoms, which develop from two to 10 days after exposure to Legionella, usually start with:

  • fever, which can reach 104 degrees Fahrenheit or higher
  • severe headaches
  • muscle pains
  • chills.

By the second or third day, symptoms can worsen and include:

  • dyspnea (shortness of breath)
  • pleuritic chest pain (pleurisy), which occurs when the lining of the lungs is inflamed
  • cough, which can bring up mucus or blood
  • gastrointestinal symptoms, such as nausea, diarrhea, and vomiting
  • mental agitation.

Legionella sources
Legionella bacteria, which cause Legionnaires’ disease, are contracted by inhaling microscopic water droplets (vapor or mist). The bacteria grow best in warm water, and they are found most commonly in human-made environments.

In addition to large water systems like those in health-care facilities, Legionella can be found in:

  • large plumbing systems
  • hot-water tanks and heaters
  • physical-therapy equipment
  • bathroom showers and faucets
  • decorative fountains
  • swimming pools, whirlpools, and hot tubs
  • mist machines, like those in the produce sections of grocery stores
  • hand-held sprayers
  • cooling towers of air conditioning systems.

 

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

University of Wisconsin outbreak hits 11

Six new illnesses have been identified in the Legionnaires’ disease outbreak at University Hospital in Madison, raising the case count to 11, according to UW Health officials. The outbreak was first reported on Nov. 28 when four cases of the deadly respiratory illness were confirmed. A fifth case and a fatality were announced the next day.
The new illnesses were not unexpected as officials expected the count to grow, due to the exposure window to Legionella, the bacteria that causes Legionnaires’ disease. Symptoms can present up to 14 days after exposure, and other patients could present symptoms up until Dec. 12, according to a hospital press release.
Four of the patients remain hospitalized, while six have been discharged or treated as outpatients. Their conditions are considered stable, and an antibiotic treatment protocol is working as expected.
One patient, who had been hospitalized with multiple, serious health problems, died last week. At the time of that pronouncement, Lisa Brunette, UW Health direction of media relations, said the “death was not unexpected.”
Hyperchlorination of the hospital’s hot water system has been successful in the reducing the bacteria, but monitoring at multiple sites within University Hospital is ongoing.
“We are confident the hyperchlorination worked as expected,” said John Marx, UW Health senior infection control practice specialist. “An aggressive program of monitoring and screening is in place to ensure the system is functioning as designed. Our commitment to the safety of our patients is unwavering.”
UW Health is working with the Wisconsin Division of Public Health (DPH) on mitigation and testing efforts and have extended an invitation to the Centers for Disease Control and Prevention (CDC), asking them to act as an additional expert resource.
Incubation period still active
If you are a patient, visitor or employee of University Hospital and are feeling pneumonia- or flu-like symptoms, you should see your health-care provider out of an abundance of caution.
By News Services on December 8, 2018

Legionella discovered at McHenry Villa

“Legionnaires lawyer Elliot Olsen has regained millions of dollars for clients harmed by Legionnaires’ disease. If you or a family member contracted Legionnaires’ disease at McHenry Villa, you might have cause to file a lawsuit. Call (612) 337-6126 for a free consultation.
An Illinois Department of Public Health (IDPH) investigation uncovered Legionellabacteria and structural issues with the plumbing system at the McHenry Villa Senior Living facility in McHenry. Three residents were sickened with Legionnaires’ disease in early November, and one of them – former McHenry city mayor Donald P. Doherty – died Nov. 21.
The Legionnaires’ disease outbreak was the third to affect McHenry County in 2018.
The IDPH sent a notice of violation to McHenry Villa regarding the sanitary hazard in its plumbing system.
“Our concern is the health and safety of the McHenry Villa residents,” IDPH director Nirav D. Shah said in a press release. “Because this community is similar to an independently operated apartment complex, implementation of water-use restrictions is not feasible, and correction of the violations may not be possible while residents are occupying the building. IDPH is notifying McHenry Villa of the violations so the owners can remediate the plumbing system and provide a healthy living community for residents and staff.”
McHenry Villa executive director Noreen Zaio said that after consulting with IDPH, McHenry County officials and McHenry Villa’s water-quality management company, evacuation of residents was not necessary.
“We take this situation very seriously,” Zaio said. “Upon learning of the test results, McHenry Villa took immediate action and is implementing a remediation plan as directed by the state.”
In a letter to residents, McHenry Villa officials said they are committed to fully complying with IDPH’s directives and guidance and will inform residents and staff of their response. Possible actions that may be taken, according to IDPH public information officer Melaney Arnold, include:
  • hiring a consultant
  • adding or replacing filters on showers, sink faucets and fixtures
  • reviewing cooling tower operations.
Former mayor passes
Doherty, 91, died of Legionella at the JourneyCare CareCenter hospice facility in Woodstock, his son told the Chicago Tribune. A lifelong resident of McHenry, Doherty contracted Legionnaire’s disease at McHenry Villa, where he had been living. Doherty was mayor of McHenry from 1961 to 1973.
The conditions of the other two residents sickened were not released.
IDPH said all three patients had outside exposure, and two of the three could have been exposed at Centegra Hospital-McHenry, part of Northwestern Medicine, something hospital officials say is not likely. It’s unknown if Doherty was one of the two believed to have been exposed at Centegra.
No stranger to Legionella
The first cluster of the year in McHenry County infected 12 people in June and July. Six of the 12 were believed to have been sickened within a 1½-mile radius of the intersection of Route 176 and Walkup Road in Crystal Lake, but the source never was identified.
Three people were affected during the second outbreak in October. The source of that outbreak was believed to be the Johnsburg Walmart Supercenter.
There were four cases of Legionnaires’ disease in McHenry County in 2017, nine in 2016, and three in 2015.
The county is located in northeastern Illinois, along the Wisconsin state line. According to the 2010 census, it had a population of 308,760, making it the sixth-most populous county in Illinois.”
Sources: By Dennis Armstrong

Preparing Cooling Towers and Heating Boilers For Winter Operation: Part 1

This is that in-between time of year when facilities managers are preparing both heating boilers and cooling towers for winter operation.  Here are two checklists that will assist in getting these systems ready for cold weather operation and help avoid unexpected equipment failure.

 WINTERIZATION TIPS FOR COOLING TOWERS:

Fall is an excellent time to prepare cooling towers for the rigors of winter operation.  Here is a list of major maintenance items to take care of:

Change the gear box oil.  Fresh oil now should get you through until spring.

  1. Replace the V-belts.  There is no good way to tell when a belt will fail.  If you replace the belts now, you can be reasonably sure you will not face an emergency change-out in mid January.
  2. Clean the hot water distribution system and the cold water collection basins.  Debris has no doubt accumulated during the warm, dry months.  A thorough cleaning eliminates the risk of clogged filters and strainers and the risk of biological growth.
  3. Make sure all distribution nozzles are clean and in place.  Proper water distribution is even more important in winter than in summer.
  4. Inspect the distribution system and cold water collection basin and seal all leaks thoroughly.  These leaks are probably the most common cause of serious ice damage in the winter.
  5. Balance water flow so that all fan cells (on towers serving a common process) receive equal amounts of incoming water.  This balance assures efficient, trouble free service.
  6. Verify that all motor control circuits are properly operating, particularly if you use fan reversal to control ice buildup.
  7. If your system includes a bypass valve to divert water around the cooling tower fill, operate this valve and make sure that it provides complete shutoff.
  8. Repair any worn or damaged access devices, such as doors, ladders or stairways.  Proper winter operation demands free access to the cooling tower.  Access devices should be made safe for operating personnel.

Image result for cooling tower in winter

By – Mark Botsford, CWT

 

 

Legionella Found At All But 3 West Orange Schools

Legionella Found At All But 3 West Orange Schools: Officials

WEST ORANGE, NJ — First they were found at town hall. Then they were found at a half-dozen other municipal buildings. Now, less than six weeks after Legionella bacteria was discovered in the water at Redwood Elementary, West Orange officials have found additional samples of the hazardous pathogen at all but three of the district’s schools.

On Wednesday, West Orange Public School District administrators provided an update on testing that’s been taking place at all 12 schools for Legionella bacteria, the organisms that lead to Legionnaire’s Disease, a severe form of pneumonia commonly found in found in potable and non-potable water systems.

Test results for each individual school can be seen here. Read Superintendent Jeff Rutzky’s letter to parents and guardians here. Updated district statements about the testing can be seen here.

The district initially began testing for the bacteria at Redwood Elementary School last month after a parent whose child was attending summer camp there reported that her child was sick with what the doctor said could be Legionnaire’s Disease. The child was ultimately determined not to have the disease, Rutzky said.

However, officials began remediation efforts at the school after test results showed four of 15 samples had “very low levels of Legionella bacteria” on Aug. 14.

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On Aug. 30, New Jersey American Water tested sinks and water fountains at Redwood Elementary School for coliform bacteria. The results were satisfactory in accordance with the Safe Drinking Water Act standards, school officials said.

Even though the Redwood Elementary School samples met the standard, OMEGA Environmental was hired to perform a disinfection procedure using a hyper-chlorinated solution on Sept. 10 and 11, officials said.

The procedure included:

  • “chlorine is pumped into the hot water heater and remains in the hot water tank for four hours to eliminate any bacteria”
  • “chlorine is then pumped through the hot water piping system and remains in the system for fourteen hours to eliminate any bacteria”
  • “chlorinated water is drained from the hot water tank and hot water piping system and flushed with fresh water”
  • “water samples are drawn and retested after the hyper-chlorination procedure to verify that the water again meets the Safe Drinking Water Act standards”

Officials also took the following steps at Redwood Elementary:

  • “installing filters on the water sources that tested positive”
  • “replacing faucets in the affected areas”
  • “proactively and temporarily covering all water fountains despite the fact that the Legionella bacteria only presents a risk from exposure to airborne droplets and not from drinking affected water”
  • “removing, cleaning and sanitizing all aerators (screens) in all rooms”
  • “where possible, changes in the plumbing systems will be done to minimize the potential for future bacterial growth”

West Orange school officials then began the process of testing the district’s other facilities for Legionella, including all 12 schools, the Central Office and the Bus Depot.

Samples for Legionella bacteria were positive in the Administration Building and all schools except Liberty Middle School, Betty Maddalena Early Learning Center, and Kelly Elementary School, officials announced Wednesday.

“All affected schools will undergo the same remediation as Redwood Elementary School by Omega Environmental, followed by retesting by Garden State Environmental,” school administrators said. “Water bottles should be available at all schools until testing and remediation is completed.”

To complete the process, the remediation is being carried out on weekends, administrators said.

The remediation schedule follows below:

  • Mt. Pleasant had the chlorination process completed on Sept. 19 and was retested for the Legionella bacteria on Sept. 24.
  • St. Cloud had the chlorination process completed on Sept. 22 and will be retested on Sept. 27.
  • Hazel will have the chlorination process completed on Sept. 28 and 29. Retesting will be done approximately four days after the chlorination process.
  • Gregory, Washington and the Administration Building will have the chlorination process completed on Oct. 5 and 6, Oct. 12 and 13 or Oct. 19 and 20. Retesting will be done approximately four days after the chlorination process.
  • Edison and Roosevelt will have the chlorination process completed on Oct. 26 or 27 or Nov. 2 and 3. Retesting will be done approximately four days after the chlorination process.
  • West Orange High School will be completed on Nov. 8 to 11. Retesting will be done approximately four days after the chlorination process.

“It is important to note that there are no confirmed cases of Legionella in West Orange,” Superintendent Rutzky said Wednesday. “We will continue to be diligent in our approach to remediate the water sources that tested positive for Legionella bacteria and proactive in completing the process as quickly as possible.”

School district administrators have been coordinating their responses with workers at the town Health Department, who have been conducting their own Legionella testing and remediation at several buildings, including Town Hall, Lafayette Park, O’Connor Park, Fire Headquarters, Firehouse No. 2, Firehouse No. 4 and Police Headquarters.

West Orange Director of Health Theresa DeNova previously provided the following information about Legionnaire’s Disease:

“It is not contagious, person to person… it is not airborne… it cannot be contracted by drinking or touching water… and the way it is contracted is by inhaling contaminated water mist.”

New Jersey American Water previously released the following statement about the situation in West Orange:

“Providing safe water is New Jersey American Water’s number one priority and a responsibility we share with all our customers. Although the drinking water we deliver is treated and meets all federal and state water quality standards and requirements, the quality of that water can change once it leaves our pipes and enters domestic plumbing systems. When we became aware of the issues the Township of West Orange experienced with Legionella in the plumbing infrastructure of its Municipal Township Building, we began proactively working with Mayor Parisi, his staff, health officials and town consultants to provide expert guidance and assistance as the town works to remedy this situation. We are committed to helping the Township resolve this issue as they work to disinfect and upgrade their building systems to ensure a healthy and safe work environment for their employees.”

Sources:https://patch.com/new-jersey/westorange/all-3-west-orange-schools-have-legionella-water-officials