Category Archives: Legionnaires Disease Control & Outbreaks

Workplace Air Monitoring

Safe Work Australia has just released Workplace Exposure Standards for Airborne Contaminants which has effect from 18th April 2013.

Every person who conducts a business must ensure that workers are not exposed to a substance or mixture in an airborne concentration that exceeds the exposure standard for that substance or mixture.

Examples of these substances or mixtures include: carbon monoxide, chlorine, bromine, chlorine dioxide, formaldehyde, petrol, ozone, toluene, acetic acid, MEK, xylene & glutaraldehyde.

Every person who conducts a business must ensure that air monitoring is carried out to determine the airborne concentration of a substance or mixture to determine whether there is a risk to health.

If you are unsure & would like one of WMAir’s Occupational Hygienists to visit your workplace to determine whether air monitoring is required, at no obligation or cost, please email your contact details to us


Three People Have Contracted Legionnaires’ Disease in Adelaide over the past few weeks

Over the past few weeks, Legionnaires’ disease has been diagnosed in three individuals who had been in the east part of Adelaide, South Australia during the incubation period. Public health authorities have asked business owners to clean & disinfect cooling towers even though a common source had not been identified yet.

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The largest outbreak of Legionnaires’ Disease may be due to insufficient heating of hot water

Insufficient heating of the hot-water system in Miami Valley Hospital’s new 12-story addition was the primary reason for the largest outbreak of Legionnaires’ disease in Ohio since 2004, according to the hospital.


The outbreak of Legionnaires’ disease at the hospital in February and March highlights an unintended result of plumbing codes that could put vulnerable populations like hospital patients at risk.


In certain cases, an outbreak of Legionnaires’ disease can be an “unfortunate consequence of something that’s intended to protect public health,” said Dr. Lauri Hicks, a medical epidemiologist with the Centers for Disease Control and Prevention.


In an exclusive interview this week with the Dayton Daily News, hospital officials announced the cause of the outbreak, which sickened 11 patients and may have contributed to the death of one of those patients.


Prior to occupancy of the $135 million patient tower on Dec. 28, a construction team made sure the water that supplied showers and faucets was heated to no more than 120 degrees Fahrenheit, as required by the Ohio Plumbing Code, hospital officials said.


Hospital officials said they had planned to heat the water to 130 to 140 degrees, but were told to lower the water temperature to comply with code requirements, which are intended to prevent scalding.


“When the codes recommended a certain water temperature, those codes didn’t contemplate a vulnerable population” and its susceptibility to waterborne bacteria such as Legionella, said Jennifer Theibert, the hospital’s risk-management director. The acutely ill are more susceptible to contracting Legionnaires’ disease than the general population.


State codes like Ohio’s that require hospitals to keep water temperatures at 120 degrees are “irresponsible,” said Tim Keane, who was hired by Miami Valley Hospital after it detected its first cases of Legionnaires’ disease in late February.


“One of the primary drivers of Legionella in health care are codes,” Keane said.


Such codes aim to minimize the risk of scalding by requiring caps on water temperatures. But Keane claims the risk of hot water systems becoming colonized with Legionella bacteria is far greater than those associated with scalding.


Legionella bacteria begin to die at 108 degrees Fahrenheit, according to the CDC. But not all of those bacteria die at that temperature, and water typically begins to cool as it moves away from the heating source, the CDC’s Hicks said. In large buildings, the temperature can drop as much as 10 to 20 degrees in some parts of the hot water plumbing system. Consequently, “bacteria may be thriving in the pipes near the shower head, but not in the hot water heater itself,” Hicks said.


Miami Valley Hospital is now heating water in the entire hospital to 140 degrees, and has the ability to mix hot and cold water at faucets and other points where people come in contact with the water to reduce scalding risks.


The hospital also has installed a hyperchlorination system to “make sure this never happens to us again,” said Barbara Johnson, the hospital’s chief operating officer.


Reduced water flow in parts of the new addition’s plumbing system also contributed to the outbreak.


Legionella is found in most water sources, but is usually contracted by breathing in mist from water that contains high concentrations of the bacteria. Legionnaires’ disease is not contagious.


The hospital spent about $61,000 to eradicate Legionella from the hot water system. It declined to release both its report on the outbreak and a white paper summarizing what it’s learned.


The hospital has received inquiries about the outbreak from attorneys representing patients who had Legionnaires’ disease, but no legal action has been taken against the hospital, Theibert said.


Contact this reporter at (937) 225-7457 or


New Strategy Used By Legionnaires Disease Bacteria

Purdue associate professor of biological sciences Zhao-Qing Luo, foreground, and graduate student Yunhao Tan identified a new way in which bacteria modify healthy cells during infection. Shown on the computer screen are cells infected with a mutant strain of the bacteria Legionella pneumophila used in their research. (Purdue University photo/Mark Simons)

Purdue University biologists identified a new way in which bacteria hijack healthy cells during infection, which could provide a target for new antibiotics.

Zhao-Qing Luo, the associate professor of biological sciences who led the study, said the team discovered a new enzyme used by the bacterium Legionella pneumophila – which causes Legionnaires’ disease – to control its host cell in order to take up residence.

“Legionnaires’ disease is a severe form of pneumonia, and this finding could lead to the design of a new therapy that saves lives,” Luo says. “At the same time it also provides great insight into a general mechanism of both bacterial infection and cell signaling events in higher organisms including humans.”

Successful infection by Legionella pneumophila requires the delivery of hundreds of proteins into the host cells that alter various functions to turn the naturally hostile environment into one tailor-made for bacterial replication. These proteins tap into existing communication processes within the cells in which an external signal, such as a hormone, triggers a cascade of slight modifications to proteins that eventually turns on a gene that changes the cell’s behavior, he said.

“Pathogens are successful because they know how information in our cells is relayed and they amplify some signals and block others in order to evade the immune system and keep the cell from defending itself,” Luo says. “Despite our understanding of this, we do not know much about how the proteins delivered by the bacteria accomplish this – how they work. This time we were able to pinpoint an enzyme and see how it disrupted and manipulated a specific signaling pathway in order to create a better environment for itself.”

The signaling pathway involved was only recently identified, and the discovery by Luo and graduate student Yunhao Tan also provides a key insight into its process. A paper detailing their National Institutes of Health-funded work is published online in the current issue of the journal Nature.

The signaling pathway involves a new form of protein modification called AMPylation in order to relay instructions to change cell behavior and has been found to be used by almost all organisms, Luo said.

The bacterial enzyme discovered by the Purdue team, named SidD, reverses or stops the AMPylation process, he said.

“It had not been known before if the AMPylation signaling process was reversible or if it was regulated by specific enzymes,” Luo says. “Now we know that it is, and we have a more complete picture that will allow us to use it as a scientific tool to learn more about complex cellular processes. By being able to turn the signaling on and off, we can control different activities and detect mechanisms we wouldn’t see under normal physiological conditions.”

The bacterium affects the host cell’s functions differently during different phases of the infection process, tapping into signaling pathways to turn on and off certain natural cellular activities. SidD stops the AMPylation process four hours after the start of infection in order to reverse an earlier modification that would be detrimental to the cell if left in place, he said.

“During its process of infection, the bacteria can trigger reactions that can lead to the death of the host cell,” Luo says. “Of course this is not in the best interest of the bacteria because it would no longer be able to replicate and continue infection, so it has evolved mechanisms to neutralize such reactions and keep the host cell alive.”

Luo said further investigation of the structure and function of the SidD enzyme is needed to better understand its role in the infection process and its involvement in other cellular processes.

“The more we can learn about an infectious agent, the better equipped we will be to design a therapy to fight it,” he says. “Before a new antibiotic therapy can be created, we must understand the enzyme enough to find chemicals to inhibit its activity. Further, because the bacteria have coevolved with us for millions of years, they provide some of the best tools for us to understand the intricacy of cellular processes.”

Luo plans to further study SidD and investigate other proteins used by Legionella pneumophila bacteria.

New Methods For Disinfection & Prevention of Legionnaires Disease

Pittsburgh, PA (PRWEB) March 9, 2011

Water in hospitals, hotels, commercial office buildings, and long-term care facilities contain waterborne pathogens, like Legionella, Pseudomonas, and antibiotic resistant bacteria. If you are elderly or a hospital patient, you are vulnerable to illnesses, like Legionnaires’ disease, which are caused by these bacteria.

Now, guidance documents developed by the World Health Organization; the Veterans Affairs Healthcare System; the New York Department of Health; and the American Society of Heating, Refrigeration and Air-conditioning Engineers (ASHRAE) offer new methods for disinfection and prevention.

Faucets, shower heads, drains, humidifiers, and hot tubs provide rich environments for bacteria to colonize. Illness is caused when water is ingested, aerosolized, aspirated, or directly instilled through tubes like feeding tubes.

“You’d be surprised at what’s in your water,” says Dr. Janet Stout, director of Special Pathogens Laboratory. ( “We want to believe that the water coming from the tap in a hospital or hotel is safe, that assumption is incorrect especially for the elderly, smokers, and anyone whose health is compromised.”

According to Stout, wherever there is water there should be concern about its quality with respect to waterborne pathogens. One study showed 41 facilities in 18 states reporting a death rate of 34% when hospitalized patients got Legionnaires’ disease from the hospital water. Of those, 88% were acute care hospitals, 12% long-term care and rehabilitation facilities.

“Unmonitored levels of bacteria pose a definite threat to public health. Yet for too long there has been a policy of avoidance especially in the case of Legionnaires’ disease where nothing is done until a case is diagnosed or there has been a death,” says Stout, a research assistant professor at the University of Pittsburgh, and leading expert in Legionella detection and disinfection. “These new guidelines offer a preventative approach as well as effective detection and disinfection methods.”

Stout will lead an educational session for the National Facilities Management and Technology Conference in Baltimore on Wednesday, March 16, 2011. In “Waterborne Pathogens: Keeping People Healthy in the Building,” ( she will identify waterborne pathogens in building water systems that pose a risk of infection; review the Do’s and Don’ts for assessing and managing risks from utility water systems; give the status of guidance documents, and the impact on utility system operation and maintenance.

Special Pathogens Laboratory®
Special Pathogens Laboratory, The Legionella Experts,® is the leading analytical microbiology laboratory offering the healthcare industry, water treatment industry, and commercial and industrial sectors reliable, high-quality microbiology services. An accredited laboratory and ELITE certified by the CDC for expertise in Legionella testing, SPL® specializes in the detection, control, and disinfection of Legionella, and other waterborne microorganisms, responsible for serious infections, including thousands of hospital-acquired infections annually.

Deadly Legionella Bacteria Threatens Power Savers

Deadly legionella bacteria threatens power savers


The high cost of electricity is forcing some low-income earners to adjust hot-water systems to save money. Source: Supplied

HOUSEHOLDERS who turn down the heat on their hot-water systems risk the spread of deadly legionella bacteria.

The bacteria was found in the tank-style hot-water systems of three of five legionnaires’ disease victims, prompting SA Health to warn the only reason householders should set the temperature below 60C was if young children or the elderly lived in the house and could be scalded.

Welfare organisations have confirmed the high cost of electricity is forcing some low-income earners to adjust hot-water systems to save money, The Advertiser said.

The Advertiser can reveal that the legionella test results, from 2009, were never made public.

The suspected link to hot water systems was only revealed publicly in a report prepared for Parliament by the independent watchdog Public and Environmental Health Council.

When asked about the issue, SA Health told The Advertiser the legionella testing was done to identify the source of five Adelaide cases of the disease in a small area of north-eastern Adelaide in late 2009, with three of the five thought to be linked to bacteria found in hot water systems in the victims’ houses.

In a written statement, Director of Public Health Protection Dr Chris Lease said: “SA Health continues to look at ways to further inform the community of the importance of safely using hot water storage tanks to avoid burns and scalds and also protect against legionella infection.

“Hot water storage tanks need to be set to store water at 60 degrees minimum to reduce the risk of legionella growth.

“All hot and mixed water sanitary outlets like shower, hand basin, bath taps, laundry sink that are not used on a daily basis should be flushed weekly with hot water at full flow for at least 15 seconds.”

UnitingCare Wesley spokesman Mark Henley said there continued to be conflicting advice about the risks of legionella and scalding of children from health authorities.

“It is not surprising that low-income people do anything they can including adjusting the temperature of hot water systems because the cost of electricity is so high,” he said.

A spokeswoman for SA Health denied there had been a cover-up and defended the fact that details of the link to hot water systems were never revealed. The spokeswoman said it was common practice in disease outbreaks not to reveal specific causes, and said warnings had been issued to councils and other health authorities.

Water heating contributes to about 40 per cent of household electricity bills, on average $600 each year, and hundreds of dollars could be saved by adjusting the temperature, depending on the age of the system.

The warning applies only to hot water systems that allow water to sit in a tank. Newer heaters which allow temperature adjustment from inside the home are not a danger.

Health authorities want householders to read information about the risks of legionella and scalding at and before making any changes to their hot water systems.

Legionella infects up to 15 South Australians each year, with airconditioner cooling towers the major source.

Large increases in electricity and gas prices have caused many people to reduce the temperature down to as low as 40 degrees, but this can be a breeding ground for the legionella bacteria in heaters which have reservoirs of water which stand for a long time.

Instant hot water systems and newer systems which allow the temperature to be adjusted close to taps are not a risk.

Legionnaires’ disease can occur if a person breathes in legionella-contaminated water vapour or dust. It cannot be spread from person to person. While the optimum temperature for it to thrive is 35 degrees it flourishes at between 25 and 45 degrees.

The use of warm water is common in nursing homes and other places where scalding is a threat and SA Health insists hot water systems which can store water at temperatures below 60 degrees must be:

INSPECTED once every month and recorded in a maintenance log book.

CLEANED once a month if impurities in the system are found.

DECONTAMINATED at least every six months.

$1.2 Million Dollars Compensation for Legionnaires Disease Death

    Febuary 2010

Sharron Morris sued Ohio

State Medical Center after her

husband, David, died after

contracting Legionnaires’

disease in Doan Hall.

Sharron Morris didn’t want another family to watch a loved one die

after contracting Legionnaires’ disease from drinking water.

So she felt some satisfaction this week when Ohio State University

Medical Center agreed to settle a lawsuit she’d filed over the death of

her husband.

David Morris died in 2007, five months after he drank water from an

OSU Medical Center faucet and came down with the disease.

“The important thing is getting it out into the community to let them

know,” Mrs. Morris said yesterday. “It was the only way I could get

anyone to do anything.”

Ohio State agreed on Thursday to pay Mrs. Morris $1.2 million.

Mr. Morris, 66, of Lima, came down with Legionnaires’ six days after

he drank tap water on the ninth floor of the medical center’s Doan

Hall. His leukemia was in remission, and he was having an outpatient

procedure when he drank the water to wash down medication.

Mrs. Morris’ complaint says that nurses and other staff members on

the ninth floor knew that the water could contain the bacteria that

causes Legionnaires’ but had been instructed not to tell patients to not

drink the water.

Instead, staff members regularly gave patients bottled water and ice

made from bottled water.

David Shroyer, Mrs. Morris’ attorney, said signs warning that the

water should not be consumed were added to the faucets after Mr.

Morris got sick.

He said he doesn’t know whether anyone else contracted

Legionnaires’ from the water and doesn’t know whether the threat

remains at Doan Hall.

OSU Medical Center spokesman David Crawford issued a statement saying that Ohio State believes the

  OSU pays $1.2 million in man’s Legionnaires’ death | The Columbus Dispatch http://www.dis10 8:18 AM

©2010, The Cs fair and adequately compensates the family for the loss of their loved one,” and that “the

risk of contracting the disease is extremely low due to the safeguards we have in place.”

Dr. Andrew Thomas, associate medical director at OSU, said the university installed special filters on

some sinks and ice machines in the hospital in March 2007 to protect from Legionella bacteria, which is a

common risk in older buildings with big plumbing systems.

“It’s hard to eradicate,” Thomas said. He said the medical center also is planning to add a system that

would inject chlorine gas into the water to reduce the risk of the bacteria.

He said it is difficult to determine where anyone picks up the bacteria. Two other OSU patients have had

Legionnaires’ since Mr. Morris and possibly contracted it in the hospital. Both of them died of other

medical problems, he said.

Medical Center employees who were deposed in the Morris case said that they knew it was not OK to

drink the water on the ninth floor because Legionella was in the water. But although the staff gave patients

bottled water, it did not warn them about drinking the tap water, employees testified.

Thomas said nurses now instruct patients not to drink the tap water.

kgray@ s $1.2 million in man’s Legionnaires’ death | The Columbus Dispatch http://w14/2010 8:18 AM