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Posted in Our Blog on August 9, 2020
In the latest Atlanta Legionnaires disease investigation, the CDC has closed several buildings it leases in Atlanta after their cooling towers have tested positive for Legionella. “During the recent closures at our leased space in Atlanta, working through the General Services Administration (GSA), CDC directed the landlord to take protective actions,” the CDC said in a statement to CNN. “Despite their best efforts, CDC has been notified that Legionella, which can cause Legionnaires’ Disease, is present in a cooling tower as well as in some water sources in the buildings. Out of an abundance of caution, we have closed these buildings until successful remediation is complete.”
Legionella bacteria thrive in stagnant or warm water and have caused recent Atlanta Legionnaires disease outbreaks. With COVID closing down building plumbing systems for months, dormant building water systems may provide the ideal breeding ground for Legionnaires disease. As people return to work and start to travel more, hospitals and clinics need to think about the possibility of Legionella, the CDC’s Chris Edens said. “Flu and coronavirus are not the only things that can cause severe pneumonia,” he said. If people turn up with pneumonia, it’s worth testing them for Legionella — especially since it can be treated with antibiotics, unlike flu or coronavirus. “This water has been sitting and could be at risk of Legionella growth.” Click here for more information on Legionnaires Disease and COVID.
The fix is not difficult. “You want to keep the cold water cold and you want to keep your hot water hot,” Edens said. Legionella flourishes at temperatures between 80° and 120° Fahrenheit. It’s killed by chlorination and other disinfecting routines, but the bacteria can grow into mats that create hard-to-dislodge sludge inside pipes, Edens said. “One of the things that we typically recommend in buildings that have been disused is flushing,” he said. That can be as simple as turning the faucet on. Let cold or hot water course through the system. Keep that water moving.”
According to the CDC, to date no one has been reported ill in this latest Atlanta Legionnaires disease investigation.
The Georgia Department of Public Health (DPH) and the Fulton County Board of Health (FCBOH) announced 12 lab-confirmed cases of Legionnaires’ disease, 63 probable cases, and 1 death of Legionnaires’ disease linked to the Sheraton Atlanta Hotel.
The source of the outbreak, which affected guests who visited or stayed at the downtown Atlanta hotel between June 12 and July 15, was likely water systems in the hotel. The hotel voluntarily closed as a result of the outbreak for remediation and sanitization.
Legionnaires’ disease is the common name for legionellosis or infection with the bacteria Legionella pneumophila, found in water systems. It is estimated that 10,000 to 18,000 people in the United States are infected with the Legionella bacterium each year.
Symptoms include fever, chills, and a cough that may or may not produce sputum. Additional symptoms include diarrhea, abdominal pain, and sometimes confusion. Some patients may experience headache, muscle ache, loss of appetite, and tiredness. Symptoms generally appear between two and ten days after exposure.
Legionnaires’ is contracted when a person breathes in small droplets of water from the air that contains the harmful bacteria Legionella. While it is not a very common mode of transmission, Legionnaires’ disease can be contracted by aspiration of contaminated drinking water. This happens when water “goes down the wrong pipe,” where a person is drinking, and the water enters the trachea or windpipe instead of going down the throat into the digestive tract.
While anyone can be exposed to the Legionella bacterium, most health people show no symptoms or recover quickly. For some, Legionnaires’ is a greater concern. People who are 50 years or older have a higher risk of infection along with those with certain medical issues. People with chronic lung disease such as obstructive pulmonary disease or emphysema are at a higher risk. Those with a weak immune system or take drugs that weaken the immune system (such as chemotherapy and drugs taken after a transplant operation) are also at a higher risk. People with cancer, underlying illness such diabetes, kidney failure and liver failure are in this high-risk category as well.
The Center for Disease Control and Prevention (CDC) recommends testing the patient for Legionnaires’ disease if the patient is in Intensive Care and has severe pneumonia or has pneumonia and a weakened immune system. The patient should be tested for Legionnaires’ disease if they have been treated with antibiotics, but symptoms have not resolved. If the patient has travelled away from home within the past two weeks and then became ill they may have come in contact with Legionella pneumophila and should be tested for Legionnaires’. Additionally, if the patient may have acquired pneumonia in a nursing home or hospital, they should be tested for Legionnaires’. Of course, if the patient has pneumonia during a legionellosis outbreak, they should be tested for Legionnaires’ disease.
You should contact your health care provider and/or the local health department if you believe you may have been exposed to Legionella and you have symptoms such as fever, cough, chills, or muscle aches.
Legionnaires’ disease is treated with antibiotics. In severe situations, life-threatening complications may occur, such as lung and kidney failure. Other complications include septic shock caused by a subsequent blood infection that may cause a sudden and unsafe drop in blood pressure.
Health care providers have four common ways of detecting the Legionella bacterium to diagnose legionellosis or Legionnaires’ disease. These include antigen testing, culture, antibody testing, and genetic testing. A urine or respiratory sample is required to complete these tests. The CDC suggests antigen and culture testing to diagnose Legionnaires’ disease. Additional testes such as sputum culture, gram staining, complete blood count, and chemistry panels may also be ordered to help give a bigger picture of the patients’ overall health and any other ailment the body may be fighting. An additional blood sample may be required for these tests.
Antigen testing is often performed as an initial test if Legionnaires’ is suspected and provides a rapid result. This testing is specific to Legionella pneumophila and detects one of the bacterium’s proteins. This can be found in the urine and sometimes other bodily fluids, but urine is the most common sample used. A negative test result does not necessarily rule out the infection, as it only detects the serogroup 1 of Legionella pneumophila, though most cases of Legionnaires’ disease in the United States are a result of this specific bacteria. This is a quick method to get a yes or no answer. The “yes” allows the health care provider to look into specific treatment right away. The “no” just means that the physician will continue the diagnostic process, which will likely include a bacterial culture regardless of the positive or negative outcome of the test.
To confirm the presence of Legionella bacteria and diagnose Legionnaires’ disease, a bacterial culture is often performed on sputum. Sputum is a medical term for what someone coughs up as a result of respiratory illness. The laboratory uses a special nutrient media that encourages the growth of Legionella and discourages the growth of other bacteria. For this reason, it is considered the “gold standard” and a confirmation tool to diagnose the infection. This test takes a little bit of time, though a positive culture may grow between 48 and 72 hours. Negative cultures are held for seven days before a final result is reported to be sure no growth occurs.
Antibody testing using Direct fluorescent antibody (DFA) staining for Legionella species is another diagnostic tool a physician may use to diagnose Legionnaires’ disease. This is a rapid test that uses a specialized stain that attaches to antibodies specific to Legionella bacteria. This test can provide results in as little as 2 to 4 hours.
This disease is often underdiagnosed because many who are infected do not develop any symptoms. Additionally, of those who do have symptoms often go undiagnosed, as the sickness presents symptoms similar to other types of pneumonia. Specialized laboratory tests must be performed to confirm the presence of the bacterium to properly diagnose the illness of legionellosis. These tests aren’t generally performed on someone presenting pneumonia symptoms unless Legionnaires’ is considered a possibility. Common diagnostic tools include detecting bacteria found in sputum, finding presence of antigens in urine, or in blood samples by comparing two different samples taken three to six weeks apart.
Yes. If the owner of a building was negligent in failing to properly reduce or prevent the spread of legionella bacteria and this causes a Legionnaires’ disease outbreak, then victims of Legionnaires’ disease can pursue a lawsuit against the negligent parties to obtain compensation.
Our mission is to help families who have been harmed by contaminated food or water. When corporations cause food poisoning outbreaks or Legionnaires disease outbreaks, we use the law to hold them accountable. The Lange Law Firm is the only law firm in the nation solely focused on representing families in food poisoning lawsuits and Legionnaires disease lawsuits.
If you were infected with Legionnaires disease in the Atlanta Legionnaires Outbreak and are interested in making a legal claim for compensation, we can help. Call us for a free no obligation legal consultation at 833.330.3663, or send us an e-mail here.