Cooling Towers Continue To Take Unfounded Blame For Legionella Outbreaks

On September 21st, 2017, online News outlet QNS, in a story on a recent outbreak, couldn’t resist adding, in an offhand way, in a report on a Legionnaires Disease infection:

“Parker Towers does not have a cooling tower, which is usually where Legionalla (sic) thrives.”
Even though the CDC says cooling towers are not the major source for outbreaks.

According to ACHRNEWS.com :

It’s important to keep in mind that out of all cases of LD, 4 percent are outbreaks and 96 percent are individual, sporadic cases. Of the outbreaks, the CDC says about 20 percent are associated with cooling towers and 56 percent are associated with the drinking water supply,” said Considine. “Out of all the cases of LD, that means cooling towers comprise maybe 1-2 percent of all incidents

One reason for many of the outbreaks may be related to our current infrastructure. While a cooling tower may be where the bacteria can grow, it is the water source that may be contaminated that introduces the bacteria. Failing water systems have added a new component to the war against Legionnaires Disease.

Startribune.com in Minnesota recently reported:

State, county and city public health officials are trying to isolate the source of the bacteria in the plumbing system of SilverCreek on Main, which provides memory care, assisted living and independent living services.

While cooling towers continue to take a bad rap for disease outbreaks, the simple fact that the incoming water now has a better chance of being contaminated only means HVAC system operators and building managers must be even more vigilant.

tctimes.com, in Michigan’s Tri-County area reported:

The city of Fenton has been informed by the Genesee County Health Department that a care facility located in the city has tested presumptive positive for the Legionella bacteria in a resident room and an adjacent area, Markland said.

We have been told by the Health Department that this is an isolated incident, in only a part of a facility and is not related to the city’s water system,” Markland (Fenton City Manager) said. “Our records show that the chlorination introduced at the city’s water plant and in the distribution system is high enough to prevent any contamination of the city’s water system.

According to the Alliance to Prevent Legionnaires’ Disease, reducing Legionella in the public water supply would go a long way toward addressing the risk. Another major problem with Legionella is that it’s resistant to chlorine. A combination of chemicals and cleaning is usually employed to eliminate the bacteria. A free toolkit is available from the CDC: Developing a Water Management Program to Reduce Legionella Growth and Spread in Buildings to help understand the complexities involved.

Water Conservation and Cooling Tower News

Conservation

The Alliance for Water Efficiency recently reported that 30 years of water conservation has reduced the amount of water usage by almost 60 gallons per resident in Tucson, Arizona. The water efficiency project followed conservation savings in 2 Arizona cities, Tucson and Gilbert. In the last 20 years, Gilbert was reported to have reduced water usage by 30% from conservation alone. The cost for Gilbert’s water and wastewater system hookup is 45 percent lower today, due to conservation savings and reduced need for infrastructure improvements over the period. Cities across the nation and California in particular, which has had great success and a 25% reduction in use recently, are looking to find similar ways to reduce use and costs.

Water quality is becoming an issue in many rural areas in California and Tucson also. Cleanup of contamination of water in the area around Tucson Airport is currently ongoing. A recent report has revealed that the arsenic levels in the drinking water at some schools in the San Joaquin Valley in Califrnia are in question. The Rural Community Assistance Corporation reported that some public water systems in the San Joaquin Valley area have levels that exceed maximum federal safety levels by as much as 300%. An open house session was held in July with Tucson Water officials and the Environmental Protection Agency to discuss water quality issues.

Legionnaires‘ Disease

73 cases, constituting a 143% increase over the last 2 years, of Legionnaires’ disease has been reportedly found in Metro Detroit during June and July of this year. Michigan health officials have not yet identified a common source of the infection. The CDC has reported that a genetic has found link between the nearby Flint Michigan water system and the infections of Flynt residents Back in 2014-2015, which killed 12 people.

Eight cases of infections from the legionellosis bacteria were detected in the Three Rivers region of Quebec last month. The source of the bacteria has still not been located. Public water fountains have been temporarily closed while the source is looked for. All main city water systems have been checked and found to be free of contamination. Local fears are high as many remember 14 deaths and more than 180 infections during a massive outbreak in Quebec City five years ago.

2 Cases Of Legionnaires’ Disease were reported at a Building in Queens, NY in the last few days. The city instituted mandatory cooling tower inspections 2 years ago but other sources are suspected, as the building does not have a cooling tower. One tenant remains hospitalized but is listed as recovering, while the other was discharged.

A spa at a Gold’s Gym in Kennewick, Wa., was the suspected source of two recent infections and currently the spa is closed for inspection.

Nine cases have been confirmed in the last outbreak between May 15 and June 26 at The Guesthouse Hotel at Graceland and there has now been a lawsuit filed against Elvis Presley Enterprises alleging “through the normal use of The Guest House at Graceland’s water system” that they were exposed to the legionellosis bacteria. The plaintiff spent over a week in intensive care. “Moving forward, the establishment will implement their preventive water maintenance plan monthly instead of quarterly for the next six months as well as continue routine sampling on the aquatics facilities”, according to Shelby County Health Department public information officer Elizabeth Hart. As of July 19, the Shelby County Health Department authorized The Guest House at Graceland to reopen the aquatics facilities.

CDC Corrects Paper on Legionnaire’s Disease – After a critical examination of a report by Pittsburgh Post-Gazette the CDC has revised its report about the VA Pittsburgh Healthcare System outbreaks that sickened 22 veterans, killing six, in 2012 and 2013. The conclusions of a 2013 report from the VA’s Inspector General found that “the outbreak was due to poor management generally and poor maintenance of the copper-silver system specifically, not that the copper-silver system itself had failed.”

Guardian Water Treatment of the UK has recently announced a Legionella Awareness Course (https://www.gwtltd.com/water-treatment/training/legionella-training-for-cooling-towers/) for cooling tower operators in the UK. Course are listed as: Week 1: Overview of ACoP L8, including HSG274 Part 1 and site specific training on testing and inspection. Week 2: Operation theory, site specific testing and inspection. Week 3: Brief recap of test procedure and final competence sign off.

Legionnaires’ Disease Rates Rise from
Cooling Tower Contaminations

Outbreak Reports Continue

According to the CDC and in spite of years of research, the scientific community remains in the dark as to the cause (but not necessarily the source) of the rising rate of infections from the Legionella bacteria in the Unites States today. Between the years of 2000 and 2015 the estimated number of cases has increased almost 450% reaching the level of approximately 6,000 cases reported by 2015.

Lenox Hill, NY – In a two week period back in June, there were several cases of Legionnaire’s Disease in and around Manhattan NY’s Lenox Hill neighborhood. One elderly person with “significant underlying health conditions” died and 8 people were hospitalized temporarily.

With the usual suspect of a cooling tower, investigations soon identified 116 systems within half a kilometer and testing began.
The New York City Department of Health and Mental Hygiene quickly found 42 had traces of Legionella DNA, 24 of which had quite low levels. Ongoing testing is being conducted to match the DNA with the individual infections to determine which of the identified cooling tower system or systems were responsible for the outbreak.

Memphis, TN – Elvis Presley’s Famous Graceland VACation destination was rocked with an outbreak of Legionnaire’s Disease the first week of July this year. By the end of the week 6 cases were confirmed. It has been estimated that those cases were initially contacted between May 15 and June 26. The Shelby County Health Department has recommended anyone with symptoms who visited the park during those dates should contact them immediately. The aquatic facilities at the hotel were closed for examination. So far, those who have been infected all stayed at the Guest House at Graceland between those dates.

W.Va. – Recently the Department of Health & Human Resources has reported an increase in the number of cases suspected of being Legionnaires’ Disease during the months of May and June this year.

Looking for Solutions

One major problem with Legionella is that it’s resistant to chlorine. Cleaning and maintaining a safe cooling tower is not as easy as it might seem. A DNA test to confirm the source takes time. One benefit there is that all cooling towers in a given area are investigated which frequently finds more contaminations than infections and helps reinforce the reality that there is more lurking there than we know. Diligence seems to be a major factor in limiting the outbreaks and local jurisdictions are starting to look into regular cooling tower inspections and mandated cleaning procedures as a layer of bureaucracy they feel is needed to help combat infections.

Lack Of Sprinkler System Increases Injury And Death

On Friday, July 14, 2017, a high-rise building fire in Honolulu, Hawaii, spread from one unit to additional units and threated engulfing the entire building after a fire broke out in one unit on the 26th floor of an apartment building. At least 3 casualties and over a dozen injuries have been reported so far. The expansion of the fire beyond the source was believed to have been the result of a building that was built in 1971, before sprinklers were required in such type of buildings, that has never been upgraded.

Many residents reported no warnings or alarms either and most said the smoke was what alerted them to the conflagration. Honolulu Mayor Kirk Caldwell stated “residents have to pay” if they want sprinkler safety protection, “It’s pretty expensive. But if it saves a life and it’s your life, it’s worth the cost.” Many local ‘rumblings’ indicated there are others that disagree and it seems possible the rules will soon be looked at to see if is possible to require such upgrades.

Most residents also indicated there were no fire safety meetings or drills they could remember…since a few after the last fire in 2003. Many residents, as reported by several local TV stations, were unaware the building had no fire sprinkler system and had never heard of any meetings or drills relating to emergency situations.

The fire burned for around 4 hours and was mostly confined to 2 floors, due to the quick reactions from the approximately 100 fire fighters that responded to the blaze.

According to the National Fire Protection Association (NFPA), there was an 80% lower risk of death and a reduction of 71% in property damage costs in buildings equipped with fire sprinklers vs. those without, between 1996 and 2001.