When people go to the hospital, they don’t expect to become sick because of their visit. Yet this has been happening for decades in hospitals across the country partly due to a dangerous bacteria known as Legionella. These bacteria are known to cause a serious and potentially fatal form of pneumonia called Legionnaires’ disease, and the rates are increasing.
In the past 10 years, the number of reported cases of Legionnaires’ disease has risen by 200%. While rarely a threat in nature, Legionella bacteria grow and thrive in man-made settings where water is warm, including water from showers, faucets, fountains and equipment. In fact, legionella bacteria is found in up to 50% of hospitals, as well as in hot tubs, decorative fountains and other buildings. Legionnaires’ disease is caused by breathing in small droplets of water containing the bacteria, usually from water used for showering or from cooling towers associated with air conditioning systems in large buildings.
Deaths from community infections of Legionnaires’ disease occur in 10-15% of cases, but that rate increases to 25-30% if infected in a hospital or healthcare facility. The symptoms of Legionnaires’ disease are no different from other forms of pneumonia. These include high fever, coughing and shortness of breath. Often the diagnosis is missed, and most cases go undetected until it is too late.
In fact, most patients who die from Legionnaires’ disease never have the cause of their illness brought to light. The Centers for Disease Control and Prevention reports about 1,000 cases per year, but admits that the true number is likely much higher. This is why early detection is imperative in saving lives, as typical treatments for pneumonia do not work. The most effective antibiotics for treating Legionnaires’ disease are levofloxacin and azithromycin.
What’s worse, typically only 50% of hospitals test for Legionella, leaving many patients and health care providers unaware of the danger. There are no federal regulations for Legionella testing and only a handful of states have adopted requirements for testing. Even with the preventative measures available to these facilities, systemic neglect continues.
“A trip to the hospital should not be a death sentence. More needs to be done,” said Dr. Janet Stout, executive vice president and founder of Special Pathogens Laboratory at Pace Analytical, a provider of regulatory testing and analytical laboratory services. “Water management programs and testing are proven to prevent Legionella infections.”
The average test costs $100 and depending on the size of the facility, it can take an average of 10-20 tests to detect the presence of Legionella. It’s highly recommended that every building that is not a small- to mid-sized house with hot water recirculation, is multi-story and has water-cooled air-conditioning systems (cooling towers) test quarterly. This includes hospitals, long-term care facilities, casinos, cruise ships and data centers.
Many hospitals believe they can do the testing themselves, but are not aware of the specialized methods that are required. It is highly recommended to have experienced professionals provide testing to ensure it’s done right.
While private homes are rarely a source of exposure for Legionella bacteria, people who are severely immunocompromised should discuss precautions with their physician.
“It’s time for action. We need to do more to prevent Legionnaires’ disease and the accompanying loss of life,” says Stout. “Test to protect!”