Legionellosis

November 25, 2013

Legionella raises exposures for building contractors

Source: http://www.businessinsurance.com, November 20, 2013
By: Gavin Souter

Legionella is a relatively new liability exposure for construction firms, but pending safety standards concerning the bacteria that causes Legionnaires’ disease should raise risk management concerns, underwriting experts say.

Contractors should ensure that projects they work on comply with the new standard to shield them from liability and to protect their workers, they say.

Legionella often is associated with entities such as cruise lines or hotels, where well-publicized outbreaks of the disease have caused deaths, but the bacteria that causes the disease can be all over construction sites, said Diana Eichfeld, Philadelphia-based assistant vice president at Ace Environmental Risk, a unit of Ace USA.

The disease usually is transmitted through inhalation of water vapor and can be located in water systems such as decorative fountains, in heating systems, and on construction materials, such as PVC and rubber, she said.…

August 7, 2013

OH Retirement Community Hit With Legionnaires

Read here about a retirement community in Ohio that has been hit with an outbreak of Legionnaires’ disease.

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July 8, 2013

Legionnaires' Disease and Premises Liability

Source: Claims Management, June 2013
By: Thomas P. Bernier and Susan E. Smith

Claims Investigation and Defense Strategies for an Emerging Trend

What is Legionnaires’ disease? Legionnaires’ disease, or legionellosis, is a serious, potentially lethal type of pneumonia that is caused by bacteria of the genus Legionella. The Centers for Disease Control and Prevention (CDC) estimates that 8,000 to 18,000 persons are hospitalized each year with the disease. There were 3,522 reported cases in 2009, the most since 1976 when the CDC first required case reporting. The incidence of reported Legionnaires’ disease cases in the United States tripled between 2000 and 2009, with medical costs estimated at $321 million per year.

As investigation and reporting have become more sophisticated, public awareness of this disease is growing, and legal action by those alleging to have contracted the disease is definitely on the rise. Claims are typically made by individuals who develop flu-like symptoms or pneumonia after staying at an apartment building, hotel, or hospital.

Legionellae are waterborne bacteria that are found in many different water sources. They have proven to be more tolerant of normal chlorine levels than other bacteria and are often present in municipal water supplies and potable water distribution systems. Interestingly, physical contact with or even consumption of water that contains these bacteria does not put a person at risk of infection. Rather, the affected water must become aerosolized into fine droplets, mist, or spray. Only then is a person who inhales sufficient amounts of aerosolized water containing virulent forms of legionellae at risk of infection. Certain individuals, such as the elderly, smokers, and those with lung or kidney disease, diabetes, cancer, or compromised immune systems, are more vulnerable to infection and are at a high risk of contracting the disease after exposure. Legionellosis is not a contagious disease and cannot be passed from one infected host to another.…

April 12, 2013

Bacteria exclusion did not relieve insurer from duty to indemnify and defend wrongful death claim arising from hotel guest contracting legionnaires’ disease

Source: http://www.lexology.com, March 29, 2013
By: Kevin R. Fincel and John O’Connor, Steptoe & Johnson LLP

In Westport Insurance Corporation v. VN Hotel Group, LLC, et al., 2013 WL 1196957 (11th Cir. March 22, 2013), the Eleventh Circuit, applying Florida law, held that the fungi/bacteria exclusion in the policy at issue did not exclude from coverage injury resulting from the legionella bacteria; accordingly, the insurer had a duty to defend a wrongful death claim brought against the insureds.

The case arose out of an wrongful death suit filed by the wife of a hotel guest who died after contracting Legionnaires’ Disease at the insured’s hotel. Id. at *1. The insureds sought to have Westport indemnify them and defend against the suit. Id. Under Florida law, “[a]n insurer is under no duty to defend if the allegations in the complaint implicate a policy exclusion.” Id. at 3 (duty to defend it broader than duty to indemnify–insurer has no duty to indemnify if it has no duty to defend). Westport filed a declaratory judgment action seeking confirmation that it was not responsible for indemnifying and defending the insureds because the policy excluded coverage for injuries resulting from pollutants or bacteria. Id. at 1. Under the terms of the policy, there was no coverage for injury “arising out of the actual, alleged or threatened discharge, dispersal, seepage, migration, release or escape of ‘pollutants.’” Id. The policy also excluded from coverage injury “which would not have occurred, in whole or in part, but for the actual, alleged or threatened inhalation of, ingestion of, contact with, exposure to, existence of, or presence of any ‘fungi’ or bacteria on or within a building or structure, including its contents . . . .” Id. (emphasis added).…

April 1, 2013

Insurance Policy Provides Coverage for Legionnaires Disease

Source: The Legal Examiner, March 26, 2013
By: Ed Normand

The Federal 11th Circuit Court of Appeals recently ruled that a comprehensive general liability policy covering a hotel must provide insurance coverage for the death of a tourist visiting Orlando from England who died after contracting Legionnaires disease sourced from the hotel hot tub. The family was visiting Orlando from England. They chose what was reported to be a Choice Hotel on International Drive in Orlando as part of a package tour. Unknown to them that same hotel had been the site of a reported outbreak of Legionnaires disease about 6 months earlier.The decedent, like many U.K. tourists was a smoker and over 65 making him susceptible to contracting Legionnaires disease from exposure to Legionella bacteria. He and his wife spent time on the pool deck sitting next to the pool spa. On his return to the U.K. he became very sick and died from Legionnaires disease. After very good work by the CDC and the European cohort to the CDC the disease was traced back to the hotel. The spa water was then immediately tested and found positive for Legionella bacteria. Thankfully Orange County Florida Health Department workers also inspected the spa and found it woefully non-compliant with health laws regarding spa maintenance. That negligent maintenance was the alleged cause of the Legionella bacteria and resulting death. Legionnaires disease is tough to pinpoint exactly but it was pretty clear that this spa was the cause of the exposure in this case where the hotel had shocking health code violations related to the spa only months after the spa was linked to a Legionnaires outbreak by investigating officials with the State and County.

March 14, 2013

Engineers' building code standards target Legionella bacteria

Source: The Pittsburgh Tribune-Review, March 9, 2013
Posted on: http://envfpn.advisen.com

An engineering group that influences building codes nationwide is drafting tough new standards to prevent Legionella, the waterborne bacteria blamed in a deadly Legionnaires’ disease outbreak in Pittsburgh.

Federal estimates show Legionnaires’, a form of pneumonia, kills more than 4,000 people and sickens about 21,000 others each year, three decades after researchers figured out how to control the bacteria in tap water.

The proposed standards would require building operators to verify they are monitoring the Legionella threat in commercial, residential and medical facilities with established risk factors, such as multiple whirlpools and spas. It also outlines methods to prevent the growth of the bacteria.

The cost of implementing these standards is unknown. Single-family homes would not be included in the proposed changes.

“It’s not the science or the engineering lacking here. It’s the lack of a management system that can be applied in a practical and defensible way,” said William McCoy, Standards Committee chairman at the American Society of Heating, Refrigerating and Air-Conditioning Engineers in Atlanta.

McCoy’s international committee, part of the 55,000-member engineering society, worked for the past six years to craft the first unified and enforceable domestic rules for Legionella control in the plumbing of large buildings, where the bacteria can fester and grow. The proposed plan could be voted on by the society’s board this year.…

March 4, 2013

New ASHRAE Standard Dictates Legionnaires’ Disease Prevention

Source: Indoor Environment Connections, April 2012
By: Thomas P. Bernier and Susan E. Smith, Segal McCambridge Singer & Mahoney, Ltd., Baltimore MD

Legionnaires’ disease is a serious, potentially lethal, type of pneumonia that is caused by bacteria of the genus Legionella. The Centers for Disease Control and Prevention (CDC) estimate that 8,000 to 18,000 persons are hospitalized each year with the disease. There were 3,522 reported cases in 2009, the most since 1976, when the CDC first required case reporting. The incidence of reported Legionnaires’ disease cases in the United States tripled between 2000 and 2009. As investigation and reporting have become more sophisticated, public awareness of this disease is growing, and legal action by those alleging to have contracted the disease is on the rise. Imminent action by the American Society of Heating, Refrigerating and Air-Conditioning Engineers, Inc. (“ASHRAE”)—adoption of Standard 188P—will make it easier for those persons to prove the legal liability of those involved with the ownership, design, construction, installation, management, operation, maintenance, and servicing of the premises where outbreaks occur.

Legionnaires’ disease is commonly associated with cooling towers because the first outbreak, in 1976, was traced to a cooling tower in the air-conditioning system at the Bellevue Stratford Hotel in Philadelphia during an American Legion convention. Subsequent outbreaks have been traced to building water systems, indoor spas and pools, whirlpool spas, humidifiers, and ventilation and cooling systems. Decorative water fountains, including water walltype fountains, were implicated in two recent outbreaks, even though regular cleaning, flushing, and disinfection protocols were in place. Hands-free, or “electronic-eye”, faucets, often found in hospitals and other healthcare facilities, have been identified as a potential exposure source. Although no disease transmissions or outbreaks have been traced to hands-free faucets, an investigation conducted by the Johns Hopkins Hospital showed that water from such faucets was more likely to be contaminated with Legionella. (Electronic-eye Faucets: Help or Hindrance to Infection Control and Prevention, presented at the 2011 Annual Scientific Meeting of the Society for Healthcare Epidemiology in America, held in Dallas, Texas.)…

December 26, 2012

Legionnaires’ prevention under dispute

Source: Pittsburgh Post-Gazette, December 24, 2012
Posted on: http://envfpn.advisen.com

When the VA Pittsburgh Health Care System first revealed on Nov. 16 that it had an outbreak of Legionnaires’ disease that sickened four patients at its Oakland veterans hospital, it blamed a water treatment system that had been in use there since 1993.

In the last paragraph of its news release, the VA wrote: “Our existing copper-silver ionization system — which reduces the presence of Legionella in water — may not be as effective as previously thought, as is the case in other health systems using this method. Consequently, we are shifting to a chlorination system to ensure better control.”

Those 45 words reignited a debate that has raged ever since Legionella, the often-deadly bacteria that causes Legionnaires’, was first identified in 1977 after an outbreak at an American Legion convention in Philadelphia, and 30 years after Pittsburgh researchers first confirmed that it was transmitted through water systems: What is the best way to prevent the spread of Legionella?

As it so often is in scientific and commercial debate, the answer to the question depends on whom you ask.

Though the federal Centers for Disease Control and Prevention, which is working with the Pittsburgh VA on its outbreak, has maintained for at least 15 years that chlorination is the best prevention method in water systems, there is no unanimous answer in the broader scientific or water treatment community.

There are passionate, well-researched voices on multiple sides of the debate. Some believe in copper-silver, some in chlorination, some in chlorine-dioxide, others in monochloramine. Together these four methods are the dominant prevention technology in use today, researchers and industry officials say. All rely on releasing minute amounts of the chemicals into a building’s water system to kill Legionella.…

January 12, 2012

Hospital fountain linked to Legionnaires’ outbreak

Source: http://www.washingtonpost.com, January 10, 2012
By: Lena H. Sun

An outbreak of Legionnaires’ disease in Wisconsin has been linked to a decorative water wall in a hospital lobby, according to a study published Tuesday that suggested the popular architectural feature can pose dangers in a health-care setting, especially for people with weakened immune systems.

In 2010, eight people contracted the severe and potentially life-threatening form of pneumonia caused by the bacteria. None had been admitted to the Milwaukee-area hospital at the time of exposure. But they all had walked by the water wall in the main hospital lobby, researchers said.

The disease is spread through inhalation contact with contaminated water sources.

One person who got sick was a delivery man. Three others were picking up medication at the hospital pharmacy. Three were outpatients. And one man was waiting to pick up his wife.

“He really enjoyed sitting next to the water wall,” said Thomas Haupt, a Wisconsin health division epidemiologist and lead author of the study. “These water walls are indeed very beautiful, but they’re very risky.”

All eight either had underlying medical conditions or other factors that increased their risks of getting Legionnaires’ disease. Three were hospitalized in intensive care and were on mechanical ventilators; all eight survived.

The study, published online in Infection Control and Hospital Epidemiology, is the second documented outbreak of Legionnaires’ disease in a health-care setting associated with a wall-type water fountain, a design that is increasingly popular in hospitals, hotels, spas and other public settings, the study said. In 2007, two cancer patients at the National Institutes of Health in Bethesda were diagnosed with the disease after being exposed to a contaminated wall-type water fountain.…

September 20, 2011

Legionnaires’ disease found in Allegheny County PA

Source: USA Today, September 16, 2011

Pennsylvania: Turtle Creek – The Allegheny County Health Department said 10 cases of Legionnaires’ disease have been discovered, two at the Hamilton Hills Personal Care Facility and eight at the nearby LGAR Health & Rehabilitation Center.  Water supplies at both facilities are being treated.  The cause of the outbreak is unknown.…