Legionellosis

Health care facility patients at risk for Legionnaires’ disease

Thursday, June 8, 2017

A report from the Center for Disease Control and Prevention (CDC) in the U.S. found that patients in health care facilities are at risk for Legionnaires’ disease.

In response, ASHRAE is alerting facilities to its ASHRAE Standard 188, which helps develop water management programs to reduce Legionella in buildings.

More than 76 per cent of Legionnaires’ disease cases acquired from Legionella exposure in U.S.-based health care facilities are “harsh,” and include possible fatal risks to patients, according to the CDC.

Legionnaires’ disease is a serious type of pneumonia caused by bacteria, called Legionella that lives in water. Legionella can make people sick when they inhale contaminated water from building water systems that are not adequately maintained.

“Determining Legionnaire’s disease causation is not simple since the mere presence of Legionella in a water system or device is not sufficient to cause disease,” says Michael Patton, member of ASHRAE Committee SSPC 188. “The bacteria must ultimately be inhaled or aspirated into the lungs of a susceptible person to cause disease.”

The report’s findings – part of the CDC’s monthly Vital Signs publication – are based upon exposure data from 20 states and New York City. According to the CDC, the analysis was limited to these 21 jurisdictions because they reported exposure details for most of their cases, which allowed the CDC to determine how Legionnaires’ disease was associated with health care facilities.

About three per cent of Legionnaires’ disease cases were determined to be “definitely associated with a health care facility,” with 17 per cent of cases listed as “possibly associated with a health care facility.”

“Since people with conditions that have reduced their ability to fight off infections are especially susceptible, it is not a surprise the report found patients in health care facilities to be at risk,” adds Patton. “It’s vitally important all buildings incorporate good design, operations and maintenance procedures that prevent growth and spread of Legionella as these are regarded as the best methods of preventing disease.”

ASHRAE notes a Water Management Plan will reduce the chance of heavy colonization, amplification and dissemination to people. ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems assists designers and building operators in developing a Water Management Plan that includes practices specific to the systems that exist in a particular building, campus or health care facility.

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