Las Vegas Legionnaires Scare

Las Vegas Legionnaires scare led to an immediate shut down of water supply at Rawson-Neal Psychiatric Hospital on October 2. Legionella bacteria was found in the hospital’s water supply during quarterly routine testing, according to a spokeswoman for Nevada Department of Health and Human Services.

No illnesses have been reported yet.

The hospital started disinfecting their water systems on October 7th. It’s been two weeks since the patients haven’t been able to take a shower or drink water inside the hospital premises. Legionnaires’ disease spreads when people breathe in aerosolized droplets (small droplets of water or mist that can be inhaled) contaminated with Legionella bacteria. Not all people who breathe in the droplet will fall ill but some do.

Hospital staff have been given clear instructions to look for signs of illnesses in the patients. Currently, there are 64 patients at the facility. The plan under place is to stop the use of all system water. Bottled water is being supplied for drinking, washing, general use and other preparation services, said spokeswoman Shannon Litz.

Patients are also provided with cleansing wipes and dry shampoo-infused caps. According to Centers for Disease Control and Prevention, the facility is disinfecting the water supply and line. The mitigation plan was initiated after being approved by Southern Nevada Health District.

Water is expected to regain running by the end of this week after the testing confirms that Legionella bacteria in the water system is effectively treated.

How does Legionella bacteria get into plumbing systems?

Legionella naturally occur in lakes and streams. It only poses a health concern when it makes its way into man-made water systems. When the condition is right, legionella grows and spreads through the plumbing systems. It’s of concern at buildings like hotels, hospitals, nursing homes and schools because they have large plumbing systems which becomes difficult to maintain.

The water system in large buildings are massive and complicated, and if anything goes wrong, lots of people can get exposed to the bacterium, said Brian Labus, an infectious disease epidemiologist.

Apart from their complexity, hospitals and nursing homes also have vulnerable populations, which means that these individuals are more at risk of contracting the disease and developing complications as well. High-risk individuals include:

• Elders aged 50 and above
• Those who smoke or have a history of smoking
• Those who have weakened immune system
• Those who have chronic lung disease or other underlying condition

Once Legionella bacteria starts spreading, it gets into small droplets which people are able to breathe in. Some of the most common sources of bacteria transmission are systems that can produce large amount of aerosolized droplets like

• Cooling towers
• Shower heads and sink faucets
• Hot tubs and whirlpools
• Decorative fountains
• Hot water tanks and heaters

Any large buildings with these systems are required to have regular testing and maintain comprehensive water-management plans to prevent Legionella growth. Legionella bacteria grows best between the temperatures of 77 to 108 degrees Fahrenheit. The reason why Legionnaires is quite common during summer and early fall.

Legionnaires was named after an outbreak in Philadelphia in 1976 sickened over 200 people and reported 34 deaths. The outbreak occurred at an American Legion convention at Bellevue-Stratford Hotel. The bacteria was discovered 6 months after the outbreak came into notice. Many health officials declared it as a health epidemic as numbers kept rising each week. The bacteria was ultimately named Legionella pneumophila.

Incubation period of legionella is two to ten days and symptoms start with:

• Cough
• Fever
• Headaches

After a day or two, symptoms progresses to the following:

• Muscle aches
• Shortness of breath
• Chest pain
• Gastrointestinal symptoms like nausea, diarrhea
• Mental changes like confusion

A mild form of legionnaires can also occur as a result of legionella bacteria. It’s called Pontiac fever. It has the same symptoms – cough, fever, headache and muscle aches – but doesn’t cause lung infection. It usually clears up within 2-5 days.

Las Vegas Legionnaires cases have increased in number since the past few years. 2 guests at Rio hotel casino contracted the disease in 2017. Cases were also investigated at Harrah’s Laughlin hotel in 2017 and 2018, a guest of Luxor died in 2012 and 6 people contracted the disease while visiting Aria in 2011.

From 2000 to 2017, legionnaires cases went up by 500% in the United States. A lot of factors could have contributed to the increase: from an actual increase in cases, better diagnosis and reporting to an increase in risk for older population or thorough investigation of the outbreaks. More than 80% of the cases were reported in elders aged 50 or above. Among them, 60% were men. According to one report, more than 95% of people ended up being hospitalized in 2014 and 2015 due to Legionnaires.

The most important factor in preventing Legionella growth in man made systems is to keep the temperature of water under control – lower than 77 degrees Fahrenheit or higher than 108 degrees Fahrenheit. It’s also important to prevent any stagnation in pipes, dead ends and growth of biofilm. If you run a hotel or hospital, and any room has been unoccupied for several days, it’s important to properly sanitize it. Since it has been unused for days, the temperature can reach danger zone and bacteria might flourish.

It’s important that building owners and managers take it upon themselves to develop a comprehensive management program for complex water systems in their facility. Unlike homes, commercial buildings have long pipes where water may remain stagnant for a long time and reach danger zone. It’s important to identify these areas to prevent Legionnaires infection.

Legionnaires is treated with antibiotics. The sooner the treatment starts, the better are the chances of recovery. Treatment mostly requires hospitalisation. Pontiac fever doesn’t require any treatment and goes away on its own. If you or a loved one contracted Legionnaires and believe you may have a case, get in touch with a Legionnaires’ disease lawyer for a free consultation.

By: Pooja Sharma, Contributing Writer (Non-Lawyer)