Story at-a-glance
- Legionnaires’ disease first entered the American consciousness in 1976 when scores of people were sickened and 29 died of a mysterious lung infection at a hotel convention in Philadelphia
- Experts have pointed to what is now called Legionella bacteria found in water sources as the culprits behind Legionnaires’ disease, which typically causes pneumonia, as well as vomiting, diarrhea, muscle pain and mental confusion
- The CDC reports that 8,000 to 18,000 people are hospitalized with Legionnaires’ annually, although it may take doctors time to determine what it is, as the symptoms at first seem like a typical, mild respiratory infection
To help ensure optimal air and water quality, clean your air conditioner, heat ducts and filters regularly, and provide filtered water for every member of your family to avoid potentially deadly bacteriaBy Dr. MercolaLegionnaires’ disease first entered the news about 40 years ago when, according to The Legionnaires’ Lawyer,1 34 people died from a mysterious respiratory ailment. The same illness emerged again recently when 12 people at Disneyland became infected with the lung disease, with one fatality. Clues left for investigators to sort out were that the individuals ranged in age from 52 to 94.One was an employee at the park, eight were visitors and three had not visited the park but had been in Anaheim, California, where Disneyland is located. It ended up being someone who hadn’t been to the theme park who died. “Atypical” symptoms include pneumonia, headaches, nausea, diarrhea, muscle aches and mental confusion.
According to Dr. Pamela Hymel, chief medical officer for Walt Disney Parks and Resorts, the source was traced to two cooling towers, in which elevated levels of Legionella bacteria were found.
The towers, while summarily shut down and disinfected,2 were more than 100 feet from public areas. Even more recent than the Disneyworld Legionnaires’ disease outbreak was one that occurred at American Airlines when a worker became sick. Investigators found Legionella bacteria, aka L. pneumophila, in four of the airport’s maintenance hangars.3
Cooling towers were also the culprit in a Bronx outbreak in 2015, killing seven people and infecting 86. Two rooftop air conditioning systems tested positive for Legionella bacteria.4 When seven people died in Portugal in 2014, the source was again traced to the same bacteria in cooling towers.5 However, Quartz reported that most cases can be traced to hot water tanks, humidifiers, whirlpool spas, fountains, hot tubs and large air conditioning systems.6
Deadline Hollywood noted that Legionella can show up in contaminated water or mist,7 and not just in the U.S.; Legionella are becoming a small part of the water crisis worldwide. In May 2017, The Wall Street Journal reported the Centers for Disease Control and Prevention’s (CDC’s) finding that “Legionnaires’ was living or had lived in 84 percent of nearly 200 cooling towers tested in the United States.”8
How Cooling Systems Spread Legionnaires’
A severe respiratory illness that broke out in Pennsylvania in 1976 was the first time its unique symptoms and subsequent “body count” had doctors and scientists desperately scratching their heads because they had no idea what it was or what caused it. Besides the 34 people who died, 221 became seriously ill. Because it occurred at a statewide American Legion convention, it was called Legionnaires’ disease.
Scientists first pointed to a pneumonia-causing bacterium, one known as rickettsia, transmitted by mites, ticks or lice but, understandably, as people continued dying, speculation was rampant.12 Newspaper reports of the outbreak hinted of biological and chemical warfare and accusations of a governmentwide cover-up.
Some thought it was a CIA experiment, parrot fever, swine flu or the plague. Others thought it might have something to do with extraterrestrials; many thought the whole thing was a hoax.13 As the Legionnaires’ Lawyer noted:
“It wasn’t until December 1976 that Dr. Joseph McDade, a CDC laboratory scientist, using the technique of guinea pig inoculation, was able to isolate the bacterium that caused the disease and identify it as Legionella pneumophila. It was further determined that the bacillus had apparently spread from the hotel’s air conditioning system.
In April, 1977, the term Legionnaires’ Disease was first published by the CDC as the official name of the epidemic disease that had caused such a national stir.”14
More History of the ‘Unclassified Agent’
Hindsight so often being a good teacher, once the cause of the disease had been identified, scientists began working backward from the watershed “incident” in Philadelphia in 1976. Experts have since learned that the genus Legionella comprises about 40 named species and subspecies.
- What for a while was called a “new” bacterium, a previously unidentified “unclassified agent” isolated as early as 1947 was identified as Legionnaires’.15
- In Austin, Minnesota, in 1957, 78 workers developed pneumonia at a Hormel Foods Corp. meat packing plant. Undetermined at the time, 22 years later tests showed survivors to have had significantly elevated levels L. pneumophila antibodies in their blood. The source was identified as the plant’s cooling tower.16
- In 1965, 81 patients developed pneumonia at St. Elizabeth’s psychiatric hospital in Washington, D.C., and 14 died. Stored serum specimens in 1977 confirmed it was L. pneumophila. The probable delivery agent: water from a lawn-sprinkling system being excavated.17
- In late summer of 1978, an outbreak occurred at a Memphis, Tennessee, hospital. Of the 44 ill, 39 included patients, employees and passersby. With an incubation period of two to 10 days, the onset “correlated precisely” with use of the hospital’s auxiliary air conditioning cooling tower. L. pneumophila was recovered from two water samples receiving air from intakes near the cooling tower.18
- When people who worked at or visited the Pontiac, Michigan, health department came down with the same symptoms in 1968, it was simply called Pontiac disease. Later, it was determined to be Legionnaires’,19 but mild cases are sometimes called Pontiac’s disease.20 Unfortunately, these incidents are just a drop in the bucket.
‘Body Count’ in Flint Attributed to Legionnaires’ Disease
Flint, Michigan, became a household name due to an “ill-thought-out attempt at cost savings” when the city’s (state-appointed) emergency manager changed the city’s water supply from Lake Huron to the Flint River in 2014. To save $100 a day, they decided not to add anticorrosives, which was a violation of federal law, Forbes21 reported, quoting Michigan’s Department of Natural Resources (DNR) Flint River Assessment:22
“Historically, the water in the Flint River downstream of Flint has been of poor quality, and was severely degraded during the 1970s due to ‘the presence of fecal coliform bacteria, low dissolved oxygen, plant nutrients, oils and toxic substances.’
In 2001, the state ordered the monitoring and cleanup of 134 polluted sites within the Flint River watershed, including industrial complexes, landfills and farms laden with pesticides and fertilizer … The river was found to be 19 times more corrosive than the water from Detroit, which was from Lake Huron, according to study by Virginia Tech.”23
A Virginia Tech investigative team found Flint’s water to contain 1,000 times higher levels of Legionella bacteria than they “expected.”24The debacle was referred to as a downhill “cascade” by the health officials parsing out what went wrong where. Corrosion of iron leaching from old iron pipes, which both stimulated the Legionella growth and inactivated the chlorine disinfectant health officials had begun plying the water with to kill the bacteria, was noted.
It was a medical, governmental and public relations nightmare, with frequent on-and-off boil-water advisories due to E. coli contamination, release of carcinogenic total trihalomethanes (TTHM) and a significant uptick in lead content. Projected costs for remediation were staggering, not to mention the toll on families.
However, Flint’s MLive News noted that while 12 deaths from Legionnaires’ were reported in the wake of Flint’s tainted water, there were likely many more. Dr. Marcus Zervos, head of Henry Ford Hospital’s Infectious Diseases division and co-principal investigator of Wayne State University’s study of Flint’s water contamination crisis, noted in courtroom testimony that:
“According to the state’s public health criteria, Legionnaires’ must only be listed as a cause of death of a person if they die from contracting the bacteria during hospitalization or 30 days after being discharged.
For example, Zervos said, if a patient contracted legionella bacteria while in a hospital, but died six months later after the bacteria weakened their heart, their cause of death — by public health definition — would be ‘heart failure,’ but could be considered by disease specialists to be precipitated by legionella.”25
Six people were ultimately charged with involuntary manslaughter.26 Currently, the water in Flint is said to meet the Environmental Protection Agency’s (EPA’s) Lead and Copper Rule.27
What You Can Do to Avoid Legionella Bacteria
Spanish authorities were flummoxed when an epidemic of pneumonia struck (at least) 150 British tourists staying at a hotel in a coastal resort town between 1973 and 1980. The hotel’s potable water system was identified as the source. But when changes to the hotel’s plumbing, water chlorination and hot water temperature were made, the “multiyear epidemic” ended.28 People with the disease can be treated with antibiotics, but antibiotic resistance is rampant due to overuse, especially by industrial agriculture.
The fact is, depending on where you are in the world, including in the U.S., drinking water from taps or fountains can be anything but safe. Norovirus, E. coli, Shigella and giardia have been identified in many outbreaks. Additionally, pharmaceuticals and other chemicals, including fluoride in the water, have sickened people.
Ensuring a source of pure, filtered water for every member of your family, whether they’re drinking it at school, work or elsewhere, is the safest way to avoid potentially deadly bacteria. You can achieve this by filtering your tap water and taking it with you in safe, nontoxic and reusable bottles when you’re out and about. Talk to your kids about the importance of what they eat and drink, because toxins are real, not a scare tactic.
In fact, more than 267 different toxins have been found in public tap water. Talking to school officials about potential toxins or bacteria in the school’s water may also be in order. Regarding water systems, the CDC has provided a number of recommendations29 for building owners and managers, state and local officials and health care providers to become informed and learn how to clean and maintain water management systems and implement programs to help prevent Legionnaires’ outbreaks.
Taking Care of Your Air Conditioning Systems to Help Prevent Illness
Most people don’t even consider their uncared-for air conditioner might be toxic and sapping their health. The compressor might be outside your house, but inside, often in the attic or basement, is usually where the condensation occurs. The pan that sits underneath the handler to collect it is connected to a drain tube. The pans get plugged fairly frequently, and that, unfortunately, creates an extremely friendly environment for harmful bacteria to grow.
Cold weather that transitions to hot water, which then sits there indefinitely, can become stagnant. It may even influence the sometimes-discolored scaly buildup on metal pieces, indicating the accumulation of a potentially deadly bacteria. Further, if you find yourself in a hotel room or some other environment where the indoor air quality may seem slightly unpleasant and maybe even reminiscent of mildew or mold, consider it the source of a potential problem.
Especially when you travel and come home with a head cold or respiratory problems, these types of environments could explain it. A runny nose, fatigue, dizziness, forgetfulness, scratchy throats and headaches are a few signs that your indoor air or water quality might not be the best. Here are tips to help ensure you’re doing what you can to prevent health problems from questionable air and water quality:
- Mold grows in damp and humid environments, so the use of a dehumidifier and air conditioner help keep your humidity under 50 percent.
- Because indoor air contains two to five times, and in some cases as much as 100 times, more contaminants than the air outdoors, investing in a whole house air purifier is recommended.
- Make sure you check your air conditioning unit at regular intervals to make sure it’s draining properly. Be sure the drain pan for the handler stays empty. You could also spray white vinegar on the actual A-frame, known as the condenser.
- Air ducts from forced air heating and air conditioning units can cause pollution in your home. If there’s dust, mold growth or signs of unwanted guest like mice, it’s time to call a professional and have the air ducts cleaned.
- Change your furnace filters every three months or more often if necessary if they appear to be dirty.