LEGIONELLA AT HARRISON MEDICAL CENTER - BREMERTON

The Kitsap Public Health District was notified about a confirmed case of Legionella (a notifiable condition per state law) at Harrison Medical Center’s Bremerton campus. In response, an investigation was conducted by an interdisciplinary team of staff from Harrison Medical Center, the Washington State Department of Health (DOH), the Health District, with guidance from the Centers for Disease Control & Prevention (CDC). There has been great support and cooperation from CHI/Harrison Medical Center throughout the investigation.

On Friday, Feb. 3, 2017 the Health District issued an order to Harrison Medical Center to take response actions effective immediately, commensurate with the recommendations from the DOH Legionella Response Investigators to protect public health and to ensure that all hot water systems at HMC are properly flushed and maintained to be free of legionella bacteria in the future.

We believe the risk to public health of Legionnaires’ disease is low because of actions already taken, and additional actions Harrison will take as outlined in the Health Officer’s order and the DOH report.

In nature, Legionella live in fresh water and rarely cause illness. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems or parts of air conditioning systems in multi-story buildings.

Most healthy people do not get sick after being exposed to Legionella.  The bacteria are NOT spread from one person to another person. People are exposed to the bacteria through inhalation of aerosols from water sources contaminated with the bacteria.

People most at risk of getting sick from the bacteria are:

  • Individuals age 50 or older
  • People who smoke or have chronic lung disease (like emphysema)
  • Those who have weak immune systems from cancer, diabetes, kidney failure, medications, or other medical conditions.

Legionnaires’ disease can cause pneumonia symptoms and typically include cough, shortness of breath, fever, muscle aches, and headaches.  

Symptoms usually begin 2 to 10 days after being exposed to the bacteria. It can take longer so people should watch for symptoms for about 2 weeks after exposure.

Below is some additional information and resources on Legionnaires’ Disease.

What is Legionnaires’ disease?
Legionnaires’ (LEE-juh-nares) disease is a type of severe pneumonia caused by bacteria called Legionella.  The bacteria got the name in 1976 after many people who went to a Philadelphia convention of the American Legion became ill from the disease.

How serious is it? What is the treatment?
Legionnaires’ disease is serious, but most people can be treated successfully with specific antibiotics (drugs that kill bacteria in the body). However, Legionnaires’ disease can be very serious and can be fatal in 5 percent to 30 percent of cases.

Who gets this disease?
Most healthy people do not get Legionnaires’ disease after being exposed to Legionella.  People most at risk of getting sick from the bacteria are older people (usually 50 years or older), people who smoke or have chronic lung disease (like emphysema), and those who have weak immune systems from cancer, diabetes, kidney failure, medications, or other medical conditions. 

Where do Legionella bacteria come from?
Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, cooling towers, hot water tanks, large plumbing systems, or parts of the air-conditioning systems of large buildings.

How do people get Legionnaires’ disease?
People get Legionnaires’ disease when they breathe in a mist or vapor (small droplets of water in the air) that has been contaminated with the bacteria. One example might be from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected. Other infections have been linked to aerosol sources such as cooling towers (air-conditioning units from large buildings) and water used for drinking and bathing.  The bacteria are NOT spread from one person to another person.

What are the symptoms of Legionnaires’ disease?
Legionnaires’ disease can have symptoms like many other types of pneumonia, so it can be hard to diagnose at first. Signs of the disease can include a high fever, chills, and a cough. Some people also have muscle aches or headaches.

A milder infection caused by the same type of Legionella bacteria is called Pontiac Fever. The symptoms of Pontiac Fever usually last for 2 to 5 days and may also include fever, headaches, and muscle aches; however, there is no pneumonia. Symptoms go away on their own without treatment and without causing further problems.

Pontiac Fever and Legionnaires’ disease are also called “Legionellosis” (LEE-juh-nuh-low-sis).

How soon after exposure do symptoms appear?
Symptoms usually begin 2 to 10 days after being exposed to the bacteria.

How is Legionnaires’ disease diagnosed?
Most people with Legionnaires’ disease get pneumonia (lung infection) since the Legionella bacteria grow and thrive in the lungs. Pneumonia is confirmed either by chest x-ray or clinical diagnosis. Several laboratory tests can be used to detect the Legionella bacteria in the body. The most common laboratory test is the urinary antigen test, which detects Legionella bacteria from a urine sample. Legionella bacteria can also be cultured (grown) in a laboratory from respiratory secretions.

Is Legionnaire’s Disease common? 
There are approximately 5,000 cases of Legionnaires’ disease reported to the CDC each year in the United States.  The CDC believes this is likely a low estimate because the illness is thought to be underdiagnosed. 

Local cases of Legionnaires’ disease

2015

2016

Washington State

58

66

Kitsap County

4

2

 

Is Legionnaires’ disease on the rise?
In general, the number of cases reported to CDC has been on the rise over the past decade. This may reflect a true increase in the frequency of disease due to a number of factors (e.g., older U.S. population, more at-risk individuals, aging plumbing infrastructure, climate). It may also be in part a result of increased use of diagnostic testing.

Where does Legionnaires’ disease occur most often in the United States?
Legionnaires’ disease appears to be more common in the northeastern United States. Researchers are not certain why that is, but it is likely related to a combination of factors.

RESOURCES:

CDC:  https://www.cdc.gov/legionella/about/

CDC Fact Sheet

Washington State Department of Health Fact Sheet

 

 


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