What should you do if an employee or occupant at your facility is diagnosed with Legionnaires’ disease or Pontiac fever? How would you respond? Who should be involved? A methodical approach to this situation is crucial. If there is a confirmed case of Legionnaires’ disease, or worse, a death, it is essential to have a plan that addresses all of the issues.
It is best to have a written, well-thought-out plan in advance of any health-related issue; however, with Legionnaires’ disease it is critical. Whenever there is a case of Legionnaires’ disease or Pontiac fever, the essential steps to reduce the potential for additional cases and to respond to the immediate issues include the following:
- Shut off drinking-water supplies; use bottled water
- Shutdown outdoor air intakes if there are cooling towers
- Consult with a physician to assess specific risk factors in other occupants such as the elderly, smokers and immuno-compromised individuals
- Consult with an industrial hygienist with significant expertise in Legionella assessments
- Have the industrial hygienist conduct a walk-through survey to identify potential Legionella bacteria reservoirs and pathways for potential exposure
- Develop a sampling plan and collect water samples for Legionella analysis using PCR and culturable methodologies
- Address human resource needs and facility-related issues
- Evaluate hot water temperatures
- Evaluate the current treatment and maintenance procedures for cooling towers and for water distribution and storage systems
- Have the industrial hygienist review laboratory data with medical and facilities components
- Design and implement treatment options based on laboratory results and water sources found to be positive for the Legionella bacteria
- Conduct follow-up sampling after treatment and following any plumbing modifications
- Develop a Legionella control plan
- Conduct annual audits of the plan’s effectiveness
Here are a few facts worth remembering:
- Legionella bacteria are naturally occurring and can be found in outdoor water sources
- Legionella bacteria grow best in warm water, typically 95 to 110 degrees Fahrenheit
- Just one colony of Legionella pneumophila bacteria in a drinking water system is a concern
- There is no validated air sampling method for the Legionella bacteria
- Treatment of water systems is not always effective due to slime layers, corrosion and sediment.