Legionella Testing, Planning, and Remediation: How a Healthcare Facility Got Two Out of Three Wrong

At Legionella Control Systems, we find it very satisfying to work with facility managers on Legionella issues for three reasons:

1. Facility managers tend to be dedicated, intelligent professionals who are truly concerned about Legionella and want to protect the people in their facility.
2. As an independent Legionella consultant, we have access to every possible Legionella preventative measure and solution, so we find the best solution for a facility – not just one or two products that we happen to manufacture.
3. We get great results, and the only thing more satisfying than watching Legionella numbers drop is creating a Legionella prevention plan that prevents a Legionella outbreak from occurring in the first place. In either case, you know you are protecting visitors and staff from Legionnaire’s disease.

That’s why when we see a Legionella outbreak in the news, we sometimes shake our heads because we know someone probably made poor choices.

For example, consider a Legionella outbreak that occurred not too long ago in an East Coast healthcare facility. We’ll limit the details to avoid naming them, but the general information paints a picture of what was likely done correctly and incorrectly.

• The situation started when the healthcare facility found Legionella bacteria in their water supply. It’s not clear whether this testing was part of their routine operation, but let’s give them the benefit of the doubt and presume that they did Legionella testing on a regular basis throughout the facility so no one became ill. That’s great.
• The facility then notified the relevant authorities about the presence of Legionella, who in turn notified the facility’s patients and staff. The notification process may vary by state, so we’ll presume this was fine.
• The facility and/or its Legionella remediation contractor tried to treat the Legionella by flushing the system with chlorine. That’s a red flag for us because studies show that chlorine is often ineffective for Legionella remediation. Sure, your household chlorine bleach does a great job of killing bacteria in your sink, but that doesn’t mean that chlorine is a good choice for Legionella control. Chlorine typically struggles with effectively penetrating the biofilm in pipes to kill Legionella. Moreover, treatment with chlorine often leads to a Legionella rebound, meaning follow-up testing shows Legionella at levels equal to or even greater than the original counts. So we consider their use of chlorine to be a very poor remediation choice.
• Based on the above, you won’t be surprised to hear that flushing the system with chlorine was not effective, and the Legionella was reported as difficult to clear.
• In an effort to protect the patients and staff, the facility turned off the water. That might be reasonable because protecting people is the most important principle. However, the water remained off for nearly a month. The result was limited meal options, toilets that overflowed, and a requirement for patients to take showers outdoors. This is a complex situation that may have involved several bad choices, so let’s just focus on the remediation: an effective Legionella remediation choice (e.g. not chlorine) probably could have resolved this Legionella outbreak much more quickly, meaning that the water would not have been shut off for a month.
• – Due to the problem associated with the water being off that long, the occupants filed a lawsuit. Yes, it is critical that occupants be protected, but a facility can’t simply shut off the water as part of their Legionella response without having a plan to deal with the lack of water. As part of the settlement, the emergency protocols are being rewritten to consider this possibility in the future. We wonder if the facility had a comprehensive water management plan. This is one of the reasons we recommend a review of your water management plan by an independent Legionella consultant such as Legionella Control Systems.

To be fair, Legionella outbreaks are not simple, and every facility brings its own challenges, but it seems as though more than one mistake was made in this case.

While facility managers genuinely care about the welfare of their building’s occupants, they aren’t usually Legionella experts. That is why they should always work with an independent Legionella expert like Legionella Control Systems. We consider all options in your Legionella water management plan including Legionella testing, emergency contingencies, Legionella remediation, and ongoing Legionella prevention and water treatment.

When lives are at stake like they are with Legionella, you shouldn’t settle for “good enough.” Contact Legionella Control Systems so we can help you manage your Legionella risk and protect your facility’s occupants.