How to Prevent Illness and Death From Legionnaires' Disease

Legionnaires' disease prevention is deadly serious business. A recent outbreak in New York City this last summer killed at least twelve, and sent scores more to the hospital with nasty pneumonia-like symptoms. The Legionella bacterium that causes the disease is particularly dangerous to the elderly and to those with compromised immune systems.

Legionnaires' disease, so named after an outbreak of the disease from contaminated water afflicted hundreds and killed dozens of attendees at an American Legion convention at a Philadelphia hotel in 1976, is a danger wherever warm water remains stagnant for an extended period of time. People can become infected by drinking or bathing in the water, and even by breathing in contaminated water vapor that can infect ventilation systems or areas around hot tubs, spas, hot water taps and the like.

The aforementioned large New York City outbreak from last summer was centered on a handful of hotels. Another outbreak killed three residents of a veterans' home in Illinois, and a number of inmates at the San Quentin prison in California were sickened by the disease as well.

Most directors of large facilities are keenly aware of the constant danger of Legionnaires' disease, and routinely invest large amounts of money in water consultants and the sanitation and treatment of their water systems. The threat, however, is vastly less understood among small investors, property managers, and even development managers.

Training and Resources Are Necessary to Prevent Outbreaks



Your association's board members should be keenly aware of the prime breeding grounds for Legionella bacteria. Maintenance staff must be trained on Legionella eradication and disease prevention, and be provided with the resources to actually conduct the required maintenance, or bring in specialized vendors with the proper certifications, equipment and skill sets, as necessary.

Any association management firm you bring on should be able to brief you on their procedures regarding Legionnaires' disease safety. But ultimately the responsibility to keep your association's residents and staff healthy lies with the board of directors.

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Liability Issues With Legionnaires' Disease



If a resident, a guest or staff member contracts Legionnaires' disease, and the infection can be traced back to your property, the potential liability for your association is significant. The Center for Disease Control estimates that the overall fatality rate for known Legionnaires' disease outbreaks is between 5 and 30 percent. Survivors can spend weeks in the hospital and amass significant medical bills.

Boards should protect owners' health and interests by ensuring insurance coverage is in place to cover the risk of an infection, and have policies with high enough limits to cover multiple infections.

Insurance Considerations for Legionnaires' Disease



Often, landlord insurance policies and HOA general liability policies don't specifically include protection for Legionnaires' disease. Some policies may have exclusions covering bacteria or fungi, or a Total Pollution Exclusion that could provide a carrier with the justification to contest a claim. However, courts have generally ruled against insurance carriers when they have tried to assert these exclusions concerning Legionnaires' disease outbreaks.

Speak with your property and casualty insurance agent about what your policy does and does not cover, and make sure to do so before any problems arise! If the carrier excludes coverage for Legionnaires' disease-related liability, it may be prudent to take out an environmental insurance policy that provides more explicit coverage.

Training and Resources Are Necessary to Prevent Outbreaks



Your association's board members should be keenly aware of the prime breeding grounds for Legionella bacteria. Maintenance staff must be trained on Legionella eradication and disease prevention, and be provided with the resources to actually conduct the required maintenance, or bring in specialized vendors with the proper certifications, equipment and skill sets, as necessary.

Any association management firm you bring on should be able to brief you on their procedures regarding Legionnaires' disease safety. But ultimately the responsibility to keep your association's residents and staff healthy lies with the board of directors.

Areas Where Legionella Bacteria Can Thrive



Legionella bacteria can grow and thrive in the following environments. Take extra care to ensure these areas are kept sanitized.


HVAC cooling towers
Water heaters
Hot tubs
Pools
Ponds
Fountains
Rarely-used plumbing lines
Ice machines
Misters


How to Prevent Legionnaires' Disease Outbreaks



Take regular samples of pool, hot tub, spa and cooling tower water. Test kits are readily available at larger hardware chains and at pool and spa specialty stores.
Schedule the testing procedure, and hold someone accountable to ensure the scheduled testing is carried out and documented.
Maintain hot tub and water heater chlorine/bromine and pH levels according to guidance provided by the Centers for Disease Control and Prevention.
Periodically scrub and disinfect hot tub, pool and cooling tower surfaces to remove the layer of biofilm that can accumulate.
Schedule hot tub and water filter replacements per manufacturer recommendations.
Set hot water heaters to store water at 140 degrees Fahrenheit or hotter.
Ensure water tanks aren't too big for their heating systems - especially with solar heating systems.
Periodically flush unused lines with hot water.
Isolate plumbing in unused buildings or buildings under construction. Legionella bacteria could accumulate in these unused areas in pipes and fixtures and leak back into the main water supply for the rest of the building.


Ultimately, the board of directors is responsible for everything the community does or fails to do when it comes to the protection of members, staff and guests from hazards that arise from water contamination in common area facilities. While there is no reason to panic, as the vast majority of properties experience no issues with Legionnaires' disease, preventing outbreaks still requires constant vigilance and leadership emphasis on the part of board members and association managers alike.

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