The focus of much of legionella mediation is on the end user but what is happening in Oakwood clearly shows the flaw in this approach. The Oakwood school district can disinfect water lines in their buildings and kill legionella bacteria but none of these steps will prevent it from coming back because the real problems begin at the source.
Legionella bacteria does not magically appear. It is a waterborne bacteria and it travels through our water systems and as a result the vast majority of Legionnaires’ Disease cases are not from outbreaks but rather from individual, sporadic cases. In fact, according to the CDC, 96% of all Legionnaires’ cases are actually single or sporadic in nature, not tied to outbreaks. Yet no one is paying attention to the vast majority of Legionnaires’ Disease cases.
“The experience at the Oakwood school district should serve as a reminder that more needs to be done to prevent Legionnaires’ Disease. Flushing water lines by running faucets and fixtures that have not been used all summer before schools begin the new year, increasing water temperature set points and other remedial steps are effective defenses against legionella but if we want to truly to stop the spread of Legionnaires’ Disease, we need a comprehensive approach and we need action now given the rise of the disease. According to the CDC, rates of Legionnaires’ cases have increased 500% in the last decade alone,” says Dr Renee Matthews, who provides primary care for at-risk patients.
The primary way people contract Legionnaires’ is from aspiration or inhalation of water containing legionella which is commonly detected in source water and can establish itself in the biofilms that coat our water distribution and plumbing pipes. Disruptions in our water distribution system such as water main breaks, flooding, maintenance, construction, and treatment changes can disrupt those biofilms, which in turn releases the bacteria downstream to points of exposure in our homes, schools, workplaces, and other facilities.
One step that can be taken to minimize the risk of exposure is for water system managers to inform nursing homes, hospitals, and other vulnerable members of our population when these disruptions occur. These notifications can help prevent exposure and ultimately save lives. Also, more should be done to ensure that water is properly monitored, managed, and treated by utilities so bacteria is not entering our plumbing systems.
A comprehensive approach to prevention is essential. It is important for state lawmakers to make improving water management a high priority. The average age of water system infrastructure in US cities is over 100 years old and the Alliance to Prevent Legionnaires’ Disease is actively working to enact policies to promote preventive policies in State Legislatures across the country.
As the saying goes, “an ounce of prevention is worth a pound of cure” and this is especially true for Legionnaires’ Disease. We can prevent the disease. We just need to have the will, determination & correct focused actions to do it.
Tonya Winders is the Executive Director of the Alliance to Prevent Legionnaires’ Disease.
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