When the coronavirus lockdown was lifted this summer and people returned to their office buildings, and school districts prepared buildings for the fall, the CDC, ODH and the Ohio Environmental Protection Agency put out warnings about Legionnaires' Disease. That led many area businesses and schools to be proactive and test for the pathogen.
School districts in Vandalia-Butler, Dayton, Kettering and Oakwood found cases of Legionella bacteria or Legionnaires' Disease in some of their buildings. They quickly treat the water, and have taken other steps to ensure the bacteria is no longer present in their facilities. Others have taken preventative measures to lessen the chance of the bacteria growing in their buildings, said Doug Dolder, a response case manager at Solid Blend Water Management Solutions.
“Ohio EPA is pleased to know that many school and office building managers are proactively flushing or disinfecting their water lines before resuming use of the buildings,” the agency said in a statement.
Doug Dolder, a Response Case Manager, for Solid Blend Water Management Solutions, test the water in a restroom at Southdale Elementary in Kettering for Legionella bacteria. MARSHALL GORBY\STAFF
What is Legionella?
Legionella is a bacteria found in fresh water such as lakes and streams. But, according to the CDC, it becomes a health risk when it grows in buildings and water systems such as shower heads and faucets, hot tubs that aren’t drained after each use, decorative fountains and water features, air conditioning units, hot water tanks, and heater and large plumbing systems that aren’t used for an extended period of time.
When the stagnant water is turned on or is stirred for the first time, the bacteria forms droplets that can cause pneumonia ― Legionnaires' disease ― when people breathe it in, said Dr. Steven Burdette, medical director of infection control at Miami Valley Hospital. Legionella can also cause Pontiac fever, the CDC says.
Legionnaires' disease symptoms include cough, shortness of breath, fever, muscle aches and headaches. In addition, it can be associated with other symptoms such as diarrhea, nausea and confusion, the CDC says. Symptoms usually begin two to 10 days after exposure to the bacteria, but it can take longer so people should watch for symptoms for about two weeks after exposure.
Given the COVID-19 pandemic, Legionnaires' disease is more dangerous because their symptoms significantly overlap, said Burdette, who is also director of the Infectious Disease Fellowship Program for Wright State Physicians and the Boonshoft School of Medicine at Wright State University.
“And so, obviously, the treatment for COVID-19 is very much supportive, and treatment for Legionella is a very certain specific antibiotics,” he said.
Unlike the coronavirus, which affects people of color and seniors disproportionately, Legionnella will impact anyone who is exposed to stagnant water that has the bacteria, he said.
Several people have gone to Miami Valley Hospital’s high risk respiratory unit with possible coronavirus infections. But it turned out that they had Legionnaires' disease, he said. He urges people to keep that in mind and let their health care provider know if their home or place of employment has had known cases of Legionella, or they’ve been exposure to stagnant water, Burdette said.
Where has Legionella been found locally?
Solid Blend deals primarily with schools and other commercial buildings. In recent weeks, the business has done assessment and remediation work in Kettering, Oakwood, Vandalia-Butler and Northmont school districts. Traces of Legionella or Legionnaires' were found in each one.
All of the districts have been cleared, although some that retested for the bacteria are waiting for results.
On Sept. 9, Solid Blend determined that Oakwood was cleared of the Legionnella bacteria, the district said. School officials hired Solid Blend to do a remediation after a trace of the bacteria was found in a girls restroom at Smith Elementary in August. The building had been closed since March, when Gov. Mike DeWine ordered all schools to close because of the coronavirus.
The district then asked Solid Blend to do an assessment on all of Oakwood’s schools, and the results were negative. No one in the district was exposed to the bacteria, school officials said.
With the exception of two sinks in two buildings, all of Kettering schools' have been cleared for Legionella bacteria, spokeswoman Kari Basson said. The sinks that still showed traces of the bacteria have been taken out of service until the district gets test results, she said.
The death of Keith “Casey” Chaffin, who worked as a custodian in the district until weeks before he died in May 2019, has been linked to Legionella, the district confirmed in July.
Three Dayton Public Schools buildings tested positive for Legionella bacteria this summer. An initial test was done on the buildings after the bacteria was discovered, the district said in a statement. A second test was done last week, but the district is awaiting the results. The water lines at all buildings have been flushed and chlorinated, and water is currently running constantly to ensure stagnation does not occur, according to the statement.
When Solid Blend is called to a facility where the bacteria is suspected, they start with a CDC environmental assessment. The comprehensive assessment helps the crew to gather information about the building’s history and its drinking water system. They also look at where the water enters the building, if there’s proper backflow protection coming in, the hot water tank and if the temperature’s a minimum of 140 degrees and the like.
“And then from there were will actually take preliminary samples, based on a good representation of that facility of both the hot and cold water and look for the results,” Dodler said.
Can Legionella get in your home?
Legionnaires’ disease can be found in homes. However, it is less likely amid the coronavirus pandemic since more people have been home, reducing the chance for stagnant water, experts say. Even so, home owners should regularly run hot and cold water throughout their homes, Dolder said.
Unlike commercial properties, houses are small enough that water moves through them quickly, and Legionella doesn’t have time to take root, he said. However, if there’s low water flow and low temperatures, biofilm begins to form on the inside of piping and fixtures, and the Legionella can embed itself in the biofilm, protecting the bacteria. Legionella can survive between 68 degrees and 122 degrees, but it thrives between about 95 degrees and 108 degrees, Dolder said.
“So if you have a hot water tank, let’s say that is set at 105 degrees or 110 degrees because that’s a nice temperature, you’re in that danger range where you can have Legionella colonize and grow inside of your hot water tanks,” he said.
So it’s best to keep the hot water tank as hot as possible ― preferably above 120 degrees ― without scalding yourself, he recommended.
Many faucets use aerators screwed on at the end to conserve water and reduce splashing. But aerators can trap scale and sediment from the pipes. Like biofilm, Legionella can embed itself in that area,Dodler said.
Every 90 to 120 days, you should remove the aerators from all faucets, clean them and disinfect them in a cup of household bleach for 10-15 minutes, he recommends.
Legionella is not a bacteria that recently surfaced during the coronavirus pandemic, Burdette said. It often appears in the summer if there’s a lot of rain, ponding or pooling of water, he said. People can also get infected when they turn on their air conditioners for the first time after and extended period of time.
“So I just encourage folks to watch for it anytime they have in and around their house sitting or stagnant water,” he said. “Legionella is one of the issues that they can run into, and they should do their very best to try to abate those issues.”