Ask the expert: What is Legionnaires’ disease?
First discovered in the 1970s, Legionella bacterium is responsible for legionellosis: a respiratory disease that can cause a type of pneumonia called Legionnaires’ disease, which kills about a quarter of the people who contract it. Legionellosis can also cause a flulike illness called Pontiac fever. Legionellosis is especially dangerous for patients older than 50, who smoke, or have chronic lung or immunosuppression conditions.
The bacterium breeds naturally in warm water and can usually be found in the parts of hospital systems that are continually wet, such as:
- Hot and cold water storage tanks
- Water heaters
- Water-hammer arrestors
- Pipes, valves, and fittings
- Expansion tanks
- Water filters
- Electronic and manual faucets
- Aerators
- Faucet flow restrictors
- Showerheads and hoses
- Centrally-installed misters, atomizers, air washers, and humidifiers
- Non-steam aerosol-generating humidifiers
- Eyewash stations
- Ice machines
- Medical devices (such as CPAP machines, hydrotherapy equipment, bronchoscopes, heater-cooler units)
Poorly maintained water systems have been linked to the 286% increase in legionellosis between 2000 and 2014. In recent years, CMS has cracked down on testing for and preventing the spread of Legionella.
Pertinent regulations include, but are not limited to, the following:
- 42 CFR §482.42 for hospitals: “The hospital must provide a sanitary environment to avoid sources and transmission of infections and communicable diseases. There must be an active program for the prevention, control, and investigation of infections and communicable diseases.”
- 42 CFR §483.80 for skilled nursing facilities and nursing facilities: “The facility must establish and maintain an infection prevention and control program designed to provide a safe, sanitary, and comfortable environment and to help prevent the development and transmission of communicable diseases and infections.”
- 42 CFR §485.635(a)(3)(vi) for critical access hospitals (CAH): CAH policies must include: “A system for identifying, reporting, investigating and controlling infections and communicable diseases of patients and personnel.”