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Last October, Johns Hopkins Hospital staff reported finding trace amounts of
Legionnaires’ disease bacteria in the hospital’s water supply. Was that a serious problem? Well,
Yes, if you were a hospital patient suffering from a chronic lung disease or your immune
system had been undermined by disease, advanced aged, chemotherapy or other drugs. No, if
People usually become infected by inhaling tiny water droplets contaminated with the bacteria.
It does not spread from person to person, unlike influenza and the common cold.
The bug has been around forever, but no one recognized it until 1976 when it made a
dramatic appearance at the American Legion Convention in Philadelphia. Over two hundred
Before that, the Legionella bacteria had been going about their lives nameless and
unrecognized. People occasionally died of a pneumonia that could not be attributed to known
suspects, but no one spotted Legionella until after the outbreak in Philly.
Since the 1976 outbreak, the appearance of L. pneumophila in water pipes, showerheads,
cooling towers and spa whirlpools has usually been greeted with alarm, sometimes with panic,
Last September, for example, two Harford County schools shut down for several days
Back in the summer of 1999, four nursing home residents—also in Harford County—
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contracted Legionnaires’ disease and two of them died. That fall, Georges Benjamin, then the
experts to survey the state’s 92 hospitals and 270 nursing homes about their ability to detect
Legionella and diagnose patients, and to make recommendations about dealing with Legionella
The following year, the committee recommended acute-care hospitals raise their hot
water temperature from 110 to 122 degrees Fahrenheit, conduct regular surveillance of their
Still, Maryland has recorded 189 cases of Legionnaires’ disease during the last three
years.
The truth is it’s not unusual to find Legionella in water pipes and tanks. Legionella’s
natural habitat is water. It likes the kind of warm, slow moving water you might find in a
Maryland reservoir, an apartment building’s labyrinth of copper pipes, or the hot water heater in
your basement.
According to Janet Stout, Director of the V.A. Medical Center’s Special Pathogens Lab
in Pittsburgh, most of the cases of Legionella acquired outside hospitals and nursing homes are
That tap water in your home is remarkably clean and safe to drink. It is filtered and
treated with chlorine before it reaches your water glass or icemaker. But it isn’t sterile. All
kinds of harmless microbial things live in it, including things like Legionella.
“The media and lay public are not aware that Legionella is a common colonizer of water
distribution systems,” wrote Stout, noting there is “a strong bureaucratic tendency to publicly
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So why doesn’t everyone get sick?
Well, partly because Legionella pneumophila is a wimpy pathogen. It goes after people
who are already ill with chronic lung diseases or suffering from the immunosuppressive effects
of chemotherapy drugs. Also, it is not found in every house. In her native Pittsburgh, Stout
Stout’s colleague, Victor Lu, is even more adamant about getting out the facts on
Legionella. In an editorial in the Journal of Infectious Diseases, he wrote, “The public must be
systems, they are rarely pathogenic for immunocompetent hosts, and that [Legionnaires’ disease]
is not a contagious disease. Ignorance leads to panic, and panic lead to irrational actions.”
If the idea of bugs in your pipes bothers you, or there is someone at home with health
problems, there are a few things you can do to reduce the risk of Legionella infection.
Raise the hot water temperature to 122 degrees Fahrenheit, and run the water for 20 to 30
minutes. This should be done every two or three months. Run the hot water for a few minutes
AIDS patients are advised to boil their drinking water or use bottled water to guard
against water-borne microbes. People worried about their susceptibility to Legionella infections
The rest of us should try to remember that water, including our tap water, is really an
ecosystem containing microbes, minerals, and trace gases. Just like us.