Michigan Urges Continued Legionella Precaution

LANSING, Mich. – To help increase awareness, the Michigan Department of Health and Human Services continues to ensure that residents and the healthcare community are aware of the risk of Legionella and what can be done to protect against the spread of Legionnaires' disease (LD).

Over the past several years there has been statewide and national increases in LD reports.  So far for 2016, Michigan has seen 51 confirmed individual cases of LD statewide. More than half of the cases are from Southeastern Michigan, including the City of Detroit, Macomb, Oakland and Wayne Counties. To date, zero 2016 cases have been confirmed in Genesee County. 

While many factors can influence reporting of LD, including increased clinical awareness, this number exceeds the average year to date count for Michigan in recent years. At this time, there is no indication of a common source for these infections. Local health departments continue to evaluate information gathered from existing patients and rapidly assess any new reports. 

Legionella is a type of bacteria commonly found in the environment that grows best in warm water, such as hot tubs, cooling towers, hot water tanks, drinkable water systems, and decorative fountains. When people are exposed to the bacteria, it can cause LD, a respiratory disease that can infect the lungs and cause pneumonia. In general, Legionnaires’ disease is not spread from person to person. However, this has been documented in extremely rare cases.

Most healthy people do not get sick after being exposed to Legionella. Being 50 years or older or having certain risk factors increases the chances of getting sick. Other risk factors include being a current or former smoker; having chronic lung disease, such as emphysema or chronic obstructive pulmonary disease; having a weakened immune system from diseases like cancer, diabetes, or kidney failure; or taking medicine that weakens your immune system. Legionnaires’ disease in children is not common.

MDHHS is collaborating with the Genesee County Health Department (GCHD) and Genesee County Medical Society (GCMS) to support their disease surveillance efforts. GCHD and GCMS released enhanced clinical guidance for Genesee County healthcare providers in an effort to better detect and track any potential cases of LD, and MDHHS is supporting this guidance through increased laboratory testing.

Legionellosis Prevention Measures for All Residents:

• Avoiding smoking is the single most important thing you can do to lower your risk of infection. Smoking increases the chances that you'll develop LD if exposed to Legionella bacteria.
• There are many causes of pneumonia in our communities with two of the most important being influenza and infection with pneumococcal bacteria. While there are no vaccines that can help protect you from Legionnaires’ disease, there are vaccines available that can prevent pneumococcal (2 vaccines) and influenza infection. All adults 65 years or older should get both kinds of pneumococcal vaccines. And adults younger than 65 with certain health conditions or who smoke are also recommended pneumococcal vaccination. Everyone 6 months or older should get an annual flu vaccine.
• Making sure that hot tubs and warm pools have the right disinfectant (i.e., chlorine) levels is important for killing Legionella bacteria. These disinfectant levels can be hard to maintain when water temperature is high. You do not need a special filter to remove Legionella bacteria in your drinking water.
• For any resident that develops pneumonia symptoms, you should see a doctor right away. Signs and symptoms of pneumonia can include cough, shortness of breath, muscle aches, headache, and high fever. Be sure to tell the doctor if you have used a hot tub, spent any nights away from home, or stayed in a hospital in the last two weeks. Legionnaires' disease requires treatment with antibiotics, and most patients can be treated successfully.

Additional Legionellosis Prevention Measures for Genesee County Residents:

• While the risk of getting Legionnaires’ disease from a home water system is much smaller than the risk from large water systems, home owners may be able to reduce the risk further by maintaining their water systems.

  • Showers: Because they remain damp, shower heads could hold Legionella bacteria. Removing the shower head, manually cleaning it to remove scale and sediment, and soaking it in a mixture of 1 tablespoon of household bleach to 1 gallon of water for about 2 hours will disinfect the shower head.
  • Humidifiers: Some homes have whole house humidifiers. You should clean and disinfect humidifiers regularly according to manufacturer’s directions. Unplug the humidifier and clean the inside and outside of the humidifier per the manufacturer's instructions. CPAP machines and nebulizers should also be cleaned per manufacturer’s recommendations.
  • Water Heaters: In some cases, Legionella bacteria have been found in residential water heaters, more often in electric water heaters. Regularly maintaining the water heater according to manufacturer’s instructions is recommended to help reduce the risk of Legionella bacteria growing.

MDHHS and GCHD also recently issued a toolkit, developed by the Centers for Disease Control and Prevention, to aid building managers in developing a water management program and identifying areas in their buildings where Legionella might grow or spread, and how to reduce that risk. The toolkit has been distributed to local health departments statewide. Buildings that should have a water management program include healthcare facilities where patients stay overnight (or that house or treat people with chronic and acute medical problems or weakened immune systems), retirement homes, assisted living facilities, hotels, and buildings with more than 10 stories. 

To view additional Legionella guidance for residents, click here. For more information about Legionnaires’ disease, visit www.cdc.gov/legionella. 

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