Published Date: 2012-02-05 17:33:15
Subject: PRO/EDR> Legionellosis - USA: (NY) hotel
Archive Number: 20120205.1033536
LEGIONELLOSIS - USA: (NEW YORK) HOTEL
A ProMED-mail post
ProMED-mail is a program of the
International Society for Infectious Diseases
Date: Thu 2 Feb 2012
Source: timesunion.com [edited]
6 cases of Legionnaire's disease have been linked to the Best Western Sovereign Hotel at 1228 Western Ave., [Albany, New York], the [New York] State Department of Health said Thursday [2 Feb 2012].
The guests who became ill stayed at the hotel between September and December , according to Peter Constantakes, a health department spokesman. Tests confirmed Monday [30 Jan 2012] that higher than normal levels of _Legionella_ bacteria were present in the hotel's water system, Constantakes said. "We are fully cooperating with the Department of Health on this matter, and have taken all recommended steps to eliminate the bacteria," said Phoenix-based Best Western International in a statement. "Of note, the Department of Health has not closed the hotel, which means that the Department of Health has determined that current guests are not at risk based upon the remedial measures we have taken. In addition, we have provided a list of recent guests to the Department of Health for monitoring. We consider guest safety most important, and we have and we will do everything we can to address the matter."
Legionnaire's [disease] is a severe form of pneumonia. It is usually caused by breathing in the mist from hot tubs, showers or air conditioning units contaminated by _Legionella_. Symptoms include fever, chills, muscle aches and a high fever. It usually develops 2 to 14 days after exposure.
The disease often crops up in hotels and water parks where people are exposed to water spray. The Luxor hotel in Las Vegas and the four-star Diamante Beach Hotel in [Calpe,] Spain (ProMED-mail post Legionellosis - Spain (02): (AN) hotel 20120203.1031069] have experienced Legionnaire’s [disease] outbreaks in recent weeks.
The 6 Best Western guests who became ill have recovered. It was [New York] state epidemiologists who tracked the illness back to the hotel. Water tests were conducted at the hotel on Jan. 24  and the results were confirmed on Monday [Jan 30, 2012]. Best Western Sovereign will flush its water system on Sunday [Feb 5, 2012] under the supervision of county officials, said Mary Rozak, spokeswoman for Albany County Department of Health.
The state and county health departments also have instructed the hotel to inform current and prospective customers about the problem, and the county is contacting guests who have recently stayed at the hotel. The hotel also has raised the temperature of the water to help kill off the bacteria. "The bottom line is everyone has recovered," said Rozak. "This is not an outbreak or a crisis. This has been identified and it is being acted upon."
In 2010, there were more than 400 cases of Legionnaire's disease in New York [State], including 10 in Albany County. The disease is usually mild and most people recover.
[Byline: Cathleen F. Crowley]
[For a discussion of Legionnaires' disease (LD) and Pontiac fever (PF), please see the prior ProMED-mail post Legionellosis - USA (02): (CA) conference, susp 20110304.0713.
The following has been extracted from the U.S. CDC document Travel-Associated Legionnaires' Disease at http://www.cdc.gov/legionella/faq.htm:
"About 20-25 percent of all Legionnaires' disease reported to CDC is travel-associated. Legionnaires' disease is important to diagnose and to report because its identification implies the presence of an environmental source to which other susceptible individuals are likely to be exposed. Clusters of Legionnaires' disease associated with travel to hotels or aboard cruise ships are rarely detected by individual clinicians or health departments; travelers typically disperse from the source of infection before developing symptoms. Therefore, a travel history should be actively sought from patients with community-acquired pneumonia and _Legionella_ testing should be performed for those who have traveled in the 2 weeks before onset of symptoms." …. "Environmental sampling/testing should only be conducted after careful consideration of the epidemiologic evidence linking a case(s) to a particular location."
Because of the multi-state nature of travel in the U. S., national-level surveillance is necessary to detect outbreaks of travel-associated Legionnaires' disease. CDC relies upon state and local health departments to conduct this surveillance.
Genotyping of patient and environmental isolates has become a helpful tool to establish transmission pathways. The predominance of one genotype in patient specimens suggests transmission from a common source. Because _L. pneumophila_ may be found in water supplies without linkage to any cases of legionellosis, the actual causative infectious reservoir should be demonstrated by means of genotyping methods (see http://www.ncbi.nlm.nih.gov/pmc/articles/PMC86783/ and
Frequently, however, this is difficult in legionellosis outbreaks because the diagnosis of Legionnaires' disease is made only on the basis of urinary _L. pneumophila_ serogroup 1 antigen testing or serology, rather than isolation of the organism from cultures of respiratory tract specimens. In the latter case genotyping of clinical isolates is, of course, not possible.
Water temperatures of 25-40 deg C (77-104 deg F) support the highest concentrations of the organism in water storage tanks of plumbing systems.
Because remediation of the Albany hotel’s water supply system has only been undertaken on Feb 5, 2012 and the incubation period for Legionnaires’ disease is 2-10 days, further cases of legionellosis may still be reported. Elimination or reduction of _Legionella_ colonization in a hot water system is difficult. For a discussion, please see http://www.health.ny.gov/press/releases/2005/2005-08-26_legionnaires/hospital_guidelines_legionella.pdf.
The interactive HealthMap/ProMED-mail map that shows New York State is available at: http://healthmap.org/r/1xMA. –Mod.ML]