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As reported by The Baltimore Sun on September 2, 2014, another resident of a Baltimore apartment community has been diagnosed with Legionnaires’ disease. The latest victim lived in the Hanover Square Apartments in Otterbein, a 200-unit subsidized housing development for seniors. Hanover Square is owned by The National Foundation for Affordable Housing Solutions Inc. and managed by Edgewood Management, which also manages the Apostolic Towers in East Baltimore, where two cases of the disease were reported earlier this year. While the condition of the latest victim is unknown, both individuals infected at Apostolic Towers required hospitalization.

Legionellosis, or Legionnaires’ disease, is a form of pneumonia caused by a bacteria commonly found in water, usually at low or undetectable levels. Under certain conditions, the bacteria multiply and cause disease by being inhaled in water particles. The first outbreak of legionellosis, back in 1976, was traced to a cooling tower in the air-conditioning system at the Bellevue-Stratford Hotel in Philadelphia during an American Legion convention. That crisis resulted in 221 cases of pneumonia and the death of 34 Legionnaires, thereby giving this infection its name.

Other outbreaks of Legionnaires’ disease have been traced to indoor spas and pools, humidifiers, ventilation and cooling systems, and, as in Baltimore’s cases, building water systems. Legionnaires’ disease is not contagious. It often is reported in clusters because a number of people are exposed to water coming from the same source. In a housing development, they may inhale the bacteria through activities such as showering, dishwashing and tooth brushing.

Between 8,000 and 18,000 people per year are hospitalized in the U.S. due to Legionnaires’ disease, according to the Centers for Disease Control and Prevention (CDC). About 27 cases of Legionnaires’ disease have been reported in Baltimore so far in 2014, according to the Health Department; there were 30 cases in 2013 and 28 in 2012. Elderly people are particularly vulnerable to legionellosis, due to lowered immunity and the presence of other health issues. The disease is typically treated with antibiotics, but has a fatality rate of about 20%. Many of those infected who do survive are hospitalized for weeks and are left with severe permanent impairment as well as enormous medical bills. When the victims are elderly, their prognosis is even more grim.

Once the source of the bacterial contamination has been identified, it is generally cleared by superheating or superchlorinating the water, while residents observe water restrictions. In the most recent local case, the residents of Hanover Square have been barred by the management company from using tap water for drinking, cooking and showers for about a month and are being provided bottled water and urged to bathe in the tub rather than showering. These measures are being imposed by the property management rather than being mandated by the Health Department, because there was only a single case of infection this time.

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We find it troubling, though, that residents of Baltimore’s senior housing complexes are once again victims of this form of water contamination. Back in 2009, a large Legionnaires’ outbreak occurred at the Stadium Place senior housing complex. Ten cases were confirmed among eight residents (average age 70) and two visitors to the complex; one person died. The situation was determined to warrant an emergency public health investigation, undertaken by the Baltimore City Health Department, the Maryland Department of Health and Mental Hygiene, and the CDC. Published by the National Institutes of Health, the research concluded: “Managers of elderly-housing facilities and local public health officials should consider developing a Legionella prevention plan.”

The importance of legionellosis control and prevention was clear to the CDC researchers in 2009; it is also reflected in the continuing efforts by the American Society of Heating, Refrigeration and Air Conditioning Engineers (ASHRAE) to develop an applicable standard of care for the operation and maintenance of building water systems. The new standard, referred to as Standard 188P, has been in the works for years. Some day it will apply to “human-occupied commercial, institutional, multi-unit-residential and industrial buildings.” In the meantime, more and more vulnerable seniors in housing complexes are going to be endangered just by taking a shower or turning on the faucet.

Owners and managers of premises where Legionnaires’ disease outbreaks can occur – as well as those responsible for the design, engineering, construction, maintenance and repair of the building’s systems – can be held accountable for the harm caused by their negligence. You can read more on our website about Legionnaires’ disease and the Heisler Law Office’s experience helping those harmed by it. If you or a member of your family has contracted legionellosis in a hotel, hospital, cruise ship, condominium development or apartment complex in Baltimore, elsewhere in Maryland, or in the District of Columbia, call us at (410) 625-4878.