TO: The University Community
FROM: President Seligman
RE: Efforts to Safeguard Patients
 any of you are aware that, in the past week, Strong Memorial has been dealing with the presence of Legionella, the bacteria that causes Legionnaire's Disease, in its water systems. Three patients have been diagnosed with Legionnaire's Disease; all had serious underlying medical conditions that caused their immune systems to be seriously weakened. One patient died on Sunday evening.
First, a few facts about Legionnaire's Disease. Legionella is a naturally occurring bacteria, commonly found in ponds and creeks, even in household water systems. It doesn't pose a serious threat to healthy individuals, but can cause Legionnaire's Disease, a pneumonia, in individuals who are immune-compromised. Thus, it poses a greater risk when it makes its way into hospitals and nursing homes, which is why those institutions test for it routinely. It also has a long incubation period; individuals can become sick up to two weeks after being exposed.
Let me summarize the facts as we know them and the steps that we are taking both to protect hospitalized patients and to deal with any potential sources of infection. I will also address what, if any, concerns the rest of the University community should have.
- On January 27, Strong Memorial diagnosed Legionnaire's Disease in a patient with
advanced cancer. Since the patient had been hospitalized for more than three weeks before developing the pneumonia, Strong began testing the water in close proximity to where this patient had been. Those tests came back negative. The patient is being treated with antibiotics and is in guarded condition.
- Late on February 13, the results of routine water tests (part of our normal, twice-a-year surveillance testing) showed the presence of Legionella in the hospital's main water system. The next day, Strong took steps to prevent admitted patients from being exposed. Patients were given bottled water and those with weakened immunity (patients on chemotherapy, those on medications following transplants, etc.) were also restricted from taking showers or bathing in tap water.
- February 14 to 15, Strong's main hot water tanks were drained, flushed with
"hyperchlorinated water," and drained again. Hyperchlorinated water was also pushed through the pipes in an effort to kill the bacteria. The water supply continues to have a higher level of chlorine, and the copper/silver ionization treatment system was also adjusted to give an added preventive boost. Following this treatment, more water samples were taken and results are expected to be available on Friday, February 24.
- Over the weekend, a second patient was diagnosed. Sadly, this patient--who suffered from advanced liver disease--passed away Sunday evening. This patient had also been admitted to Strong before the water system was treated.
- On Monday, February 20, Strong made the decision to extend precautions through the entire hospital and Ambulatory Building. Even though the Ambulatory Care Facility has a separate water system, samples taken last week now test positive. In the spirit of taking all possible precautions, outpatients visiting this building are now being given bottled water, although the risk to them is no higher than that which they encounter in their own homes, schools, or workplaces. Nonetheless, the hospital "superheated" the ACF water system on Monday night, raising the water temperature to levels that will kill Legionella. As an extra step, Strong also "hyperchlorinated" the ACF water system on Tuesday night.
- On Tuesday, February 21, a third patient was diagnosed. This patient has been at Strong since February 2, and has been undergoing chemotherapy. This third patient is on antibiotics and is in satisfactory condition.
- Also on Tuesday, Strong received results of tests taken on the water system that serves the Emergency Department and units directly above it. These tests were negative, and the hospital is allowing these units to return to using tap water.
Of course, throughout this process, Strong Memorial leaders have been in close contact with the New York State Department of Health. February 21, DOH staff praised Strong's Infection Control, Facilities, and Administrative staff for their vigilant and thorough response. I, too, deeply appreciate the rapid and thoughtful response at Strong.
Let me focus on the implications that these cases have on faculty, staff, and students who are not at Strong Memorial. As I mentioned earlier, Legionella is a ubiquitous bacteria, present in many environments. Healthy individuals can shower in water with
Legionella, drink it, cook with it, etc. without getting sick. It poses a serious threat when it comes in contact with people with seriously weakened immune defenses. Therefore, there is no reason to be concerned about consuming water on our campus, or bathing in our dorms.
If, however, University staff and students have specific concern, they are invited to contact Environmental Health and Safety at x5-3241. UHS staff are in close contact with staff and Infection Control experts at Strong who are managing the situation. I
regret any concern this may cause, but wish to reassure you that you are not at risk.
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