In defiance of 40-year strenuous efforts since its discovery, Legionnaires’ Disease continues to steadily rise in the United States since 2003, proving its relentless persistence. This deadly variant of pneumonia, commonly caused by the bacterium Legionella pneumophila, leads to critical care admissions and causes long-lasting health implications for many survivors. This escalating trend, observed by Centers for Disease Control and Prevention (CDC), signals an urgent need to further strengthen our defense strategy.
Every year, a staggering number of 10,000 to 18,000 individuals in the U.S. are infected by Legionella, primarily through exposure from potable water – most worryingly, in large infrastructures such as hospitals. Our apprehension over possible exposure to Legionella is not misplaced when we use faucets, showers, and even when we come into contact with the mist from cooling towers.
So why are our buildings such fertile grounds for Legionella? Blame it on our building system conditions that provide an ideal environment for the microbial growth. Legionella and other pathogens find hospitable breeding grounds in the warm conditions, plumbing pipe that are often laden with corrosion, scale, and biofilm, providing for their unfettered growth.
It is of pertinent concern that approximately half of our large structures, hospitals included, are colonized by Legionella. The right steps in testing and identifying lethal variations of Legionella, coupled with the implementation of robust water safety and management plans, would indubitably enhance our ability to manage the risk.
The CDC emphasizes that effective management of water systems in buildings is our bulwark against outbreaks. Findings from CDC reports in 2016 suggest that most disease outbreaks occur due to process failures, human errors, equipment malfunction, or external conditions. It is therefore incumbent upon building owners and managers to evaluate the risk of their water systems to Legionella proliferation and accordingly chalk out and implement water management protocols in line with industry guidelines.
The indispensability of knowledge about building water systems and their risks cannot be overstated, and certification in Legionella water safety and management can enhance this expertise. Unfortunately, conventional maintenance procedures like flushing hot water tanks or cleaning aerators often prove to be ineffective in curbing the growth of Legionella within building water distribution systems.
In our fight against Legionella and waterborne pathogenic infections, smarter plumbing design can be our ally. These novel designs incorporate antimicrobial features and materials, mitigation measures against stagnation, programming and control of flush cycles through advanced technology, probably even reducing water age to enhance water quality. Particularly in healthcare facilities, there has been evidence of infection in patients with the same bacteria found in sink drains due to splash, aerosolization, or leaking. To counter this, the introduction of self-disinfecting sink drains and internal washing systems to inhibit biofilm build-up can be decidedly effective.
With a sense of optimism, it can be surmised that innovative plumbing design will play a significant role in the effective management of water systems to prevent infections due to Legionella and other waterborne pathogens.