Officials have not, yet, figured out how the patients became infected or where the bacteria came from.

KINGSTON — Health officials on Thursday tested the water and the residents at the Golden Hill Health Care Center in trying to determine how two residents of the nursing home, including one who died, contracted Legionnaires’ disease, according to Ulster County’s public health director.

Dr. LaMar Hasbrouck said the source of the bacteria had not been determined as of Thursday evening,

The two residents, women ages 88 and 91, were hospitalized with pneumonia recently and later were diagnosed with Legionnaires’ disease, a water-borne respiratory condition that usually is contracted by inhaling a mist or vapor contaminated with the Legionella bacteria.

The 91-year-old, who had underlying chronic medical conditions, died on Tuesday. The 88-year-old was treated successfully and was “doing well” on Thursday, Hasbrouck said. Neither woman has been identified.

Hasbrouck said the two cases at Golden Hill — which is owned an operated by the county — are “not an outbreak per se,” and he stressed that health officials have not determined if the two women even were infected at the nursing home. No other residents of Golden Hill have contracted Legionnaires’ disease, according to county officials.

Hasbrouck said the two affected women lived on different floors of the Golden Hill building and used different showers, which, he said, could lead one to hypothesize they were “two sporadic infections.”

The Legionella bacteria can be found in shower vapors or in air conditioning units, though Golden Hill does not have the kind of air conditioning that emits vapors, county officials have said.

Legionnaires’ disease — which gets its name from a 1976 outbreak at an American Legion convention in a Philadelphia hotel that killed 34 people — cannot be transmitted from person to person.

Hasbrouck said that, for the time being, Golden Hill residents are taking precautions against contracting Legionnaires’ disease, including bathing instead of showering. They also are not drinking the building’s water, he said, even though the disease cannot be contracted that way.

No residents are being moved out of the nursing home, and visitors still are allowed.

Golden Hill gets its water from the city of Kingston, but it passes through a pumping station on the Golden Hill property before entering the building. Hasbrouck said health officials have confined the testing to the nursing home’s water system and are not recommending city residents take any special precautions with their water.

Kingston Water Superintendent Judith Hansen said her department is in compliance with all local, state and federal water standards and that parts of the city’s water system are tested daily. She said Golden Hill’s water system — which the city operates for the county — is tested weekly.

Hansen said the Kingston Water Department is required to test the city’s water 27 times per month for coliform bacteria — which acts as a “surrogate” for other types of bacteria, and its presence is used as an indicator of contamination — but usually conducts such tests 10 times as often.

Hansen said she has seen “no indication of any bacterial compromise” of either the city’s or Golden Hill’s water supply but that she will defer to the testing being conducted by state health officials. She said the state Health Department had asked her to provide water samples from the past year for Golden Hill’s system but not the city’s.

Hansen also said Golden Hill’s water supply is disinfected more aggressively than the city’s because it sits in the nursing home’s tank longer than Kingston’s water normally is dormant.

According to the U.S. Centers for Disease Control and Prevention, between 8,000 and 18,000 Americans are hospitalized with Legionnaires’ disease each year, and the condition can be fatal percent in 5 to 30 percent of patients.

Symptoms usually surface two to 14 days after exposure to the bacteria, the CDC says, and most cases can be treated successfully with antibiotics.( source )

Now that we’ve scared the pants off of some people, which always happens when some folks read a story about the unexplained appearance of a mysterious ailment, we will leave you with some facts about Legionnaires’ Disease from Health.HowStuffWorks.Com which some of you may find interesting:

• The Legionella pneumophila bacterium causes Legionnaires’ disease, an “atypical,” but serious, form of pneumonia.
• People who are most susceptible are the elderly and those who smoke, have lung disease, or have impaired immune systems.
• Taking steps to kill the bacteria before it has a chance to contaminate the water is essential. L. pneumophila thrives and grows in stagnant water.
• Occupational Safety and Health Administration recommends twice-yearly cleanings of large (heating/cooling) systems.
• Smokers are more likely to get lung infections such as Legionnaires’ disease.

So how does all this relate to water testing? Simple: Legionella pneumophila bacterium cannot live in propery disinfected water. Therefore regularly scheduled water testing can work very well as a way of keeping Legionella pneumophila bacterium from making their home in your building’s water system.

Other Postings Mentioning Legionnaires’ Disease:

• Legionnaires’ Disease Can Spread Through the Air
• Bacteria and Microorganisms in Water
• Sources of Bacteria and Microorganisms in Drinking Water

The waterborne Legionella pathogen that causes typically treatable but potentially fatal Legionnaire’s disease is found in domestic drinking water systems, cooling towers, evaporative condensers and decorative fountains. Other contained systems like vehicle washing equipment are also at risk. A May 2008 public Legionnaires’ outbreak was linked to a self-serve carwash in Australia and two Albany, NY bus washing system employees who contracted the illness in August 2007, according to industry trade reports. ( source )

Health officials and scientists often find Legionella pathogens in closed water systems with elevated water temperatures. The higher temperatures make maintaining an adequate disinfectant level in the water very difficult and for that reason certain pathogens can flourish in these environments.

In cases where the water gets converted to a mist by sprinkler systems, produce misters or other devices, the Legionella pathogen can become airborne and have an excellent opportunity to infect a large number of people very rapidly.

Signs of exposure include, but may not be limited to, high fever temperatures and flu-like symptoms. People with suppressed or weakend immune systems tend to become infected faster and often times more seriously than people with healthy immune systems.

What methods exist for preventing the growth and distribution of the Legionella pathogen?

Thermal Heat/Flush – Water temperature raised to as high as 160ºF for up to 30 minutes to sterilize systems. Chemical-free, commonly-used method requires no additional equipment. Labor intensive and can prove ineffective for long-term Legionella infestation management. Can damage older pipes and creates potential for scalding.

Shock (Hyper) Chlorination – Chlorine injected into water distribution system. Initial shock chlorination levels approach 50 ppm, and taper off to create 2ppm to 5ppm chlorine cycle. Chlorine decomposes rapidly at elevated water temperatures; Legionella re-colonization can occur in as little as one to two weeks during continuous chlorination following the shock. Highly corrosive to plumbing (can be offset in part with silicate corrosion control). Places facility employees handle stored chemicals or implement disinfection at risk for exposure to chlorine byproduct Trihalomethane (THMs, linked to several types of cancer).

Chlorine Dioxide – Chlorine Dioxide (CIO2) is EPA-approved for potable water disinfectant use under CFR Par 141-National Primary Drinking Water Regulation. Commonly used in Europe, CIO2 is a gas generated by either chemical or electrolytic means and distributed throughout the water distribution system. The powerful oxidant kills Legionella and other bacteria. CIO2 readily decomposes in drinking water and residuals decrease as water system temperatures rise, making this treatment approach difficult in hot water systems. CIO2 is corrosive to plumbing infrastructure and creates byproducts including chlorate and chlorite; field testing for EPA maximum limits is required.

Copper-Silver Ionization – Latest advance in disinfection methods dissolves and distributes small amounts of copper and silver ions throughout water systems to eradicate bacteria. Continuous eradication metallic ion unit is required. Highly effective in eliminating Legionella, particularly in recirculation hot water systems, according to research and monitoring of hospital-implemented systems by Janet F. Stout, Ph.D., University of Pittsburgh special pathogens laboratory director and an international expert on waterborne pathogens. ( source )

Each Legionella prevention method requires testing on one level or another. Thermometers, high range free chlorine test strips, chlorine dioxide test strips, and/or dissolved copper in water test strips can all play a key part in maintaining a safe, Legionella-free closed water system.