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Legionnaires’ Disease; Yes It’s Still Around
 By Elliot Olsen
Elliot Olsen has been representing clients who are victims of Legionnaires’ disease and foodborne illness for nearly 20 years. He takes cases at Siegel Brill from clients all across the country.
Below are some questions that we asked Elliot regarding Legionnaires’ disease and his practice.
How many cases of Legionnaires' disease are reported in the U.S.?
One of the things that is striking about these cases is how many there are per year, even though many people think it is a disease that has “gone away” similar to polio or measles. It is still around and is more common that people think.
The case numbers for Legionnaires’ disease have been on the rise since the year 2000. This could be due to the frequency of the disease, because there is an aging population and they are at greater risk, or it could be due to increased and more exact testing for Legionnaires' disease.
According to the CDC, in 2015 there were 6,000 cases of Legionnaires’ disease in the United States. Because the disease is often undiagnosed, this number is most probably significantly lower than the true incidence.
Is there a recent example of a Legionnaires' outbreak locally in the Twin Cities?
In August/September of 2016 there was an outbreak in Hopkins. According to the Minnesota Department of Health, the people affected got sick from a cooling tower at a company called Citrus Systems, Inc.
As a result of the outbreak, 23 people were sickened and one person died. All of them lived, worked in, or were just visiting the city of Hopkins. A frightening aspect of this disease is that many of these victims were simply “passing by.” In other words the victims did not necessarily work at Citrus Systems but were made ill because the cooling tower “aerosolized” the bacteria in water droplets and spread them over a large geographic area. Anyone that inhaled those droplets had the potential to become ill.
CLICK HERE TO READ A STORY FROM MPR ABOUT THE HOPKINS OUTBREAK
How is Legionnaires Disease detected and linked to a certain location?
Because of the advanced testing technologies now available, Legionnaires' disease can be traced to a specific site. The disease was first detected in 1978 during the outbreak in Philadelphia for which it was originally named. At that time, outbreaks had to be quite large for officials to be able to identify the source.
Today, health department officials can detect smaller outbreaks with very advanced detection methods. The protocol for an outbreak includes isolating the Legionella bacteria from people that have become sick by testing their sputum. The labs then do genetic fingerprinting on the bacteria to subtype it. Further genetic testing on the bacteria isolated from the water in the cooling towers can provide the genetic fingerprinting needed to match the source with the person infected.
HOPKINS:
In the local Hopkins outbreak, the Minnesota Department of Health confirmed that the Citrus Systems cooling tower was the source of the outbreak. In post-field testing the bacterial isolates from water in the cooling tower were further analyzed using genetic testing. It was subsequently determined that the DNA fingerprint was an exact match to the patients with Legionnaires’ disease.
NEW YORK CITY/BRONX:
In a recent outbreak in the Bronx in New York City, the Health Department took water samples from over 100 cooling towers in the area. When the cooling tower samples tested positive for Legionella pneumophila, the Department of Health performed further genetic testing and matched the water sample results to Legionella bacteria isolated from specific victims.
Can you give an example of a case you are working on currently?
I do have a case that I am currently working on with a client in the Bronx. A number of people were made ill from the cooling tower at the Opera House Hotel. My client was not a guest at the hotel but was just a passerby in the area visiting his brother and doing some shopping. He inhaled the bacteria from the cooling tower and was stricken with Legionnaires’ disease.
CLICK HERE for more information on this outbreak.
The NYC Department of Health tied 138 Legionnaires’ disease victims to the cooling tower at the Opera House Hotel; 128 of them were hospitalized with 16 fatalities. Fever, cough, and shortness of breath were the most common symptoms. The median length of the hospital stay was five days. Typically, Legionnaires’ disease affects people who have something else wrong with them. In this outbreak, 78% of the 138 victims had chronic health problems like alcoholism, asthma, cancer, COPD, diabetes, HIV, or renal disease. The three most common problems were alcoholism, diabetes, and asthma.
How can companies with cooling towers help prevent Legionnaires’ disease?
When a business has a cooling tower, that business should be doing regular testing on the water in their tower to make sure that the chemical levels are high enough to kill Legionella bacteria. The business also needs to monitor and test the water for Legionella and other pathogens to ensure that the chemicals in the water are working.
Some companies get lazy and they skimp on these steps. Some don’t fully understand the potential health risks associated with having a cooling tower. These towers are pretty sophisticated pieces of equipment so there is no reason why a company who has a tower shouldn’t know how to properly maintain it.
What criteria does a Legionnaires’ disease client have to meet for you to represent them?
I only represent people who have been confirmed by the health department as being part of the outbreak. If someone just says that they were in the area and got really bad pneumonia, I usually won’t represent them, because I need to piggyback on what the health department has done. Clients that I take on have a specific diagnosis of Legionnaires' disease from a doctor and have confirmation from their local health department that they are part of the outbreak. Also, the clients that I represent in these cases usually have been hospitalized.
What are the warning signs/symptoms of Legionnaires' disease?
In addition to full blown pneumonia, the symptoms are: cough, fever, muscle aches, headaches, and shortness of breath. Occasionally patients will also experience diarrhea, nausea and confusion.
Symptoms usually begin 2-10 days after being exposed but can take up to two weeks to manifest.
Can you talk about a case that you have previously settled?
One case that I settled was a 15 year old girl in Ohio who had leukemia. She went to the hospital for treatments for her disease and unfortunately the hospital water supply was contaminated. At the time, her immune system was compromised so she was very susceptible to the Legionella bacteria. The Legionnaires' disease that she contracted greatly lengthened her hospital stay; so much so that she had to go on a ventilator under sedation for several weeks. Even when she started to recover she had to have a tracheotomy to receive supplemental oxygen because her lungs weren’t strong enough to breathe with a nasal cannula. The tracheotomy left her with an unsightly scar on the front of her neck.
She was hospitalized for four months when her original hospital stay should have been ten days. The settlement was interesting. The hospital realized what had happened and never sent out billings on anything related to her Legionnaires’ disease. Thus, the hospital paid all of the expenses associated with her Legionnaires’ illness and she also received a significant sum for pain, suffering, disfigurement, and permanent disability. Fortunately, she eventually made a good recovery. There were only two people that got sick in this incident so the hospital was quite lucky.
The hospital ultimately revamped their entire water supply and never contested that it was the source of the Legionnaires’ disease.
Your clients come from all over the country; how do they find/choose you?
Legionnaires’ disease cases are quite easy to handle remotely. I have a national practice in Legionnaires’ disease and if I am not admitted in a particular state, I work with a lawyer in that state to get admitted for the purposes of that particular case.
The local lawyer helps me understand the local rules and the judges, but I personally handle 90% of the work on the case. Whatever I pay the local lawyer comes out of my share not the client’s share of the settlement, so ultimately it doesn’t cost the client more to hire an experienced person like me versus a local lawyer.
What do you like about practicing this type of law?
I really do enjoy the science part of it, understanding how the health department tracks it and the different kinds of genetic fingerprinting that are done. I enjoy the combination of working with both microbiologists and epidemiologists; understanding the science of both sides.
Also I get great satisfaction in defending my clients. Many of the older clients with Legionnaires’ disease don’t end up bouncing back fully. The older you are, the less likely you are to make a full recovery. In many cases I am dealing with the family of an older client and I enjoy working with both that client and their supportive family members.
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