Legionella Bacteria Found in Middle School and Quaker Ridge Water Systems

legionellaAs if COVID did not pose enough of a challenge to the reopening of the Scarsdale Schools, now the district has announced that legionella bacteria, the cause of Legionnaires’ disease, has been found in the water at Scarsdale Middle School and the Quaker Ridge School. An email from the district says, “The bacteria can cause a form of pneumonia that can be severe. While found in drinking water, the disease may result by breathing in or aspirating small water droplets containing a pathogenic type of legionella bacteria.”

Testing at the school was conducted on September 4, but results were not reported until September 14. You can see the test results here: As a result, the district covered all water fountains and drinking stations with the exception of water stations that include UV filtration, that kills the pathogens. They will supply water bottles for drinking at both schools, and plan to replace all water fountains with UV filtration stations. According to an email from School Superintendent Dr. Thomas Hagerman, “District Food Services in the two affected schools will suspend the use of kitchen sinks at for food preparation until mitigation is complete.” It’s not clear how they can prepare food without water.

In order to eradicate the bacteria, the district plans to disinfect the system, flush the lines and retest. This work will be done at all seven schools.

According to Scarsdale resident and physician Darlene Lefrancois, “It is unfortunately Legionella pneumophilia, a highly pathologic strain, and per reports it was at two out of four sources at Quaker Ridge and five out of six at the Middle School, representing an extensive degree of small to moderate colonization.”

She continued, “I am glad to see they are planning on regular retesting going forward, also addressed in the Sept 17th briefing. I am dismayed they didn't deal with this issue before reopening the schools. Nobody needed this and it was foreseeable. As I had guessed I think the COVID closures of school in March and low flow of the water is a contributor. Given this testing was done as part of the reopening plan it's unfortunate this was not dealt with prior to actual reopening schools for instruction.”

Providing some background on the bacteria, LeFrancois said, “We have unfortunately had a number of cluster outbreaks of this disease during my tenure working as a physician in the Bronx. While there are a couple of select classes of antibiotics that can treat the disease (these do not include the B-lactam class e.g. penicillin), they are certainly not 100% effective. Mortality numbers overall are as high or even higher than for COVID-19. Immediate source control is essential to eliminate the risk and until that is achieved anyone in attendance or working at the school may be at risk of acquiring this serious infection from various water sources. Thankfully, as the briefing points out, there is no person to person spread. As an important aside, the clinical presentation can be similar to that of a typical pneumonia but is very often atypical (hence why Legionella pneumonia is considered an "atypical pneumonia"). Specifically, gastrointestinal symptoms (e.g diarrhea, vomiting) are very common and may be the predominant symptom at presentation. The community should be made aware of what to look for.”

An August 27, 2020 article in the NY Times alerted the public to the risk of legionella in schools that were shutdown since March. A district in Ohio found the bacteria in five of their schools and it was detected in four schools in a district in Pennsylvania.

In order to reopen and comply with safety procedures to mitigate the risk of COVID, the Scarsdale Schools had to take many measures to alter the configuration of classrooms, install hand sanitizers and signage, purchase PPE and draft rules, regulations and procedures for to govern school attendance. Facilities Director John Trenholm retired in July which may have further stressed the administration. Testing for legionella is not part of the district’s usual protocol. In an email to parents dated September 16, 2020 Dr. Hagerman explained, “Testing for legionella is not a requirement for schools and mitigation measures are not regulated. However, we decided to add this testing as part of our broader building restart plan based on the CDC recommendations outlined in the Guidance for Reopening Buildings After Prolonged Shutdown or Reduced Operation. Going forward, we will engage in regular legionella testing as part of our comprehensive environmental testing plan.” 

The CDC report warns about the risk of both mold and legionella in buildings that have been shutdown. It opens as follows:

“The temporary shutdown or reduced operation of a building and reductions in normal water use can create hazards for returning occupants. Two potential microbial hazards that should be considered prior to reopening after a period of building inactivity are mold and Legionella (the cause of Legionnaires’ disease). For mold, a “prolonged period” may be days, weeks, or months depending upon building-specific factors, season, and weather variables. For Legionella, a “prolonged period” may be weeks or months depending on plumbing-specific factors, disinfectant residuals, water heater temperature set points, water usage patterns, and preexisting Legionella colonization.”

We’re not sure if the district conducted air quality reports to test for the presence of mold before the opening of school. For now, we don’t see these results posted on the district website, but do know that the district committed to annual testing of both air and water quality. Here is the link to the facilities page on the district website. 

Regarding legionella, in a memo to parents dated September 15, Dr. Hagerman said, “We wish this communication wasn’t regarding yet another challenge to overcome, but we would rather know and be able to complete a course of mitigation than the alternative. These are challenging times indeed, and we thank you for your support as we navigate this unusual school year.”