Legionella Update

Following nationwide recommendations issued by the Centers for Disease Control and Prevention on safely re-opening buildings after pandemic shut-downs, JHU has been conducting enhanced monitoring of showers and other plumbing fixtures across its campuses for the presence of the Legionella bacteria.

Last updated: August 13, 2021 at 3 p.m.

In addition to its level of use, the age and design of a plumbing system can increase the propensity for Legionella to proliferate, either throughout a building or in individual fixtures. The AMR residence halls are among our most historic buildings, and as such, require additional maintenance and care.

Note that the AMR I building had an isolated elevated reading of Legionella bacteria earlier in the summer and was treated following standard protocols. Nonetheless, in an abundance of caution, we took the added step of replacing all shower heads in AMR I along with AMR II and AMR III.

Last updated: August 13, 2021 at 3 p.m.

In response to the detection of Legionella bacteria in the summer of 2021, the university pursued an aggressive remediation plan in close consultation with the CDC, city health officials, and Johns Hopkins public health experts:

• The buildings’ pipes have received repeated thermal shock treatments, in which extremely hot water is run through the pipes;
• Standard chemical treatments were repeatedly applied;
• The water in the pipes has been repeatedly flushed, and;
• Hospital-grade showerheads that filter out bacteria, which are commonly used in medical facilities for the most vulnerable and immune-compromised patients, have been installed.

After the detection of Legionella bacteria in a handful of fixtures in AMR II in January 2022, the university has taken a number of steps, including the installation of hospital-grade showerheads, which have proven effective in filtering out Legionella bacteria.

Last updated: January 22, 2022 at 8 a.m.

In addition to its level of use, the age and design of a plumbing system can increase the propensity for Legionella to proliferate, either throughout a building or in individual fixtures. The AMR residence halls are among our most historic buildings, and as such, are more prone to the development of Legionella. The disuse of the building during the winter break led to the recurrence of Legionella there.

Last updated: January 22, 2022 at 8 a.m.

Yes. The buildings’ pipes have been repeatedly treated, tested, and flushed, and in response to the detection of Legionella bacteria in AMR II in January 2022, we have re-installed in affected fixtures hospital-grade showerheads that filter out bacteria and are commonly used for immune-compromised patients. Through this combination of mitigation strategies, we are confident these dorms can be occupied as planned.

Last updated: January 22, 2022 at 8 a.m.

Yes. Because Legionnaires’ disease is a respiratory infection, the exclusive concern is Legionella bacteria that are inhaled, not ingested (e.g., by drinking water). We are also continuing the enhanced monitoring of our water systems and anticipate that normal levels of water use will prevent a recurrence of the issue.

Last updated: August 13, 2021 at 3 p.m.

The university will continue its regular testing of water and will notify residents of any issues and efforts to mitigate the situation if needed.

Last updated: January 22, 2022 at 8 a.m.

Yes, eating at the FFC is safe, as it uses different water systems than the AMRs. Further, the higher temperatures that are used in dishwashing kill the bacteria. Legionella is transmitted through inhalation, not ingestion. Therefore, the causes for concern are limited to showers, not water uses like washing hands, food preparation, and drinking.

Last updated: August 13, 2021 at 3 p.m.

Yes. Through its enhanced testing efforts, the university has not detected persistently elevated levels of Legionella in any plumbing other than a handful of bathrooms in some of its most historic residence halls, AMRs II and III, and we are confident that those buildings are safe for use due to the aggressive mitigation measures that have been put in place.

Last updated: August 13, 2021 at 3 p.m.

• No. No cases of Legionnaires’ disease have been reported in Johns Hopkins affiliates. Symptoms usually begin 2 to 10 days after being exposed to the bacteria, so any period of concern has passed. Of the handful of staff members working in these facilities, none reported any symptoms of Legionnaires’ disease or Pontiac fever, and all were offered testing.
• Furthermore, individuals who test positive for Legionella (legionellosis) are required to be reported to the Maryland Department of Health. Public health workers at both local and state levels follow individual cases to ensure proper treatment, identify potential sources of infection, provide education to reduce the risk of transmission, identify susceptible contacts, and take other measures aimed at reducing the spread of disease. We have not received any reports from the state or city health departments.

Last updated: August 13, 2021 at 3 p.m.

• Legionella is a naturally occurring bacterium in water that is common in the lakes and reservoirs that supply water to municipal systems like Baltimore’s.
• It can proliferate to levels of potential concern when water sits in the pipes of an unused building for a long period of time, as occurred in some JHU buildings as a result of the pandemic.
• At higher levels of concentration, the Legionella bacterium can cause respiratory infections known as Legionnaires’ disease and Pontiac fever in people over 50 years of age and/or at high risk due to unrelated health conditions.
• Legionella is transmitted through inhalation, not ingestion. Therefore, the causes for concern are limited to showers, not water uses like washing hands, food preparation, and drinking. But no illnesses have been reported in any Johns Hopkins affiliates.

Last updated: August 13, 2021 at 3 p.m.

• Low levels are normal in natural and man-made water sources in Baltimore, but ordinary daily use of water in a building usually prevents its buildup in the building’s pipes.
• Legionella growth in buildings affected by COVID-related shutdowns is an expected phenomenon. Last year, the CDC issued guidelines for testing and treating plumbing systems that have seen little use during the pandemic, and we are following those guidelines.
• During the pandemic, a number of schools, hotels, and office buildings across the country have shown elevated Legionella readings in their plumbing because of disuse.

Last updated: August 13, 2021 at 3 p.m.

While there are no uniform national standards for evaluating Legionella bacteria levels, Johns Hopkins has been consulting with the CDC, city health officials, and Johns Hopkins experts about our testing and results, including what levels of Legionella bacteria require treatment. Out of an abundance of caution, we have intervened and taken remediation steps at even lower levels than advised by public health officials.

Last updated: August 13, 2021 at 3 p.m.

Legionella bacteria are transmitted through inhalation, not ingestion. Use of showers and hot tubs are of greatest concern because people can inhale contaminated droplets that build up from the steam. Water uses such as drinking, food preparation, and washing hands are safe.

Last updated: August 13, 2021 at 3 p.m.

Most people exposed to Legionella do not get sick. According to the CDC, those at highest risk for contracting the illness are individuals over the age of 50, people with chronic lung diseases such as chronic obstructive pulmonary disease or emphysema, and those with compromised immune systems.

Last updated: August 13, 2021 at 3 p.m.

Legionnaires’ disease is a respiratory infection that presents with symptoms similar to those of the flu or COVID—fever, coughing, shortness of breath, muscle aches, and sometimes nausea and diarrhea. Pontiac fever is a milder infection than Legionnaires’ disease with primarily fever and muscle aches that begin between a few hours to three days after being exposed and usually last less than a week. Both are treated with antibiotics. Legionnaires’ disease and Pontiac fever are not typically spread person to person, and neither illness has been reported in any Johns Hopkins affiliate.

Last updated: August 13, 2021 at 3 p.m.