Saturday, January 23, 2010


Most of us are aware of the incidence of Legionnaires' disease at the Golden Hill Nursing facility in Kingston. In the last several days, the authorities and health officials have gone through the building and grounds to look for the source and the means to eradicate the bacteria.

I attended the quickly called meeting of the Health & Human Services Committee (HHS) a few days ago and left with a renewed sense of confidence in our health staff and diminished fears of what the future hold for the current residents.

You've heard about the hot-water flush they have done to the domestic water pipes. It was one of very few options to achieve this goal, it's also the least threatening to the water system that is already well past it's prime. Because of the weak pipes throughout the building, Lowe Plumbing was called in to have personnel stationed with equipment on the ready to shut down any leaks that may occur when the flush is done.

We know 17 of the 32 samples taken from locations throughout the facility revealed evidence of the bacteria. But we were also
informed at the meeting, that Legionella is not that uncommon in New York State. Anywhere that water is transported through long distance pipes at mild temperatures is susceptible to contaminants. Hot water pipes in at Golden Hill travel as far as 400 feet from the water heater. Legionella, like other forms of Pneumonia, take hold and cause harm in persons with compromised health immunities.

The name of the disease stems from the original cases in the 70's where the American Legion Hall was frequented by the elderly and thus fertile ground to cause an epidemic. The situation is similar here in that clients at Golden Hill are more susceptible than the general public. Persons with compromised health situations anywhere are more susceptible to complications from exposure.

One client at Golden Hill passed away recently and, although not the cause of death, Legionella was present in the client's system. Thus, tests were done on anyone with respiratory ailments and another was discovered. I understand that when only one person is afflicted with Legionella at any one location, it usually goes unannounced throughout the state. Only when there are two or more, does the New York State officials get involved at this level.

I should also point out that not only have the Golden Hill staff been terrific in their handling of this issue, but the fact that Health Director La Mar Hasbrouck is an actual MD which provided such a wealth of insight and training during what could have been a bigger disaster.

The City of Kingston Water Department does monthly testing of the water at the facility, taken at several random locations during the year, but they do no have the ability to test for Legionella. This too will change. Only hours after the incident was confirmed, KWD offered as solution to the problem. A little late I'd say. Other means will be instituted for the continued testing of the water.

This will no doubt spur the conversation once again about what the county should do about it's ancient Health Care Campus and whether the county should be in the health care business at all. The service is high quality, but the cost to the taxpayer will continue to increase until the federal government provides a clearer message as to where funding sources and insurance payments will come from.

What struck me was at one point someone said: "We are going to flush the new wing first". The age of the new wing? Early 70's.
It's still called the new wing! Good grief.


Anonymous said...

Mike, Good job in stating the facts so that the general public can understand what legionnaire's is all about. Sounds like you are enjoying, at least so far, your time in county government.
We are fortunate that we were able to hire a true medical doctor for the county who could address this in a timely fashion. Not to mention that he has a background in infectious diseases. Only concern is how long he will stay with his credentials.

Anonymous said...

It's bitter sweet that we have renewed attention toward the betterment of our health care facility while the economy is in the tank.
You'll find, the reason the last leadership hesitated to get to the root of the problems of Golden Hill is because the public is still gun shy about spending taxpayer dollars on a capital project of that size. Why? ...look no further than the debacle of the jail. It's too soon and the trust in the management skills of any legislature isn't there. I really don't blame them.

Anonymous said...

I have had nothing but good experiences while visiting Golden Hill. The staff treated my dad and all the other patients there with great care and respect. Lets make this clean up work and get back to the good service and reputation that Golden Hill is known for.

Brooke Winter said...

Hi Mike,
If Dr. Bill McCoy, author of the book PREVENTING lEGIONELLOSIS can be of any help, please let us know. We routinely deal with facility owners and managers for improvement of water safety via Water Management Plans. Thanks for your good work educating the general public about issues such as this.
Brooke Winter

Anonymous said...

Has anyone else realized we wont be getting pictures of our City Council members at meetings anymore?

Now we will be getting the Madsen view of the Legislator meetings instead. Thanks Mike. Now I have to learn a whole new slew of names and issues just to keep up.

Anonymous said...

There are really two philosophies related to immune function and pathogenic disease, highlighted by the H1N1 situation:
1)bolster the immune system as a first line defense
2)take all kinds of measures to ensure the nonexistence of pathogens in the environment insofar as possible.
The latter by nature is inherently impossible to achieve to the nth degree so one can only do the best one can do.
Having said that what has been reportedly done while late is worthy of note nevertheless. Legionaire's disease has not proven the level of public health threat it was when first discovered, so understandably when the issue of public attention comes to the fore to deal with preventing same it is reasonable from that standpoint to suggest not doing much as the problem didn't seem to exist. There is much hardly understood about pathogenic disease although medicine would have us believe otherwise, and as such, the situation remains difficult to place in a neat little box to wrap up neatly therein.
This does raise the issue of preventive living in a health care facility in terms of bolstering immune function in the elderly and as a front line defense is often the best one.
Ultimately, the right steps in this regard were taken and understandably late although certainly not comfortably late by any means.