By Hamed Aleaziz and Victoria Colliver
San Francisco Chronicle
SAN FRANCISCO, Calif. — A Legionnaires’ disease scare swept San Quentin State Prison on Friday after an inmate tested positive for the potentially deadly illness, prompting officials to shut off water and attempt to track down the source of the bacteria that causes the disease.
Doctors confirmed that the prisoner had Legionnaires’ after he was tested Thursday at a local hospital, said Dana Simas, a spokeswoman for the California Department of Corrections and Rehabilitation. He was in stable condition in a local hospital and was receiving antibiotics. About 30 other San Quentin inmates showed pneumonia-like symptoms and were under observation Friday, but no official diagnoses had been made, Simas said.
Legionnaires’ is a severe type of pneumonia that kills about 4,000 people a year in the United States, according to data from the federal Occupational Safety and Health Administration. The inmates, who were being treated at the prison’s on-site medical unit, were not “gravely ill,” Simas said. Meanwhile, two inmates who showed symptoms were hospitalized, but no official diagnosis had been made on them as of Friday afternoon.
As a precaution, the prison shut off all water Thursday afternoon, shortly after the inmate was diagnosed, because the disease is often spread by inhaling mist or vapor from water contaminated by Legionella bacteria, she said. It is not spread from person-to-person contact. By Friday afternoon, after speaking with public health experts, prison officials allowed inmates to use toilets again in the housing units and resume the monitored use of water for cooking, she said.
A Marin County public health official said residents outside the prison are not at risk.
The prison houses about 3,700 inmates, including those on Death Row. San Quentin also serves as a reception center for new prisoners in the state’s corrections system, but intake has been “temporarily halted” while officials investigate the source of the disease.
Until they are able to determine that, prison officials were trucking in both bottled water and tanks filled with water for drinking, Simas said. Portable bathrooms had also been brought in for a period of time. Marin County public health officials were assisting the prison with the response.
“I think that us and the Marin County Public Health Department are responding quickly and appropriately to the incident and hope to resume normal operating procedures as soon as we are able to,” Simas said.
Dr. Matt Willis, the county’s public health officer, said residents should not be concerned.
“It’s important for people to know that this incident is isolated to the San Quentin community because of the nature of this infection,” he said. “It’s acquired through exposure to aerosolized droplets usually from a single source.”
Willis said it was fortunate that the issue was detected early.
“Even with just one case, to be taking these steps is going to ensure that the potential spread is going to be minimized,” said Willis.
“The likelihood of a good outcome is high” for the prisoner with Legionnaires’, he said.
The prison receives its water from the Marin Municipal Water District and stores it in a 3 million-gallon tank on-site. The district tested its water supply immediately and the results, they said, “strongly indicate” that its water is not the source. “There is no reason to believe that other MMWD customers are at risk,” the district said.
Don Specter, director of the nonprofit Prison Law Office in Berkeley, which defends the rights of inmates and sued the state over inadequate health care in 2001, said his organization was monitoring the situation. A federal court-appointed receiver runs the state’s prison health care system as a result of the lawsuit, which also led the U.S. Supreme Court to mandate a reduction in the state’s prison population.
“We are glad that the prison officials, the receiver’s office and Marin County Public Health are taking quick and decisive action,” Specter said.
The Centers for Disease Control and Prevention estimates that 8,000 to 18,000 people in the United States are hospitalized annually with Legionnaires’ disease. In most cases, the disease is treated with antibiotics.
Legionnaires’ disease got its name after a 1976 outbreak at an American Legion convention in Philadelphia that killed 34 people and sickened 221.
While outbreaks across the country tend to draw media attention, health experts say most cases crop up individually or in small clusters because the source is usually a specific water supply.
Willis said some people develop the disease after exposure to a source while others exposed to the same source do not. The reasons remain unclear.
“There’s a lot we don’t know about Legionnaires’, but we do know certain people are more vulnerable to serious disease when they are exposed to” the Legionella bacterium, he said.
People exposed to the bacterium can also develop an illness called Pontiac fever, which isn’t counted among those infected with Legionnaires’. “What we presume is their immune system is able to keep the infection at bay so they have a much more benign form of the disease,” Willis said.
This summer, in the largest outbreak of Legionnaires’ disease in New York City’s history, 12 people died and more than 120 became ill. City health officials linked the outbreak to the cooling tower of the Opera House Hotel in the Bronx. Two new cases in the city were reported this week after the outbreak was thought to be over.
In another ongoing outbreak, Illinois state health officials have diagnosed the disease in 23 residents of a veterans’ home in Quincy, but no deaths have been reported.
The Bay Area has also been hit by occasional cases and outbreaks, the worst likely being in 1991 in Richmond when two janitors at the city’s Social Security Administration building died from Legionnaires’ disease and another 15 people got sick.
Hamed Aleaziz and Victoria Colliver are San Francisco Chronicle staff writers. E-mail:haleaziz@sfchronicle.com and vcolliver@sfchronicle Twitter: @haleaziz @vcolliver
About Legionnaires’ disease
What is Legionna ires’ disease? A severe, often lethal, form of pneumonia caused by the bacterium Legionella pneumophila. It got its name after the 1976 outbreak at an American Legion convention in Philadelphia.
How is it contracted? By breathing a mist or vapor contaminated with the bacterium. A popular theory is that it’s contracted by inhaling contaminated mist from water sources, specifically the large water distribution systems of large buildings. Other sources may include humidifiers, mist machines, whirlpool spas and hot springs. The disease cannot be spread from one person to another.
What are the symptoms? Initial symptoms, which may not appear for two to 14 days after exposure, include tiredness and weakness. This can develop in a cough, high fever, muscle aches, diarrhea, vomiting, chest pain and shortness of breath.
How is it treated? Usually it can be successfully treated with antibiotics, but sometimes it can be fatal. The disease is most life-threatening in older people, smokers and those who have lung disease or compromised immune systems.
How can it be prevented? Proper maintenance of the water systems in which Legionella grow, including drinking-water systems, hot tubs, decorative fountains and cooling towers, is advised.
Sources: U.S. Centers for Disease Control and Prevention; Legionella.org; Chronicle research.