DAUPHIN COUNTY, Pa. (WHTM) — Select Medical, which runs Penn State Rehabilitation Hospital in Derry Township, is addressing possible legionella bacteria in water at the facility, both organizations confirmed.

Legionella can cause Legionnaire’s disease, a lower respiratory infection.

“The challenge with it is that it has a mortality rate of about 10% in individuals who are diagnosed,” said Natalie Exum, an environmental health scientist at the Johns Hopkins Bloomberg School of Public Health’s Department of Environmental Health and Engineering. “If you are more elderly and you are in the hospital, it can have a fatality rate of even 25%. So it’s a very serious infection.”

Craig Harry, now of Williamstown, Upper Dauphin County, was a patient at the rehab hospital after being transferred from another Select Medical facility to continue recovering from an illness, which included a three-week medically-induced coma.

He was scheduled to return home this past Monday.

But Harry said “they came around [last] Friday morning — they’re like, ‘Don’t use water.’ I’m like, ‘For what.’ He said, ‘for anything.’ He said, ‘Don’t brush your teeth. Don’t wash your hands. You can’t get a shower. Don’t drink it.'”

Harry said workers distributed bottled water.

“I’m like, ‘Why?'” Harry said. “And they said, ‘Well, there was a gentleman that was here who was diagnosed with Legionnaire’s.'”

Harry said hospital staff indicated the diagnosis came back on Jan. 9, although they didn’t warn patients until Jan. 26.

Exum said on one hand, time is of the essence once health authorities know where a Legionnaire’s disease case originated. On the other hand, “You have to find the problem and then do something about the problem. And that requires time,” she said.

A Legionnaire’s case, Exum said, could have come from anywhere the affected person was before a 12-to-14-day incubation period.

“Legionella bacteria in our drinking water is a lot more common than I think we all realize,” Exum says. The disease is still rare, although less rare than it once was.

“And that has left the research community trying to understand why,” Exum said. She said climate change — the bacteria thrives in warm, moist environments — could be a contributing factor.

“We are fully cooperating with the Pennsylvania Department of Health and taking all necessary infection control measures, guided by the CDC and state, to ensure the safety of our current and future patients as well as our staff,” a Select Medical spokesperson said in a statement.

“We’re working in close coordination with Select Medical to investigate any potential connection between the patient illness and the rehabilitation hospital and together will take any actions needed to protect patients, staff and the community,” a Penn State health spokesperson said in a statement. “Our focus is always on safety and the quality of patient care.”

Neither organization commented on whether water tests at the hospital confirmed the presence of the bacteria.

“The Pennsylvania Department of Health works closely with all facilities where there is a potential for healthcare-associated legionella cases,” a department spokesperson said in a statement, adding the department doesn’t comment on specific investigations or potential investigations because of confidentiality laws.

Legionella bacteria “forms in the biofilms of pipes. And so most often your exposures are coming from where the water aerosolized from, say, a shower,” Exum said. “The bacteria has to get into a water droplet in the air that then gets breathed into your lungs.”

Exum said patients in a facility with contaminated drinking water wouldn’t risk contracting the disease as long as they aren’t using the water, although a separate consideration is the practicality of remaining in a facility where showers aren’t possible.

“You definitely have to shut the water down,” she said. “And so there’s a question of how long can you really have people take sponge baths.”

Especially, Harry said, in a physical rehabilitation hospital, where personal care is part of the therapy.

“One of the things with occupational therapy was that they wanted to make sure that you could clean and bathe and dress yourself on your own,” he said.

Harry said even though he was “angry” and “bawled like a baby” when he heard the news Friday, he didn’t necessarily blame the hospital — no way to know, for example, whether the health department told the hospital about the disease case immediately after the department learned about it, he said.

“Everything else with the Select group, they were top of the ball, you know — straightforward about everything,” Harry said. He transferred to the Derry Township facility after a stay in a Select Medical unit within Penn State Holy Spirit Medical Center in East Pennsboro Township, Cumberland County.

Exum said there’s no way to judge the performance of hospital leaders in a specific incident without knowing more details about what they knew and when. But generally speaking, the fact alone that water at a facility tested positive for legionella — during, for example, routine testing even though no one got sick — could actually be a positive sign.

“I would much rather be going to that facility than I would one that’s not paying attention to their drinking water,” she said.

Exum said because legionella can be in pipes or anything holding water anywhere — especially places where water sits for periods of time — immunocompromised people can protect themselves by being vigilant at home about cleaning common trouble spots, such as shower heads that don’t have hospital-grade filters. Soak them in a 10%/90% bleach/water solution and then rinse them before re-attaching them, she said.

Hospitals, she said, need “all hands on deck” when they suspect legionella bacteria contamination in their water, because the problem can be anywhere — including somewhere in a pipe that might only affect one or two rooms.

“You really have to kind of get out your riser diagram and have your facilities managers — everyone,” she said. “So you need an epidemiologist, but you also need an engineer who really understands how the water flows — what the hot water system looks like.”

Legionnaire’s disease is named after the outbreak when it was first identified, at an American Legion convention in Philadelphia.