Editor’s Note: This story has been updated to reflect that CMS reopened its building on Aug. 5.

The Centers for Medicare and Medicaid Services building in Baltimore, Maryland had been closed since early June.

During major renovations, the General Services Administration discovered Legionella bacteria in CMS’ water supply. It only reopened in early August.

The Social Security Administration building, also in Baltimore, two-and-a-half miles away, has turned off about 20 water fixtures because it too discovered higher than normal levels of the bacteria in its water supplies.

SSA has kept its building open while treating its water system.

Before anyone panics or says the sky is falling, the discovery of Legionella bacteria in the water supply is more common than most people know, and it’s a scarier concept than it is an actual threat to the average person’s health.

But even the mention of Legionnaires’ disease can elicit fear and increase anxiety among federal employees, especially after the pandemic as more employees are returning to the return to office. Legionnaires’ disease is a type of serious pneumonia caused by a type of bacteria called Legionella. The less serious version of Legionnaires’ disease is known as Pontiac fever. The Centers for Disease Control and Prevention says the most common way for someone to get sick is by breathing in mist containing Legionella.

But CDC and private sector experts say studies have shown that approximately 50% of all building water systems contain Legionella. This is due to its natural prevalence in water as well as many potential sources of exposure to Legionella in the community or even from home water systems.  At the same time, water sources in buildings became stagnant because of the pandemic and now the continued inconsistent number of people in buildings, meaning faucets or water fountains don’t get flushed out as regularly as maybe they once did.

“According to the Centers for Disease Control and Prevention (CDC), most healthy people exposed to Legionella do not get sick, and outbreaks are relatively rare,” said Courtney Springer, the assistant commissioner for Office of Facilities in GSA’s Public Buildings Service, in an email to Federal News Network. “The safety of federal buildings we oversee is a top priority, which is why GSA has consulted with federal, state and local health organizations as well as industry experts to develop an aggressive water quality management program to ensure the safe, continued use of facilities. GSA’s water quality management policy requires baseline testing and aligns with industry standards and best practices. This year, GSA is performing baseline water sampling/testing in 1,400 GSA-controlled federally owned facilities and 6,000 leased spaces. The effort includes testing for heavy metals and water-borne bacteria, such as Legionella.”

Janet Stout, executive vice president and founder of Special Pathogens Laboratory, A Pace Laboratory and a former federal executive who worked on microbiology and Legionnaires’ Disease with the Veterans Health Administration, said the average person isn’t unaware of, nor impacted by, Legionella bacteria found in water building systems, to include but not be limited to cooling towers or air conditioning, any warm water distribution system in buildings.

“It’s understandable that it’s unnerving for people to learn Legionella is in their water with absence of context and information,” said Stout, who is working with GSA to educate building managers and others to earn the Legionella Water Safety and Management Specialist Certification/ASSE 12080.

GSA testing water systems

As part of GSA’s focus over the last few years to improve the water quality and establish a baseline in federal buildings, Springer said out of approximately 7,400 GSA-controlled federally owned facilities and leased spaces, GSA has received results for 1,441 locations. Of those, 371 locations (25.7%) have shown the presence of Legionella bacteria in exceedance of established thresholds.

But to be clear, Springer said, the presence of Legionella is common and does not equate to someone contracting Legionnaires’ Disease.

For instance at CMS and SSA, the Maryland Department of Health told Federal News Network there has been no reported cases of Legionnaires’ Disease. And because Legionnaires’ Disease is a reportable disease, healthcare facilities and physicians are required by law, in most states, to report cases to the state’s department of health.

A spokesperson said SSA is not aware of any cases of Legionnaires’ Disease or Pontiac fever tied to its Woodlawn, Maryland campus.

“We continue to provide information and regular updates to our employees regarding testing and water quality management,” the spokesperson said. “We have approximately 20 fixtures that are being flushed and re-tested out of over 1,100 available fixtures campuswide.”

A CMS spokesperson also told Federal News Network that they closed the CMS buildings out of “abundance of caution.”

“We will resume normal campus operations when remediation of the Baltimore campus is complete, and we are confident that the issues have been resolved,” the spokesperson said. “Most employees and contractors are working remotely. All other CMS locations are operating as usual. CMS is not aware of any health issues impacting the workforce.”

Water remains usable despite bacteria

Stout said employees at CMS, SSA or really any federal agency – GSA says it found Legionella bacteria in his headquarters across 13 water fixtures this year – shouldn’t be concerned and can continue to use the water.

“I’m doing a lot of education for GSA buildings and I tell them when I worked at the VA hospital that was found to have Legionella, I would drink the water with no hesitation,” Stout said. “The disease itself is pretty rare. Maybe 2%-to-5% of all pneumonias are caused by this bacteria. People who get it, typically, have pretty significant underlying health problems that go on to develop disease after being exposed.”

Stout said it’s not a new building or an old building problem either, but one that happens when it does. That is why GSA’s testing program is so important.

“To some extent it can be random, but it’s not unexpected to find Legionella in buildings. But why some and not others is complex. There is no one single factor,” she said. “This is why testing is so important because you can’t predict which building will be positive.”

GSA became more focused on this proactive testing program in January after seeing a decrease in water quality, including an increase of Legionella bacteria, over the past 20 years.

Even though GSA established its order on drinking water quality management in 2016, the CDC says it has seen a 9-fold increase in cases of Legionnaires disease between 2000 and 2018. Vacancy in commercial buildings led to a significant decrease in cases during COVID, however counts have risen since the pandemic

GSA updated its drinking water quality order in 2023 to address these increased threats to bring in more third-party testers analyzing at least 10% of all water sources used by employees.

“How we work with agencies depends on who is responsible for operations and maintenance (O&M) in the facility, and our water quality management policy is designed to apply industry-leading water management practices to protect the health of building occupants in all facilities under GSA’s jurisdiction, custody or control,” Springer said. “When facing water quality challenges, effective management relies on preventive maintenance, immediate corrective actions and follow-up testing to verify the effectiveness of those actions. Corrective actions may include flushing, adjusting water temperatures, monitoring chlorine levels or building modifications such as replacing pipes or fixtures.”

The CDC has guidance for people who are 50 or older, a current or former smoker, have chronic lung disease, or have a weak immune system to help protect themselves in case of water problems. The CDC says if you fall into any of these categories, employees should consider things like not taking a shower at a facility and filling a sink slowly to avoid creating mist.

Stout said if someone comes down with pneumonia with symptoms like fever, coughing and/or shortness of breath, they should tell their doctor that their building’s water contained Legionella bacteria.

“Often physicians do not think about what is the cause of pneumonia and they could give you the wrong medication. But if they are in position ask for a test, it does impact treatment. And it’s an easy test through urine to see if the patient has Legionnaires’ Disease,” she said.

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