Apr
29
2015
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A male patient who was being treated at the Veterans Affairs Pittsburgh Healthcare System passed away last week due to Legionnaires’ disease.  A health investigation is underway to find the source of the man’s illness.

According to Dr. Brook Decker, infection prevention director for the VA Pittsburgh health system, “it seems most likely that this is a community-acquired case,” and not one connected to the VA.

It is still unclear where the man was exposed to Legionella, but the VA is unlikely to be the source as the man had very limited exposure to the hospital and the Legionella testing results at the VA Pittsburgh have been clean, as of late.

To read more about this story, please click here.

 

Posted by jzacher">jzacher at 4:08 pm
Apr
28
2015
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According to a newly released VA document, a former infection prevention official had warned the Department of Veterans Affairs about Legionella problems in Pittsburgh a year and a half before the outbreak of Legionnaires’ disease occurred.

The Centers for Disease Control and Prevention (CDC), however, authorized the VA Pittsburgh Healthcare System’s detection procedure in August 2009 and so the review by the Office of Inspector General (OIG) was closed.

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“No further work was appropriate by the OIG since the CDC is recognized as the expert in this area, and they certified the facility as having the expertise,” said Catherine Gromek, an Inspector General spokeswoman.

However, 18 months later, an outbreak of Legionnaires’ disease occurred causing 16 illnesses and 6 deaths.

To read more about this story, please click here.

Posted by jzacher">jzacher at 5:10 pm
Apr
27
2015
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Glan Clwyd Hospital

A coroner for North Wales East and Central in the United Kingdom is calling for speedier actions for suspected Legionnaires’ disease cases following the death of a 54-year-old woman.

According to coroner Ruthin John Gittins, timing played a part in the death of Sally Ellison, a social worker, who died at Glan Clwyd Hospital in June 2012 after returning from a vacation in Tunisia approximately a week prior.

Unfortunately, Mrs. Ellison’s Legionella testing did not occur until the day before she died.  An autopsy showed that Mrs. Ellison’s cause of death was cardiac arrest due to multiple organ failure due to Legionella.

To read more about this story, please click here.

Posted by jzacher">jzacher at 5:36 pm
Apr
24
2015
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Today at the 64th Annual Epidemic Intelligence Service (EIS) Isaac Benowitz discussed the importance of prompt response times to community outbreaks of Legionnaires’ disease.  In particular, Mr. Benowitz discusses the recent outbreak at a large housing complex in NYC that occurred in 2014-2015.

The source of the outbreak was attributed to a cooling tower on the premises.  It was concluded that the use of the polymerase chain reaction (PCR) to discover the presence of Legionella in addition to culture “allowed action to prevent further illness 5 days earlier than using culture alone.”   The conclusions of this study of the NYC outbreak also say that “[a]dequate water disinfection may help prevent Legionellosis outbreaks.

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For the full abstract of Healthcare-Associated Outbreak of Legionnaires’ Disease on an Inpatient Hematology-Oncology Unit-Alabama, 2014, please click here.

The 2015 EIS Conference runs from April 20-23 at the Crowne Plaza Hotel Atlanta Perimeter at Ravinia in Georgia.  More details on this conference can be found here.

Posted by jzacher">jzacher at 4:06 pm
Apr
22
2015
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Earlier this week at the 64th Annual Epidemic Intelligence Service (EIS) Conference hosted by the CDC, Louise Francois Watkins discussed a study that was done regarding a Legionnaires’ disease (LD) outbreak in the Inpatient Hematology-Oncology Unit at a hospital in Alabama.

The patients in this unit are immunocompromised cancer patients and therefore more susceptible to infection by Legionella bacteria.  During the outbreak that occurred in May 2014, 10 cases (nine inpatients and one visitor) were identified.

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The study concluded that the outbreak source likely came from an uncommon Legionella pneumophila 1 strain ST36, which was found in the hospital’s potable water system and suggests that “clinicians caring for immunocompromised patients should maintain a high index of suspicion for healthcare-associated LD.”  The study also indicated that “strict water restriction precautions were effective and should be considered in LD outbreak settings involving immunocompromised patients.”

For the full abstract of Healthcare-Associated Outbreak of Legionnaires’ Disease on an Inpatient Hematology-Oncology Unit-Alabama, 2014, please click here.

The 2015 EIS Conference runs from April 20-23 at the Crowne Plaza Hotel Atlanta Perimeter at Ravinia in Georgia.  More details on this conference can be found here.

Posted by jzacher">jzacher at 11:36 am
Apr
21
2015
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Today at the 64th Annual Epidemic Intelligence Service (EIS) Conference hosted by the CDC, Amanda Kamali, MD will lead a discussion about nosocomial Legionella infections.

Dr. Kamali discussion will focus on the idea that “current investigation practices for hospital-associated Legionella infection may not be enough to detect and prevent future cases.”

In European hospitals, testing for Legionella in water systems is required quarterly; in the US, however, the CDC only requires hospitals to test if there is an outbreak (2 or more confirmed cases) or one transplant unit case.

The EIS looked at Legionellosis surveillance data from LA County for October 2005-August 2014 and found that among the nosocomial cases, 72.8% were definite nosocomial cases and 27.2% were identified as possible nosocomial.  15% of the definite cases were followed by additional cases at the same facility.  Because of this, Dr. Kamali concludes that it would be important to conduct preventive environmental testing for Legionella after one confirmed case.

For the full abstract of Nosocomial Legionella Infections – Los Angeles County, October 2005-August 2014, please click here.

The 2015 EIS Conference runs from April 20-23 at the Crowne Plaza Hotel Atlanta Perimeter at Ravinia in Georgia.  More details on this conference can be found here.

Posted by jzacher">jzacher at 12:39 pm
Apr
20
2015
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The Physical Plant Department (PPD) at the University of New Mexico works to create a safe and beautiful space for students, employees, and visitors of the campus.  About two years ago, PPD decided to integrate a Hazard Analysis of Critical Control Points (HACCP) based water safety program.  This program would include testing, remediation, monitoring, and maintenance of the potable water system (i.e. bathroom sinks, drinking fountains) as well as water features and cooling towers.

The PPD recognized the potential dangers of waterborne pathogens often present in large water systems.

“Reducing the risk to our campus community is worth the expense of developing this water safety program at UNM,” said Dr. Gary Smith, associate director of PPD Environmental Services.

The UNM campus is considered a “large water system” by the New Mexico Environment Department and pumps approximately one million gallons of water from its wells each day.

Many pathogens can exist in a large water system such as UNM including Legionella bacteria, Giarda, Pseudomonas, Acinetobacter, Aspergillus, and others.

According to Dr. Smith, “UNM takes the stand that it’s important to apply principals that are documented to prevent public illness from water systems.  We want people to feel safe while visiting our campus, and it’s important to lead the way and show we take our responsibility as facility maintenance managers seriously.”

The PPD preventative maintenance program includes daily, weekly, or monthly flushing of various water sources.

According to Dr. Eleana Zamora, assistant professor at the UNM School of Medicine, and vice chief of staff at the Sandoval Regional Medical Center, individuals in New Mexico are less likely to contract Legionnaires’ disease due to the dry climate.  “We have a really dry environment, it’s not humid, so it doesn’t tend to be as much in the environment as in other places like back east.”

UNM does treat some cases of Legionnaires’ disease each year, however.  In 2014, there was a total of eight cases reported to the New Mexico Department of Health.  For comparison, the health department in Michigan reported 236 cases in the same year.

UNM is one of the few universities in the US that has decided to implement a HACCP-based water safety program.

To read more about this story, please click here.

Posted by jzacher">jzacher at 1:47 pm
Apr
17
2015
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A case of Legionnaires’ disease involving a 54-year-old woman has been reported to the Hong Kong Centre for Health Protection (CHP) of the Department of Health.  This case represents the ninth case reported to the CHP this year.

The woman experienced symptoms including fever, cough, and shortness of breath since April 9; she first consulted with her doctor before being admitted to Pamela Youde Nethersole Eastern Hospital.  She was then transferred to intensive care on April 16.  Test results showed that she was infected with Legionella bacteria.

Legionnaires’ disease is frequently contracted while traveling; after some questioning, it was revealed that the patient had traveled to Taishan, Guangdong in China from April 2-8.  An investigation by the CHP is still ongoing.

In 2014 and 2013, Hong Kong received reports of 41 and 28 cases of Legionnaires’ disease respectively.

To read more about this story, please click here.

Posted by jzacher">jzacher at 10:08 am
Apr
16
2015
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Edinburgh building

Independent  expert on waterborne diseases, Dr. Mike Allan, has said he intends to conduct an unofficial inquiry into a Legionnaires’ disease outbreak that resulted in the death of four people.

An investigation of the 2012 Legionnaires’ disease outbreak in Edinburgh failed  to find the source of the outbreak.   92 people were infected with Legionella bacteria in this outbreak, four of whom ultimately died.

Dr. Allan, a private contractor for NHS Greater Glasgow and Clyde who led Legionella testing for 14 years, said that the three-year investigation had “failed all of the families.”

To read more about this story, please click here.

Posted by jzacher">jzacher at 4:04 pm
Apr
15
2015
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West Palm Beach VA

Potentially deadly Legionella bacteria were discovered at the VA Medical Center in West Palm Beach, Florida.  The bacteria were also discovered just a few months ago in January at the same facility.  The West Palm Beach VA attempted to disinfect after the first finding in 2015, but the bacteria returned.

“It’s in the system.  You know we hyper-chlorinated.  We hoped that we resolved it.  Obviously we didn’t resolve all of it,” said Jon Roberts, West Palm Beach VA chief of facilities management.

All drinking fountains at the medical center have been shut down due to the Legionella finding.  Many filters on shower heads and ice machines have also been changed.  Bottled water has been distributed to to in-patients for teeth brushing.

It is concerning that the bacteria has returned within a few months, but according to Christine Tugwell, nurse manager for infection prevention at the West Palm Beach VA, “[the bacteria] can re-grow.  “it can live in pipes and water systems and re-grow itself so we are very proactive in taking the approaches that we’re doing.”

So far, no patients or staff have become ill with Legionnaires’ disease as a result of the bacteria.

To read more about this story, please click here.

Posted by jzacher">jzacher at 10:40 am