Through the Legionella Looking Glass – Part 2: A Look at Current Practices and State of the Science

In the April issue of the Healthy Indoors, Dr. J. David Krause, a senior toxicologist and Associate of a Florida-based health sciences firm, discusses complex public health issues involving Legionnaires’ disease.  Topics in his thorough and well-thought article include:

• Difficulties with tracking Legionnaires’ disease outbreaks
• Limits of public health agencies such as local and state health departments and the Centers for Disease Control and Prevention (CDC)
• Efficacy and accuracy of testing methods for the different strains of Legionella bacteria which cause Legionnaires’ disease
• Legionnaires’ disease as an under diagnosed and under reported illness
• Relying on surveillance is difficult when the disease is under reported and under diagnosed.  Also, current practices do not always include water system testing or treatment for some facilities.
• Difficulties for public health organizations to take a global approach to control, investigation, and prevention of Legionnaires’ disease.

Currently, there are many inconsistencies regarding Legionella.  For example, “municipal water systems have specific bacterial testing requirements, but Legionella is not among them.  The non-regulatory ‘maximum contaminant level goal’ (MCLG) established by the US EPA for Legionella is zero, but testing for Legionella by municipal water suppliers and achieving this goal is not required.”

This is especially troubling considering a study that was recently published in Environmental Science & Technology, which reported that Legionella pneumophila serogroup 1 (LP1) was found in “nearly half of cold water tap samples taken from 68 different water supplies across the United States.”

To read Dr. Krause’s full article, please click here.

Legionnaires’ disease outbreak at UPMC Presbyterian in Pittsburgh

Legionella bacteria at the University of Pittsburgh Medical Center (UPMC) Presbyterian have contributed to three Legionnaires’ disease cases, one of the three patients died from their illness.  The potentially deadly bacteria were found in the ice machines at UPMC Presbyterian and health officials are saying Legionnaires’ disease in patients who aspirate ice chips is highly unusual.

This discovery prompted a massive sterilization of 500 ice machines at UPMC’s 20 hospitals.  According to officials, machines testing positive for Legionella are being removed; all others are being sterilized and fitted for filters.

After a patient tested positive for Legionnaires’ disease, hospital workers tested the water system, but results were negative for Legionella bacteria.  It was later revealed that the patient was restricted to eating ice chips and aspirated a chip which caused bacteria to enter the lungs causing pneumonia.

“When we realized that clinical connection, we said , ‘Ahh, the ice machines!’ and we went and tested the ice machines, and we found Legionella,” said Tami Minnier, the chief quality officer at UPMC.

It was found that Legionella was in less than 20 percent of ice machines at UPMC Presbyterian.

“We discovered that Legionella can grow in ice machines to a degree that we previously hadn’t thought of,” Minnier said.

Following the discovery of Legionella, UPMC officials notified the Pennsylvania Department of Health, Allegheny County Health Department, and the Centers for Disease Control and Prevention (CDC).

To read more about this story, click here.

4th Legionnaires’ disease case now associated with outbreak at senior home in Florida

A fourth case of Legionnaires’ disease has been confirmed at Camellia at Deerwood, home for the elderly in Jacksonville, Fla.

Department of Health spokesman Charles Griggs said that two residents developed pneumonia associated with Legionella bacteria in March and April.  This observation caused the Department of Health to investigate further and they discovered that there was a related case in November 2013.  Another case this month was confirmed while the investigation was still ongoing.

Perry Brown, facility manager at Camellia, did not say whether any additional residents have become ill since the public health advisory was released by the Duval County Health Department on April 21, but he did say “we are working directly with the Health Department to keep our residents safe.”

To read more about this story, please click here.