Texas Infant born in birthing pool dies of Legionella infection

According to investigators at the Texas Department of State Health Services, an infant in Texas died a few weeks after being born due to a Legionella bacteria infection.  The bacteria are commonly found in warm water in hot tubs and water systems.

The baby was born in a heated birthing pool at home and taken to the hospital six days later due to breathing problems and other signs of an infection.   The infant ultimately died in January 2014 after being hospitalized for 19 days.

In July 2014 there were reports of Legionella found in birthing pools in the UK; public health alerts and advisories were issued after one baby died as a result of exposure to the waterborne bacteria.

According to Elyse Fritschel, an epidemiologist at the Texas Department of State Health Services, "[infants] are in a higher risk category because of their underdeveloped immune system, and their developing physiology."

Public health investigators in Texas reviewed the disinfection process used by the midwifery center that provided the family with the birthing pool.  Investigators also tested the pool and water used to fill the tub for bacteria.

Unfortunately, by the time public health investigators were able to inspect, the birthing tub was already disinfected and placed back into storage, and so Legionella was not detected.  Legionella was not detected in the water either, however, "current testing techniques don't detect this bacterium 100 percent of the time."

"Because Legionella is pretty ubiquitous in the environment, it's not a big stretch to imagine that it would be in the water system, and there were no other exposures that were identified," said Fritschel.

According to the American Academy of Pediatrics and the American College of Obstetricians and Gynecologists, giving birth using a birthing pool is generally not recommended because there are no proven benefits and there are a number of potential health risks for the baby including waterborne pathogens.

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Olympic Games in Rio de Janeiro Raises Legal and Public Health Questions regarding water quality liability and Legionella bacteria

Working Title: Olympic Games in Rio de Janeiro Raises Legal and Public Health Questions regarding water quality liability and Legionella bacteria

By: Jules Zacher, JD MA; Tawny Vu, MPH

Outline

I.        Introduction – importance/significance of XXXI Olympiad

       a.       Guests and athletes of the games will travel from all over the world and all could be exposed               to bacteria

II.      Dangers associated with Legionella for travelers

       a.       False sense of security in hotels (water coming in from water company is not necessarily                      safe)

       b.      Lack of knowledge about water system maintenance within large facilities

       c.       LD can be debilitating or even lethal

       d.      LD is under-diagnosed

       e.      Cases of LD are under-reported

III.    History of litigation in U.S.

        a.       American legal system

        b.      Causes of Action

        c.       Jules Zacher’s cases

                              i.      German citizen who contracted LD at a hotel in New York while traveling for work

                              ii.      Las Vegas hotel LD outbreaks

                              iii.      Spa-associated LD at hotel in Maryland

IV.    Liability of corporations

        a.       Liability of American-owned corporations to American citizens

        b.      Liability of Brazilian corporations, including Brazilian subsidiaries, to American citizens

V.      Liability of Brazilian entities, such as the Brazilian Olympic Organizing Committee

VI.    Conclusion

        a.       Legionnaires’ disease is dangerous and it has international concerns

        b.      There is liability

        c.       Prevention is key

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.

State association applauds Trib's reporting on VA Legionnaires' disease outbreak

State association applauds Trib's reporting on VA Legionnaires' disease outbreak

Three Tribune-Review staffers won the Pennsylvania Associated Press Managing Editors public service award for their investigation of a fatal Legionnaires' disease outbreak at the Pittsburgh VA Healthcare System.

The award, announced on Friday, was among 14 given to Trib Total Media staffers in the annual journalism competition sponsored by one of the state's premiere journalism organizations.

To read more about this story, please click here.

New Legionnaires' disease cases at Jules Zacher, PC

Jules Zacher was recently retained to represent one of the victims of the Legionnaires' disease outbreak at IU Health University Hospital in Indianapolis, IN.   He was also retained for three cases involving the outbreak at the Integrated Health Campus in Allentown, PA that sickened at least 8 patients or visitors of the health facility.

Jules Zacher is an attorney at law who has been practicing for over 35 years.  He is known across the country for his experience with Legionnaires’ disease cases and has been recommended numerous times by both clients and other attorneys.

He has had success representing victims of Legionnaires’ disease in federal and state courts across the country and is currently working on numerous cases in Hawaii, California, Nevada, Ohio, Pennsylvania, and New York.