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.

To read more about this story, please click here.

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.