29 de mai de 2014

Some UAB patients who tested positive for legionella bacteria released from hospital

BIRMINGHAM, AL -Some UAB patients who tested positive for legionella bacteria have been released from the hospital.

UAB says eight patients tested positive for the bacteria in the hematology-oncology unit.

Two patients died, but the cause of death for those two patients has not yet been determined.


 Legionella can cause a severe form of pneumonia. 

According to the CDC, the bacteria that causes the illness typically travels by water.

Dr. Loring Rue, UAB chief patient safety officer, couldn't release much information because of confidentiality, but says some patients who tested positive for the bacteria have been released.

He says others are still undergoing chemotherapy.

As we've reported, Dr. Rue says UAB flushed its water system to eliminate bacteria and installed filters on faucets in the affected areas.

In the meantime, UAB is awaiting test results to confirm legionella is out of the system.

"We've put these filters in place that will obviously reduce the risk of exposure. If again, the cultures come back negative on Friday, then we feel pretty confident that this has been... We feel pretty confident that it's been eliminated now, but this will be our confirmation of that," said Dr. Rue.

The Jefferson County Health Department held a news conference to address legionella bacteria. 

Officials talked about the symptoms people should look out for including a high fever, coughing and shortness of breathe. 

In a statement, UAB said, "We will continue to make the safety of patients, staff and visitors our primary concern and communicate throughout this process."

Here is the statement released from UAB about the bacteria cases:

"It is important to note that the water system that provides water to the hematology/oncology unit serves only floors 5-7 in the Women and Infant building and no other areas of the hospital (5 is not a patient care floor in WIC). You can attribute this to Loring Rue, M.D., Chief Patient Safety and Clinical Effectiveness Officer:

UAB Hospital has lifted most of the water restrictions it implemented in a limited area of the hospital late Saturday. Those precautionary measures were implemented out of an abundance of caution pending final results of tests after eight patients on one unit - hematology/oncology - tested positive for legionella, a bacteria that can cause a form of pneumonia called legionellosis.

We took proper actions to address the presence of legionella and installed special filters on shower and faucet heads, flushed the water system, and shocked it with extreme temperatures, to ensure safe use. We have consulted with public health authorities including local and state departments of health and the Centers for Disease Control and Prevention (CDC) and implemented these measures pursuant to proposed guidelines of the American Society of Heating, Refrigerating and Air Conditioning Engineers (ASHRAE) commonly followed in the U.S. and referred to by the CDC. We have no knowledge of new infections contracted after our remediation efforts.

Until we receive the test results that confirm these steps addressed the presence of legionella, we have asked that patients wear masks when flushing the toilet. Although the initial water restriction limited sink and shower use, that has been addressed by the filters.

Two patients who were on the unit prior to the remediation of the water system and tested positive for legionella, have died. The causes of their deaths have not been determined. We only know that in addition to their original illness the patients tested positive for legionella.

Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water, like the kind found in hot tubs, hot water tanks and large plumbing systems common in office buildings, schools, hotels and hospitals. Most people are exposed to legionella regularly and do not contract legionellosis. People with weak immune systems are more susceptible to legionellosis. According to the CDC, most cases of legionellosis can be treated successfully with antibiotics.

We will continue to make the safety of patients, staff and visitors our primary concern and communicate throughout this process."



Este problema existe no Brasil, estima-se que mais de 5.000 pessoas possam ir a óbito provocado pela Legionella (pnuemonia). Não só em hospitais, podemos ser contaminados em vários locais.
Saiba mais sobre a Legionella no site www.legionellaespecialistas.com.br

28 de mai de 2014

Conversations with Water Leaders: Peter Brabeck-Letmathe, Chairman of the Board, Nestlé S.A. on Nestlé’s Water and Wastewater Management Practices


This feature news is part of Singapore International Water Week's (SIWW) series of 1 on 1 interviews with global water industry leaders, Conversations with Water Leaders. In this edition, Peter Brabeck, Chairman of the Board, Nestlé S.A. shares the concept of Creating Shared Value and how it can improve water and wastewater management. He also sheds light on the new 2030 Water Resources Group initiative and ways on how water can be made priority on the political agenda. Read about Peter Brabeck-Letmathe

The Conversations series is part of SIWW's initiative on practical discussions and solutions. In line with this, Water Leaders Summit will continue to engage policy makers, utilities, governments, industry experts and water leaders with aims to identify and craft solutions to pertinent water issues. Discussions from the SIWW Water Utilities Leaders Forum will also be further deliberated at the summit.

Finally, do log onto Virtual Water Expo to view the solutions showcase and keep abreast of the latest products, equipment and services available from global water players!
In recent years, Nestlé’s management practices of water and wastewater have been one of the best among major Fortune 500 companies. You have personally played an important leadership role to put water on the international political and industrial agenda. 
Can you please tell us what events and facts triggered Nestlé’s and your interest in water?
Some eight years ago, as we were celebrating the 140 years’ anniversary of Nestlé, I was reflecting on the biggest challenge for our company, and I realised that water was critical. From there, I began to look into water-related issues and in particular, the water situation in the world. I was astonished by what I discovered: there was a clear problem emerging in the discrepancy between our use of water and global water availability. Studies show that we are using 10% more water than is sustainable in the long term and that this gap is expected to widen with the growth of the global population, with prosperity and urbanisation.
Availability of and access to water matters for Nestle on many levels: our farmers need water to grow raw materials for our products; we need water in our factories to process these raw materials, e.g., as a solvent and for cleaning and hygiene in general; and consumers need safe water to prepare many of our products.
Underlying all this, water is essential for the survival of humankind; water is a human right.
Too many of us, however, take water for granted and do not attribute any value to it, despite the fact that it is the by far most valuable resource we have.
Nestlé almost single-handedly created and established the concept of Creating Shared Value. It is now an important part of Nestlé’s DNA.
Can you please elaborate on creating shared value and how it can improve water and wastewater management practices and processes?
We have just published our 2013 Annual Report as well as our annual Nestlé in Society report. This explains the concept of Creating Shared Value (CSV) and what it means for us: it is our fundamental belief that for our company to be successful in the long term and to create value for our shareholders, it must also create value for society. Now, this is not a new kind of ‘DNA’ for the company; it is a concept that has its roots firmly in the - almost - 150 years of Nestlé’s life history.
In CSV, we at Nestlé focus on three areas: nutrition, rural development and water. The approach is action-oriented and fully transparent. For each area, we have defined clear commitments and we report on our progress. With respect to water, our approach centres on water use efficiency, effective water treatment (by the way, the first wastewater treatment plant in the Nestlé Group was built in the 1930s) and engaging with suppliers, particularly farmers, to help them make their agricultural processes less water intensive.
But corporate initiatives alone will not bring about the changes needed to really tackle the challenge of water. Our fourth pillar within the water CSV-strategy is, therefore, advocacy for effective water policies in individual watersheds.
Water is a local issue, there are no global solutions; at the same time, it is a horizontal and complex issue for which isolated piece-meal actions will have little or no effect. Indeed, once the problem of overdraft in a watershed has been identified, the active co-operation of all stakeholders is needed - in a context of strong government leadership. This is the approach taken by the 2030 Water Resources Group which I chair.
Water must be used more efficiently and we need to make it clear that this is an urgent issue that has to be tackled now. One of the key risks is for our supply of food– 70% of all freshwater withdrawn for human use goes to agriculture and more than 90% of water actually used is to grow crops. If we don’t find comprehensive and cost-effective solutions very soon, the water overdraft in major cereal-producing regions may lead to a major food crisis in the world.
How is this 2030 Water Resources Group initiative different and can new partners be integrated in its efforts?
2030 Water Resources Group is an innovative public-private partnership involving the private sector, civil society organisations, the World Bank Group, three regional development banks and several governmental development organisations. The group has a global view, but acts locally. It provides information and advice for governments to set coherent strategies in countries and watersheds, taking a disruptive approach that aims to overcome the various political and ideological rigidities often found in solutions to water overuse.
We are constantly looking for new partners, particularly at the local level and on the business side. Wherever we are active, we are building up or extending multi-stakeholder groups: Peru, Mexico, South Africa, Tanzania, Jordan, Mongolia, India (Karnataka) and possibly Lebanon, Bangladesh and Kenya.
Water becomes an important component of the national political agenda when there are serious floods, prolonged droughts or natural disasters. In between, it often vanishes from the political agenda. As the Singapore experience shows, for water management and national water security to improve, water must remain a high priority on the political agenda.
What can be done to prioritize water on the political agenda?  
Water-related issues are complex – they involve numerous uses and users, problems of overdraft, problems of quality - and all aspects overlap. Further complexity arises out of the political, societal, environmental and even spiritual aspects of water. So water-related issues represent a major challenge that, in a first stage, require communication based on the clear identification of all the issues involved and their causes.
In order to keep water high on the political agenda, we then need alignment on priorities. At the end of 2012, I was invited, as a ‘business ambassador’, to provide input to the UN Secretary General on water-related post 2015 UN Development Goals.
I proposed that water be included as a stand-alone goalwith four key targets, all of which would require a joint effort on the part of all stakeholders under the leadership of governments:
1) Universal access to safe drinking water by 2025 at the latest, with a parallel focus beyond 2025 on the quality of water, taking us from a focus on “improved” water to a focus on “truly safe drinking water”. Water for survival is a human right! Moreover, I stressed the importance of looking for ways to implement this goal; declarations are never enough. A key issue here that would need to be addressed is finding agreement across governments and stakeholders on the amount of water any individual who cannot pay should be able to access at zero cost. This amount must be set such that it  can be provided within the current financial resources of municipalities.
2) Improved sanitation. Accelerate the provision of access to improved sanitation to at least 120 million additional people per year, aiming for universal access before 2050. Data on actual improvements achieved to date show that this is realistically possible and, with strengthened efforts, I am convinced that political leaders can set themselves more ambitious targets.
3) Adequate treatment of all municipal and industrial wastewater prior to discharge by 2030. There is a need to introduce best practice initiatives to reduce groundwater pollution from agricultural production.
4) Address the water overdraft.  If we don’t change the way we are using water today, we put all the three targets mentioned above at risk. The nexus discussion – water-food-energy – moreover demonstrates that water shortages will become a choke point for economies, particularly for those economies which are today moving out of widespread poverty. Even worse, and as mentioned above, we risk shortfalls of up to 30% of global cereal production due to water scarcity by 2030.  In sum, we have to bring freshwater withdrawals (for all uses) back into line with sustainable supply (natural renewal minus environmental flows), watershed by watershed.
This fourth target is clearly relevant for the first three. We need to use water more efficiently and we need to make it clear that the water challenge is urgent and must be tackled now.
What are the water-related messages you would like to convey to the participants of the Singapore International Water Week?
I would like to invite all participants to reach out to non-specialists; those who come to the Singapore International Water Week know the problems surrounding water and know how to address them. But this knowledge has to be shared. There are many ways to do this; one that I have decided to focus on is my personal water blog – www.Water-Challenge.org. Most of my readers are interested citizens and stakeholders from a diverse set of backgrounds; they are not necessarily part of the specialist water community. So I would like to invite input and comments on my blog from participants in the Singapore Water Week. Needless to say, there are many more ways to reach out and I welcome any thoughts and ideas in this regard.
My second message to you: please support ongoing efforts to include a water-related goal in the post-2015 UN Development Goals. Since awareness of the challenges and of the solutions is not, by itself, enough, we must align and focus on clearly defined targets such as those I proposed above.

27 de mai de 2014

Hotel Hot Tubs Contain Deadly Germs, Including Feces and Legionnaires' Disease Causing Bacteria

You might want to think twice before you set foot into a hotel hot tub. These hot tubs are found to contain germs and bacteria. (Photo : Wikimedia)
You might want to think twice before you set foot into a hotel hot tub. These hot tubs are found to contain germs and bacteria.
Two US experts are warning travelers that hotel hot tubs contain a host of disgusting and even dangerous creatures. Michele Hlavsa, an epidemiologist and chief of healthy swimming for the Centers for Disease Control of Prevention; and Charles Gerba, PhD, a professor of microbiology and environmental studies at The University of Arizona say that you may be picking up some bugs in the hot tub.
According to the Huffington Post, the warm temperature of the hot tub makes keeping disinfectants that kill germs at an effective level. One of the germs found in hot tubs is Pseudomonas aeruginosa, which can cause an infection called Pseudomonas folliculitis or hot tub rash. Pseudomonas aeruginosa are able to multiply in the water when the disinfectant levels drop and can remain in the water until the levels increase again.
"People tend to sit in hot tubs for a while, so their skin is exposed to contaminated water for a while," Hiavsa told the Post. The hot tub rash starts off as itching and spots that develop into rash and can also include pus-filled blisters around hair follicles.
Another illness that can be picked up in hot tubs is Legionnaires' disease, which can be fatal. This type of pneumonia can be caused by the germ Legionella, which is found in warm water and can simply be contracted by breathing in the steam from  hot tubs.
Humans can also bring in their own germs into the hot tub. "The average bather has about a tenth of a gram of feces in his gluteal fold, which is a nice way of saying butt crack,"  Gerba told the Huffington Post. He further explained that with five people, "you have a tablespoon of poop in the hot tub."
The irritant called chloramine is also created when human urine and sweat mix. Chloramine can sting eyes and irritate the respiratory tract.
In order to reduce some of these germs, the CDC recommends having hot tubs with smooth tiles, no odor and a temperature that doesn't go higher than 40 degrees C. They also suggest that people bathe before getting into the hot tub so products like makeup and sun lotion don't take up the disinfectant so it can focus on germs. Also, never get the water in your mouth.

25 de mai de 2014

Plano de Segurança da Água da Copasa vai intensificar ações pela qualidade da água - Legislação sobre o PSA

A preocupação com a qualidade da água na Companhia de Saneamento de Minas Gerais (Copasa)é pauta frequente no planejamento e nas ações da gerência de informações. O monitoramento é feito em cada ponto do processo, para buscar sempre o melhor resultado do produto que chega aos consumidores.

Pensando em sistematizar seu controle de qualidade, e distribuir aos municípios mineiros abastecidos pela Companhia um eixo norteador para servir de referência nesse processo, a equipe da Copasa está em andamento com estudos e diagnósticos para formulação de seu próprio Plano de Segurança da Água (PSA).

O plano, explica o gerente da Divisão de Pesquisa e Controle de Qualidade da Água e do Esgoto (DVQA), Airis Antônio Horta, é fundamentado nas guias da Organização Mundial da Saúde (OMS), que orientam a elaboração de um documento que organize os processos de avaliação e monitoramento. No contexto da saúde pública, a OMS atenta para a importância de que sejam estabelecidas diretrizes que permitam aferir e assegurar a qualidade da água para o consumo humano.

A elaboração do Plano, observa Horta, “é um trabalho que as empresas de saneamento estão buscando e que será muito importante. A partir do momento em que tudo estiver estabelecido, poderemos contar com uma segurança ainda maior para a qualidade da água. E também, como consequência, num segundo momento, diminuir os custos operacionais", destaca o gerente.

Uma vez finalizado, o Plano de Segurança da Água, que compõe o Planejamento Estratégico da Copasa, permitirá às equipes, de forma mais organizada, não só avaliar os sistemas e realizar a monitorização operacional, mas também construir planos de gestão para minimizar os riscos envolvidos.


PSA na legislação brasileira

O Brasil se tornou o primeiro país do mundo a incluir a questão do Plano de Segurança da Água (PSA) em sua legislação. Com a Portaria MS nº 2.914/2011, o Ministério da Saúde incorporou as ferramentas conceituadas pela Organização Mundial de Saúde (OMS), com diretrizes e recomendações para que os responsáveis pelo sistema ou pela solução alternativa de abastecimento de água realizem avaliações sistemáticas, com atenção a riscos à saúde, para garantir a melhor água para consumo humano.

Vereador recebe exemplar do livro sobre Legionella do qual é um dos autores

Publicado em  por  em 

O médico e vereador Gilberto Natalini (PV-SP), é autor de um dos capítulos do livro “Legionella na Visão dos Especialistas” e recebeu, na manhã deste dia 20 de maio, do organizador da publicação, o consultor Marcos d’Avila Bensoussan, dois exemplares do livro que pode ser encontrado na edição digital e gratuita na internet.
O livro, que tem a colaboração de autores brasileiros e estrangeiros vai ser traduzido para a lingua inglesa para divulgação nos Estados Unidos, informou o organizador do livro que estava acompanhado do consultor e avaliador de risco de Legionella Fernando Bensoussan.
Leia abaixo o artigo do médico e vereador Natalini:
A importância das Políticas Públicas e da informação para se enfrentar a Legionella
A Legionella é uma bactéria presente no meio ambiente, que vive preponderantemente na água. Quando a água é volatizada esta bactéria passa a acompanhar as gotículas. A Legionella ainda pode estar presente no ar e usar como meio de contágio as partículas de pó. A bactéria entra em ação ao ter contato com o pulmão de pessoas que estejam suscetíveis a adoecer, com a imunidade baixa, por exemplo.
Uma vez aspirada, a bactéria da Legionella causa infecção pulmonar – um tipo de pneumonia – chamada de Legionelose ou mal dos legionários. Recebe este nome porque foi identificada nos Estados Unidos pela primeira vez em 1977, quando um surto deste tipo de pneumonia atacou integrantes da Legião Americana.
A Legionella ataca principalmente pessoas com a saúde vulnerável como crianças, idosos e doentes. Dados da Previdência Social Brasileira indicam que em um ano, em média, há 2 milhões e 300 mil internações por pneumonia no Brasil. Mas ainda não há dados suficientes para saber quantos casos são causados pela bactéria Legionella que se não diagnosticada e tratada especificamente pode levar o paciente a óbito.
A temperatura ambiente entre 36° e 40° é ideal para a reprodução das bactérias da Legionella. Ela pode estar presente, segundo especialistas em saúde pública, em ambientes comuns no dia a dia das pessoas como caixas d´água, chuveiros, lava a jatos, na água aquecida por sistema solar, no ar condicionado, nas saunas, piscinas, fontes, climatizadores (ventiladores que jogam gotículas de água), umidificadores, entre outros.
O ar é elemento essencial para a vida humana e esta se extinguiria se dele fosse privada e, em ambientes interiores, onde as pessoas permanecem por mais tempo durante sua vida, as técnicas de tratamento do ar, modificando sua temperatura, vazão, pressão, pureza, ruído, velocidade e umidade são condições imprescindíveis.
O ar nos ambientes interiores precisa receber tratamento mecânico adequado para se tornar agente de conforto e qualidade e preservação da vida.
Esse tratamento está ligado a um projeto bem elaborado para a escolha do melhor equipamento, instalação e manutenção dentro das normas técnicas vigentes, um cuidado especial com os sistemas de filtragem, pois a este caberá barrar possíveis impurezas e agentes patológicos, uma rede de distribuição de ar provida de elementos distribuidores do ar de forma homogênea em todos os ambientes climatizados, e de uma rede de dutos que receba limpeza na periodicidade necessária para mantê-la isenta de toda e qualquer sujidade.
Cientistas do Brasil e do exterior afirmam categoricamente que a poluição de ambientes interiores provoca doenças ocupacionais, infecciosas e alérgicas e agrava as doenças pré-existentes com ônus para a sociedade como é o caso da Legionella, um mal invisível.
No Brasil, a Legionella ainda é pouco conhecida. A informação é a melhor forma para prevenir a contaminação da população. Por isto é importante colocar a Legionella na pauta de discussão das políticas públicas.
Ação no legislativo
Para criar a condição da Saúde para todos é essencial pensarmos no desenvolvimento de políticas públicas. Ainda no estágio inicial, mas com toda a dedicação órgãos de Saúde como a Covisa de São Paulo (Coordenação de Vigilância em Saúde) tem feito acompanhamento da bactéria Legionella no munícipio. No mundo acadêmico, as universidades também desempenham papel fundamental, como a Faculdade de Medicina de Ribeirão Preto da USP que pesquisa o desenvolvimento da bactéria no país e como atuar na prevenção, detecção e cuidados com relação a isto.
Como vereador tomei a iniciativa de apresentar à Câmara Municipal de São Paulo projeto de lei, que está tramitando na Casa, e que institui mecanismos para garantir a qualidade do ar dos ambientes interiores, em estabelecimentos com mil metros quadrados ou mais de área construída, na cidade de São Paulo.
Sabemos que nos ambientes climatizados a falta de manutenção e de limpeza realizada com a frequência correta em dispositivos de ventilação e de ar condicionado pode contribuir com a disseminação de doenças respiratórias que atingem, principalmente, pessoas com a saúde vulnerável ou que já tenham problemas respiratórios. Isto reduz ou compromete a qualidade de vida dos cidadãos.
Nosso objetivo com este projeto de lei é proteger a saúde da população ao exigir cuidados com o ar condicionado que, se não for higienizado devidamente, pode ser um meio propagador de diversas bactérias, entre elas a Legionella, este mal invisível.
O projeto de lei tem como objetivo fiscalizar os equipamentos para ar condicionado, de qualquer tamanho, capacidade ou destinação, fabricados no Brasil ou importados de qualquer origem. A futura lei vai exigir que os equipamentos estejam de acordo com as norma da Associação Brasileira de Normas Técnicas (ABNT) que estabelece regras específicas para ar condicionado, sejam sistemas unitários ou centrais, ou qualquer outra norma técnica que a venha substituir, para poderem ser instalados no Município da Cidade de São Paulo.
Buscamos com este projeto de lei atrelar a concessão de alvará de funcionamento, que é renovada periodicamente, a apresentação de certificado de cumprimento de todas as exigências técnicas das normas disciplinadoras da qualidade do ar em ambientes interiores que sejam assinadas por engenheiro mecânico devidamente inscrito no Conselho Regional de Engenharia e Arquitetura (Crea) e que sigam todas as normas regulamentadoras (NBRs) da ABNT; portarias específicas Ministério da Saúde e da Agência Nacional de Vigilância Sanitária (Anvisa).
Para as edificações, construções residenciais ou comerciais que já possuam o alvará, o projeto de lei propõe que no momento em que forem chamadas pela administração municipal para revalidação deverão apresentar o certificado de adequação à norma no prazo máximo de trinta dias. Aprovada a lei que institui mecanismos para garantir a qualidade do ar dos ambientes interiores, em estabelecimentos com mil metros quadrados ou mais de área construída, na capital paulista, a fiscalização vai ficar sob a responsabilidade da Covisa ou do Departamento de Controle do Uso de Imóveis (Contru).
Há previsão de multa e até mesmo cassação de licença de funcionamento para estabelecimentos caso não seja cumprida a regra.
Um destaque do projeto de lei é incentivar que se celebrem convênios com universidades e instituições, sediadas no município da cidade de São Paulo, que busquem por meio da pesquisa científica e a propagação de conhecimento técnico sobre a Legionella e outras doenças infeccionas para colaboração em prol da saúde pública.
Cabe lembrar que o Ministério da Saúde apresenta medidas básicas referentes aos procedimentos de manutenção e limpeza dos componentes dos sistemas de climatização, para garantir a qualidade de ar do ambientes interiores, estabelece que os responsáveis com grandes sistemas, acima de cinco toneladas de refrigeração deverão manter um responsável técnico habilitado, o qual deverá implantar e manter disponível no imóvel Plano de Manutenção, Operação e Controle adotado para o sistema de climatização.
Segundo orientação técnica da Anvisa, recomendam-se padrões referenciais de qualidade do ar interior em ambientes climatizados de uso público e coletivo como complemento às medidas básicas, para efeito de reconhecimento, avaliação e controle da qualidade do ar interior de ambientes climatizados.
Ainda não há dados estatísticos sobre a Legionella no país. A Saúde pública brasileira tem trabalhado a questão, mas ainda há pouca divulgação sobre esta bactéria. Diante disto vemos que debater a existência da Legionella e as consequências de sua existência para a saúde humana é fundamental, tanto no âmbito da área publica de Vigilância em Saúde, assim como no meio acadêmico com as universidades que desenvolvem pesquisa no setor. Ambos podem apontar os rumos tanto para o Legislativo e o Executivo de todo o país para caminharmos em busca de resultados e os melhores métodos, ações e políticas do setor público para a implementação de serviços de assistência à saúde da população.
Gilberto Natalini
Médico e Vereador PV/SP
Esse artigo está publicado no Livro Legionella na visão de especialistas e pode ser acessado clicando aqui

23 de mai de 2014

An Unlikely Source of Legionella Infection

A recent study has revealed that the bacteria Legionella, commonly found in fresh water, is able to survive in certain automobile windshield washer fluids and can grow in washer fluid reservoirs, potentially exposing people to the bacteria.
Researchers from Arizona State University examined windshield washer fluid from Arizona school buses, revealing frequent contamination with high levels of Legionella and demonstrating that washer fluid spray can release potentially dangerous numbers of these bacteria into the air.  These results suggest that automobiles may serve as a source of transmission for Legionella infections.
Although windshield washer fluid is not normally associated with spreading disease, this project was begun after a series of epidemiological studies found motor vehicle use to be associated with increased risk for Legionnaires’ disease. 

21 de mai de 2014

Risco de pneumonia no trânsito

Pesquisador do Arizona State University, como parte de pesquisa de doutorado, investigou a relação. que já havia sido apontada em outros estudos no Reino Unido, de que motoristas profissionais (como motoristas de ônibus, taxistas, entre outros) tinham maios representatividade estatística nos casos de Legionella  adquiridos na comunidade. A descoberta realizada corrobora para as especulações realizadas anteriormente, de que a água utilizada para limpar parabrisas poderia ser a fonte de disseminação da bactéria.
O estudo foi realizado com ônibus escolares no Arizona e identificou concentrações bastante elevadas da bactéria, já que o reservatório, pela proximidade com o motor atinge temperaturas ideais para desenvolvimento microbiológico. Contudo, o risco se encontra no fato de que essa água, que pode estar altamente contaminada é aspergida para a limpeza do vidro. A novidade desse estudo é que o pesquisador resolveu ir mais a fundo. Nas divulgações anteriores (por volta de 2 anos atrás), foi amplamente divulgado que aditivos e detergentes para limpeza de parabrisas encontrados no mercado seriam capazes de inibir ou diminuir o risco da Legionella. Este estudo não apenas mostra que a grande maioria desses produtos não apenas é incapaz de inibir a amplificação da Legionella, como inclusive promove e auxilia seu desenvolvimento.
O estudo realiza uma ressalva. Em países frios, como o próprio Estados Unidos, é comum adicionar metanol nos reservatório de água para limpeza dos parabrisas para evitar o congelamento da água nos períodos de frio intenso. or ser um álcool, essa substância poderia, em teoria, ser capaz de inibir o crescimento microbiológico. O estudo propositadamente foi realizado no Arizona, que pelas condições climáticas, dispensa o uso do metanol. No nosso caso, no Brasil, que essa ressalva se torne um alerta.

Referencias:

- See more at: http://www.legionella.blog.br/2014/05/21/riscos-de-legionella-no-transito/#sthash.l2rJfRg0.dpuf

20 de mai de 2014

LEGIONELLA NA VISÃO DE ESPECIALISTAS - Lançamento no Congresso da Revista INFRA

Hoje dia 20/05/2014, o livro foi lançado durante o Congresso da Revista INFRA em São Paulo.


Leonardo Cozac, autor do capítulo 10 (Legionella e o ar condicionado) - Conforlab


Dr Szymon Gartenkraut, autor do capítulo 5 (Legionelose como doença profissional) - COVISA


Marcos d´Avila Bensoussan, idealizador do livro e autor do Prefácio e do capítulo 1 (Como a Legionella ficou conhecida) - SETRI


André Castilho, autor do capítulo 3 (Características gerais da Legionella ssp) - COVISA


Fernando Henrique Bensoussan, autor do capítulo 24 (Avaliação de risco de Legionella: A ferramenta contra uma epidemia) - SETRI

Vereador Dr Gilberto Natalini - LEGIONELLA NA VISÃO DE ESPECIALISTAS

Hoje dia 20/05/2014, fomos recebidos no gabinete do Dr Gilberto Natalini para fazer a entrega do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS, do qual ele é autor do capítulo 21 ( A importância das Políticas Públicas e da informação para se enfrentar a Legionella).



Presentes Marcos d´Avila Bensoussan, Dr Gilberto Natalini e Fernando Henrique Bensoussan

18 de mai de 2014

Windshield Wash Breeds Germs Causing Deadly Legionnaires

Windshield washer fluid, sprayed by drivers to help see out of their car windows, may be a breeding ground for bacteria that causes the deadly pneumonia known as Legionnaires’ disease.
Previous studies have tied riding in automobiles to the illness, though researchers didn’t know how or why it happened. An investigation into fluid dispersed by school buses in Arizona seems to have provided the answer, according to research released today by the American Society for Microbiology at its meeting in Boston.
Three quarters of the buses tested in one district in Arizona were positive for the bacteria, the study found. When the contaminated fluid was sprayed, the researchers detected levels of the bacteria that spread within a range that could be contracted and cause outbreaks of Legionnaires’ disease.
“Washer fluid has the traits a potentially dangerous source of Legionella exposure needs,” Otto Schwake, a microbiology Ph.D. student at Arizona State University in Tempe and the study’s lead author, said in an e-mail. “It is aerosolized, heated and people are regularly exposed to it. The results from this study support previously demonstrated epidemiological evidence for a link between automobiles and Legionnaires’ disease by providing microbiological data on survival, presence and transmission of Legionella in washer fluid.”
Today’s study is the first to find the bacteria Legionella in an automobile’s washer fluid and aerosolized in the spray, Schwake said.

Hot Tubs

The Legionella bacteria are found naturally in the environment, most commonly in water. They are associated with hot tubs and cooling towers found in large-scale air conditioners and are transmitted through a mist or vapor, not person to person.
The airborne bacteria are contracted by inhaling small drops of contaminated water. Cases often involve air conditioning and heating systems in buildings or public showers. The disease was named after an outbreak at a meeting of the American Legion in Philadelphia in 1976.
Most of the people exposed don’t become sick, the authors said. Those most at risk include the elderly, smokers and those with weakened immune systems, Schwake said.
The researchers in the study first measured Legionella survival by growing samples of the bacteria in washer fluid in the lab. They then examined Legionella in washer fluid collected from school buses in central Arizona.
They found that the amount of Legionella in the washer fluid was higher in the summer than winter months.

Calculating Risk

Researchers are working on a model to calculate the risk of Legionnaires’ disease from windshield washer spray. Schwake said more data is needed before any safety precautions can be given.
“We are exposed to an enormous number and variety of microbes every day from countless sources, the overwhelmingly vast majority of which are harmless,” he said. “That being said, unknown sources of pathogen transmission certainly exist and need to be studied. Due to the sheer lack of data, I believe any study examining the relationship between Legionella and automobiles would be greatly useful.”
  May 18, 2014 1:00 PM GMT-0300 




Leaders Convene at The 2nd Annual Smart Water Leadership Summit To Address Disease and Injury Caused by Bacteria and Other Hazards in Building Water, and Water Scarcity Issues

NAPERVILLE, Ill., May 16, 2014 /PRNewswire/ -- Concern about injury and death from bacteria in pipes and fixtures in buildings and water scarcity issues, served as the major topic of discussion for leaders from around the world on May 6 and 7 in Washington D.C. Phigenics, a water management services company leading the call for greater industry awareness of standards for building water systems, hosted this leadership forum at The 2nd Annual Smart Water Leadership Summit. Free access to video recordings of all presentations and panel discussions are available at: www.smartwaterleadership.com.

"In the US, there are more deaths caused by bacteria in our building water systems than deaths caused by food related contamination and by HIV/AIDS," said Dr. William McCoy, a microbiologist and world renowned expert on preventing disease and injury from building water systems and CTO of Phigenics. "In many cases, commercial conflicts of interest have impeded progress, and where supplemental disinfection has been applied, regulatory requirements under the Safe Drinking Water Act have been ignored."

"Even with the significant loss of life and costly lawsuits occurring around the country, most people are still unaware of the problem," said Ashton McCombs, CEO of Phigenics. "Bringing together leaders in the water industry to discuss and share management practices will improve the way we manage these systems. We must ensure that building water systems across the country are operated safely and cost effectively, and we must conserve water and energy."

Panelists in the discussion: "Healthcare Building Water Safety: Case Studies in Leadership"  made a compelling case for  HACCP - based water management as the new best practice standard for improving water safety and conservation. Furthering this call-to-action,Clifton McLellan, Vice President of Global Water Programs for NSF International stated that "NSF International is developing a number of related initiatives to improve the safety of building water systems built on the principals of HACCP. These include HACCP for building water systems education and training courses, HACCP standards to include certification and audit plans of buildings, and HACCP standards to include system and product design."

Leaders from the water efficiency community also echoed these sentiments and benefitted from the discussion about how to ensure water safety while also seeking to conserve water. "What was interesting about this summit for me was the emergence of public health as a concern in water efficiency," said Mary Ann Dickinson, CEO of the Alliance For Water Efficiency. "We always assumed there would be enough flow to take care of the pathogenic issues and there would be sufficient disinfectant in the water going through the buildings. Learning that these are important issues that we need to think about was an important eye opener for us."

Featured participating organizations in order of the agenda included: NSF International, Veterans Health Administration, Novant Health, Mayo Clinic, Centers for Disease Control and Prevention, Gordon & Rosenblatt, University of Rochester Medical Center, US Environmental Protection Agency, Pennsylvania Department of Environmental Protection, Association of State Drinking Water Administrators, American Water Works Association, SETRI, US Green Building Council, Jones Lang LaSalle, Alliance for Water Efficiency, Kaiser Permanente, University of Arkansas, Walmart, InterContinental Hotels Group, Kohler Company, Alliance for Water Stewardship, and The Water Council.

This was an invitation-only event for professionals in facility management, infection prevention, EH&S, regulatory compliance, engineering, sustainability, corporate operations, microbiology, disease prevention, research, government policy and regulation, academia, and related disciplines. 



For more information go to:

14 de mai de 2014

PLANO DE SEGURANÇA DA ÁGUA E LEGIONELLA


Entrevista para a Revista GreeBuilding em 12/05/2014, onde falamos sobre Plano de Segurança da Água, Legionella e sobre o livro LEGIONELLA NA VISÃO DE ESPECIALISTAS.

http://vimeo.com/95146394

Lançamento do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS - Washington DC/USA - Maio 2014



http://www.youtube.com/watch?v=Z0nN99JK5Bk&feature=youtu.be

9 de mai de 2014

Ice machines were source of Legionnaires'

After one patient died and two were sickened by Legionnaires' disease in November and December at UPMC Presbyterian, where they contracted the disease, UPMC has a message for hospitals nationwide."Hospitals in the U.S.: If you have not been looking in ice machines for Legionella, please look," Tami Minnier, UPMC's chief quality control officer, said Friday. "That's the message."The three hospital-acquired Legionnaires' cases were the first to occur in more than two years at UPMC Presbyterian, she said, and led to a thorough cleaning and disinfection of all of the hospital system's 500 ice machines in 20 hospitals -- including 80 machines in Presbyterian.Although the cases occurred about five months ago, Ms. Minnier said that UPMC began talking publicly about it this week because it had a difficult time finding existing hospital protocols on Legionnaires' disease and ice machines and little discussion about the issue around the country.The second goal of going public, she conceded, was to make sure the public did not put UPMC in the same boat as the Veterans Affairs Pittsburgh Healthcare System. The VA was lambasted with criticism over the past 1½ years for how it dealt with an Legionnaires' outbreak here that infected at least 22 veterans, six of whom died over a 16-month period in 2011 and 2012.She said the UPMC outbreak began in mid-November when an older woman who was immuno-compromised was in the hospital and contracted what was thought to be pneumonia.Several days before the woman died in mid-November, doctors confirmed that she had contracted Legionnaires' disease, Ms. Minnier said.The staff remembered that the woman had aspirated while sucking on ice chips in the hospital.Tests confirmed that the ice machine the ice chips had come from was contaminated with Legionella bacterium.But a question remained: How did Legionella bacterium, which typically grows best in warm water, grow in the cold water used in the ice machine?After tearing apart the machine, Ms. Minnier said, staff discovered that ice machines contain a water reservoir located next to a compressor, which can heat up enough to warm the water in the reservoir and allow the growth of Legionella.Presbyterian then began testing for Legionella in all of its ice machines, starting with those in areas where immune-compromised patients were treated.Before it could test all of the machines in the hospital, during the first two weeks of December, two more patients in other parts of the building tested positive for Legionnaires' disease.Further testing of ice machines near those patients' rooms found Legionella as well, and testing of all of the machines found about 20 percent of Presbyterian's 80-plus ice machines were infected.


Read more: http://www.post-gazette.com/news/health/2014/05/02/UPMC-Pittsburgh-hospital-ice-machines-Legionella-patients/stories/201405020165#ixzz31G5zisWn

7 de mai de 2014