Risco biológico LEGIONELLA - Artigo na revista ABHO

Nosso artigo técnico sobre a LEGIONELLA na revista da ASSOCIAÇÃO BRASILEIRA DE HIGIENISTAS OCUPACIONAIS

Largest Federal Employee Union Pushes OSHA to Investigate Legionella Reports at Illinois Veterans Hospital

AFGE logo. (PRNewsFoto/American Federation of Government Employees)

WASHINGTON, March 14, 2014 /NEWS.GNOM.ES/ – The American Federation of Government Employees (AFGE) is calling on the Occupational Safety and Health Administration (OSHA) to take a deeper look at reports of elevated levels of Legionella at the Edward Hines Jr. Veterans Affairs Hospital in Illinois.  In a Feb. 28 letter to Assistant Secretary of Labor for OSHA Dr. David Michaels, the union urges the agency to inspect reports of Legionella and “ensure that a process exists for regular testing, and that appropriate actions for remediation take place.”

Union activists at AFGE Veterans Affairs (VA) Local 781 notified the AFGE national office of its concerns that unsafe levels of the bacteria may be present at the hospital. The letter to OSHA explains that patients and staff can be at risk if the proper precautions aren’t taken and that the VA’s track record on handling Legionella has been poor in recent years. The VA came under heavy scrutiny for its mismanagement of the Legionnaires’ outbreak at the Pittsburgh VA that has been linked to death of five veterans.

“AFGE wants proper testing and effective remediation for the safety of our members and the veterans we serve,” said AFGE National President J. David Cox Sr. “If the VA is to stand by its delivery of world-class care, it must be diligent in maintaining its facilities and protecting those who are treated and work in its hospitals and other sites.”

An August 2013 report by the VA’s Office of Inspector General found that many VA facilities tested positive for Legionella and that current methods of hyper-chlorination and super heating were not sustainable in treating the water.  A number of concerns are outlined in the letter to OSHA including possible long-term health concerns for patients and staff who are exposed to hyper-chlorinated water, the VA’s questionable testing methods that do not adequately identify the strain of Legionella present, and the agency’s failure to follow guidelines delineated by its own inspector general.

“We cannot afford for the VA to drag its feet when it comes to patient care,” said AFGE National VA Council President Alma Lee. “The concerns that our members have brought to light must be addressed swiftly. OSHA’s immediate involvement will ensure that the proper testing is done and the water is safe for our patients and staff.”

The union’s letter asks for OSHA’s intervention on this matter and acknowledges its shared concern for a healthy workplace and the safety of America’s veterans treated by dedicated public servants at VA facilities.

A link to the letter can be found here.

Maior número de casos de «legionella» no Porto e Braga

Região Norte regista 60 por cento dos casos de doença dos legionários

Por: Redacção / CM    |   2014-03-12 16:19

Nos últimos quatro anos foram notificados em Portugal 284 casos de doença dos legionários, provocada pela bactéria legionella, com a região Norte a ser aquela que regista a maioria das situações.

Da análise feita pelo Instituto Nacional de Saúde Ricardo Jorge (INSA), entre os anos de 2010 e 2013 evidencia-se que mais de 60% dos casos notificados eram de residentes na região Norte, com destaque para os distritos do Porto e de Braga.

Segundo os resultados publicados no boletim de março do INSA, na região de Lisboa e Vale do Tejo ocorreram um quarto das situações, particularmente nos distritos de Lisboa e Setúbal.

A região Centro regista, no período de quatro anos, oito por cento dos casos e o Alentejo e o Algarve apenas dois por cento cada.

A maioria do total de casos notificados em Portugal deu-se nos homens com mais de 30 anos, com o período do inverno e da primavera a serem os que registaram menos casos, «o que corresponde à distribuição sazonal esperada».

Isto porque a multiplicação da legionella é favorecida pela temperatura e pela humidade. Aliás, estas bactérias podem existir em reservatórios naturais ou em artificiais, como humidificadores ou sistemas de ar condicionado, piscinas ou jacuzzis.

Nas conclusões do artigo, os investigadores do Instituto Ricardo Jorge alertam para a importância de se realizar uma «vigilância e uma investigação epidemiológica ativas» que permitam uma «rápida identificação e controlo das fontes ambientais da infeção».

É ainda salientado que a doença, apesar de ser de declaração obrigatória, estará a ser subnotificada e subdiagnosticada. Ainda assim, o número de casos tem vindo a aumentar ao longo dos últimos anos, tal como acontece no resto da Europa.

http://www.tvi24.iol.pt/503/sociedade/legionella-legionarios-doenca-dos-legionarios-porto-braga-tvi24/1544125-4071.html

Memo shows VA Pittsburgh knew about potential for Legionnaires' outbreak 6 of those sickened by disease died

PITTSBURGH —A new memo has surfaced showing the Veterans Affairs Pittsburgh Healthcare System knew Legionella bacteria could surface in the hospital more than a year before the threat became public knowledge.

Read more: http://www.wtae.com/news/memo-shows-va-pittsburgh-knew-about-potential-for-legionnaires-outbreak/24943578#ixzz2vs6A4000

Legionnaires' bacteria shuts down Dartmouth police station

By CURT BROWN
cbrown@s-t.com

DARTMOUTH — The Dartmouth Police Station is being shut down after the bacterium that causes Legionnaires' disease was found in the hot water heating system, Police Chief Timothy M. Lee said Friday night.

Lee said an officer got sick about a month ago and was hospitalized. After tests showed that the officer had Legionnaires' disease, a form of pneumonia, the station was checked. A report came back Friday that the legionella bacterium had been found in the department's hot water system, he said.

With the station being shut down until further notice, Lee said emergency 911 calls are being transferred to the Westport Police Department where a Dartmouth dispatcher has been assigned to handle those calls.

All non-emergency calls are going through the mobile command center Bristol County Sheriff Thomas M. Hodgson has provided to Dartmouth police. The vehicle, parked in the Dartmouth Police Station's parking lot, will be used to conduct dispatch services and regular business, the chief said.

Dartmouth arrests are being booked at the state police barracks on Faunce Corner Road in Dartmouth.

A total of 82 employees, including 67 police officers, work out of the Russells Mills Road station, Lee said.

Legionnaires' disease got its name in 1976 when a number of Legionnaires attending a convention at a Philadelphia hotel came down with the disease. The Centers for Disease Control said on its website that it carries a mortality rate of 5 percent to 30 percent.

According to the CDC, the bacteria grow best in warm water, such as the kind found in hot tubs, cooling towers and hot water tanks.

People get Legionnaires' disease when they breathe in small droplets of water in the air containing the bacteria. The bacteria are not spread from one person to another, the CDC said.

Lee said the Dartmouth Board of Heath has hired a consultant, who will clean the water supply.

“They tell us as long as we don't use the hot water in the building it is safe,” he said.

However, out of “an abundance of caution,” officials decided to close down the building and make alternative arrangements, Lee said.

“We want to make sure everyone is safe. They deserve a safe work environment,” he said. “We will do everything we can to remediate the problem before we go back in.”

The department was still in the process of moving dispatch out of the building Friday night, the chief said.

He added that he does not know how long it will be before the station reopens.

“I expect it will be until the middle or the end of next week before we will have answers,” he said.

PLANO DE SEGURANÇA DA ÁGUA - PORTARIA 2914

O tema vem sendo apresentado pela SETRI desde 2012 e agora estamos vendo as ações importantes sendo realizadas. Lembramos que todos que possuem tratamento alternativo também devem ter seu Plano de Segurança da Água.

http://www.setri.com.br/?page_id=35


Gerência de Comunicação Social da Casan:

Manter avaliações constantes nos Sistemas de Abastecimento de Água, desde o manancial de captação até o cavalete, na chegada da casa do cliente. E trabalhar não apenas corretivamente, mas de forma preventiva. Essas são metas do Plano de Segurança da Água que a Companhia Catarinense de Águas e Saneamento (CASAN) está colocando em prática.

O planejamento atende a Portaria nº 2.914/2011, do Ministério da Saúde, que trata dos procedimentos de controle e de vigilância da qualidade da água para consumo humano e seu padrão de potabilidade.

A primeira fase de aplicação está direcionada ao diagnóstico. No ano passado foram realizados levantamentos técnicos em unidades dos sistemas de abastecimento da Grande Florianópolis (Sistema Costa Leste/Sul),  na Região Norte/Vale do Itajaí (em Itaiópolis) e  na Região Oeste (Xaxim, Barra Grande, Faxinal dos Guedes, Coronel Freitas e Xanxerê).

Para os primeiros meses de 2014 estão previstas avaliações em Morro da Fumaça (Superintendência Regional de Negócios Sul/Serra), em Rio do Oeste e Santa Cecília (Superintendência Regional de Negócios Norte/Vale do Itajaí) e em Bom Jesus do Oeste e Itá (Superintendência Regional de Negócios do Oeste).

As visitas técnicas têm a participação de integrantes das Agências, das Superintendências, da Gerência de Políticas Operacionais (GPO) e da Gerência de Meio Ambiente e Recursos Hídricos (GMA). O objetivo é levantar informações, identificar dificuldades e pontos críticos sobre mananciais e sistemas de abastecimento, visando à disseminação de boas práticas operacionais e a adoção de medidas preventivas de gestão de riscos.

Essas são etapas iniciais do trabalho, que deverá gerar subsídios para elaboração de planos de contingência, que ajudarão nas respostas a falhas ou a eventos imprevistos – e os desafios já se tornam claros para as equipes que colocam a proposta em prática.

Desafios

“Uma das primeiras necessidades que sentimos foi desfazer a ideia de fiscalização. O objetivo não é apenas vistoriar e apontar erros. Queremos somar, diagnosticar os problemas e discutir de que forma podemos conjuntamente buscar soluções”, explica a Engenharia Sanitarista e Ambiental Kelly Cristina da Rocha Matos, da Divisão de Planejamento Operacional (DIPLO).

Outra dificuldade é que o trabalhador chamado a auxiliar nos diagnósticos precisa conciliar sua atividade diária a mais uma demanda. Assim como aqueles que recebem as equipes de avaliação devem dar continuidade a seu trabalho, e ao mesmo acompanhar a visitação, explicar os sistemas, assumir problemas e debater as informações em reuniões.

“O Plano de Segurança da Água é uma visão inovadora na área de saneamento, ele depende de avaliações constantes e de uma visão voltada aos processos, não apenas a problemas pontuais”, complementa a engenheira Andreia May, também da GPO/DIPLO.

Segundo ela, diante do desafio que é colocar o Plano em prática, o apoio dos diversos setores envolvidos tem sido fundamental. Um estímulo à continuidade é que os diagnósticos revelam problemas que em grande parte não exigem investimentos significativos para correção.

“A implantação do Plano é difícil, assim como tem sido para outras Empresas de Saneamento do Brasil. A fase de diagnóstico é só uma primeira etapa, para que possamos convidar outros órgãos para  participarem do processo, pois o objetivo é chegarmos aos planos de contingência e de emergência, medidas de controle para reduzir ou eliminar os riscos à saúde ”, avalia a bióloga Leda Freitas Ribeiro, que atua na Divisão de Políticas de Qualidade. “A aplicação integral do Plano vai depender da atuação integrada de diversos órgãos, pois o suprimento de água não é uma responsabilidade só da CASAN”, salienta a bióloga.

Manual dá suporte às atividades

Para aplicação do Plano de Segurança da Água a CASAN desenvolveu um Manual de Avaliação de Boas Práticas Operacionais. O documento fornece diretrizes, critérios e requisitos a serem considerados para a avaliação dos mananciais, sistemas de captação e adução, tratamento, reservação e distribuição. Foi organizado para subsidiar os avaliadores, contribuindo para minimizar o caráter subjetivo de alguns requisitos, tornando o processo mais transparente para avaliadores e avaliados.

É utilizada como referência a metodologia de Barreiras de Proteção, adotada pela Empresa Baiana de Saneamento (Embasa). O levantamento é realizado com apoio de planilhas eletrônicas, permitindo pontuações que podem ser calculadas automaticamente, de acordo com pesos previamente estabelecidos.

“Mas é preciso ficar claro que a pontuação não é para comparar sistemas. É uma forma de definirmos prioridades, de avaliarmos que problemas precisamos corrigir com maior agilidade”, ressalta Andreia May, mais uma vez lembrando que o Plano de Segurança da Água (PSA) é considerado uma ferramenta inovadora na área de saneamento, pois tem como fundamentos a abordagem de risco, o foco no consumidor, fornecimento de água segura e de qualidade.

 

Saiba Mais

:: A experiência da CASAN com o Plano de Segurança da Água foi aprovado para apresentação no XVI Simpósio Luso-Brasileiro de Engenharia Sanitária e Ambiental, em Lisboa, Portugal.

:: Empresas estaduais de abastecimento de água que possuem iniciativas com Planos de Segurança da Água em andamento: Companhia Catarinense de Águas e Saneamento (CASAN), Companhia de Saneamento do Paraná (Sanepar), Companhia de Saneamento do Estado de São Paulo (Sabesp), Companhia de Saneamento de Minas Gerais (Copasa) e Empresa Baiana de Águas e Saneamento (Embasa).

Fonte: Gerência de Comunicação Social da Casan

REVISÃO DA PORTARIA 2914/11

Desde 1977, o Ministério da Saúde é responsável por elaborar normas e estabelecer o padrão de potabilidade da água para consumo humano no Brasil, bem como zelar pelo seu efetivo cumprimento, em articulação com as Secretarias de Saúde ou órgãos equivalentes dos Estados, Municípios, do Distrito Federal e dos Territórios, conforme estabelecido pelo Decreto n.º 79367.

A legislação em vigor relacionada a potabilidade de água é a Portaria GM/MS nº 2.914, de 12 de dezembro de 2011, que além do padrão de potabilidade, estabelece as competências e responsabilidades atribuídas tanto ao controle da qualidade da água para consumo humano, sob a responsabilidade dos fornecedores de água; como ao setor saúde, responsável pela vigilância da qualidade da água para consumo humano no país.

Nesse sentido, e considerando a importância do constante aprimoramento da legislação, o Ministério da Saúde disponibiliza este espaço virtual que permite a qualquer cidadão contribuir com o processo de revisão da Portaria GM/MS nº 2.914/2011.

http://177.153.6.85/portaria2914/theme/portaria.html

LEGIONELLA NA VISÃO DE ESPECIALISTAS

O livro LEGIONELLA NA VISÃO DE ESPECIALISTAS, deverá estar disponível em Abril/14.

Owner fined after Legionella found at Holy Name Care Home in Hull

By Hull Daily Mail  |  Posted: March 04, 2014

A NORTH Hull care home has been given a £2,500 fine by a health watchdog.
The Care Quality Commission issued Molescroft Nursing Home (Holdings) Ltd with two fixed penalty notices of £1,250 after the company failed to report a positive Legionella test result and the suspension of a manager.
Both penalties relate to Holy Name Care Home in Hall Road, north Hull – one of two homes where the organisation provides care.
Legionella was found in five of nine water samples taken at the home as part of routine testing on September 23.
The Care Quality Commission (CQC) says although Molescroft Nursing Home (Holdings) Ltd took action to protect people's safety, they did not report the situation, as required under regulation 18 of the Health and Social Care Act.
Malcolm Bower-Brown, the CQC's regional director for the North, said: "Every provider has a legal duty to ensure it meets national care standards to ensure residents receive the service they are entitled to expect.
"Failure to notify the CQC of serious issues or events that have the potential to impact directly on the safety and welfare of residents is unacceptable.
"Molescroft Nursing Home (Holdings) Ltd has now paid the fine and we will continue to monitor the home closely as part of our regulatory responsibilities."
After the fine for the Legionella test, a second penalty was imposed when Molescroft Nursing Home (Holdings) Ltd failed to notify the CQC of the suspension of a manager, as required under regulation 15 of the Health and Social Care Act.
Both fines have been accepted by the organisation and paid.
Molescroft Nursing Home (Holdings) Ltd issued the following statement: "There was no outbreak of Legionnaires' disease, or any other disease, at Holy Name Care Home.
"Holy Name is a new care home and, at the relevant time, some unoccupied areas had not all been fully commissioned, which led to some routine tests for Legionella coming back positive.
"The tests were conducted as a proactive measure and were carried out by a professional third-party company upon the home's request.
"The system was professionally chlorinated at the earliest possibility in order to kill any traces of the disease, which is the appropriate measure to undertake.
"Health and safety at the home is taken very seriously and areas are regularly monitored and cleaned as required within the home's cleaning schedule.
"The home was fined by the CQC for two technical breaches of reporting requirements under the Health and Social Care Act.
"Both fines have now been paid and neither fine related to the presence of Legionnaires' disease, or any other disease, and this was reflected in the low value of the fines.
"For absolute clarity, at no time were the residents of the home at any risk and the home has always acted in an appropriate manner."

Molescroft Nursing Home (Holdings) Ltd also provides care at Beverley Grange Nursing Home in Molescroft, Beverley.

Legionella victim says compost must carry warning

A GARDENER left fighting for his life after being struck down by a rare legionella bug today added his voice to calls for the introduction of warning labels on bags of compost.


Iain Fraser, who owns the Elephant House coffee and tea room on George IV Bridge where JK Rowling penned part of the first Harry Potter book, spent more than three weeks in hospital in September.
The 61-year-old was one of six people hospitalised after contracting the legionella longbeachae bug, which is linked to compost and potting materials.
His condition became so serious that concerned doctors advised his children, living in New Zealand, to fly to the Capital as they believed he may not survive.
An outbreak in the Lothian region last year led to a flurry of warnings to the public, informing them of precautions they could take to lessen the chances of infection.
And with cases on the rise in Scotland, Mr Fraser today said he believes warning labels should be added to compost packaging – a measure than has already been adopted in Australia and New Zealand where the bug is traditionally more common.
But the Scottish Government today said it had “no plans” to act on Mr Fraser’s pleas, arguing that there was no evidence the step had worked in the Southern Hemisphere.
Mr Fraser, of Stockbridge, said: “I was quite a fit 61-year-old, but I nearly died. I have two kids in New Zealand and my wife was told to get them over now because I might not see them again.”
Mr Fraser said he is now well on the road to recovery, but that warning labels should be added to compost.
“I’m not after publicity, I just want the warning labels,” he added. “I became very ill dealing with a bag of compost and I know there are five others.”
Mr Fraser came forward after the Evening News revealed how Margaret Malcolm, 72, was left close to death by the bug. The grandmother of ten, from Prestonpans, also called for warnings to be added to compost bags to highlight the risks, saying many people were oblivious to the dangers.
But the Scottish Government today appeared to pour cold water on the appeals for warnings to be added to packs.
A spokeswoman said: “The current British Institute of Standards guidance already requires manufacturers to provide generic information on safe handling and use of compost. There are currently no plans to introduce specific warning labels on bags of compost. Research has shown that specific labelling on this issue has little or no impact.”

European Hygienic Engineering and Design Group - EHEDG Guidelines for Legionella em Português

O guia já está disponível em português. Contou com a colaboração da SETRI.

http://www.world-of-engineering.eu/::3446.html

Father’s plea after disease claims daughter’s life - Legionella

By ANGELA CLUTTERBUCK Feb. 19, 2014, 9 p.m. Callie Mail

http://www.colliemail.com.au/story/2099978/fathers-plea-after-disease-claims-daughters-life/?cs=1443

A PAPER mask worth a few cents would have saved the life of a Collie woman who died from Legionnaires Disease.

That is the view of Mark Hutchings, who lost his 42-year-old daughter, Sharon Camisa, on January 14 after she contracted a strain of the bacteria linked to potting mix.

Mr Hutchings is the first to say his daughter should have sought medical treatment sooner.

His mission is not to lay blame on manufacturers or the health system, rather, he wants to warn everyone about the dangers of using potting mix without a mask, so no other family has to suffer the heartache his has.

Mr Hutchings also wants legislation introduced that would see dust masks attached to, if not alongside, potting mix at the point of sale.

Ms Camisa died in Sir Charles Gairdner Hospital after spending weeks in a coma, leaving a husband, two children and a grandchild.

"In the end her lungs were so damaged they fell apart," Mr Hutchings said.

"She haemorrhaged to death. It was a nightmare for everyone, weeks watching her die slowly."

While Ms Camisa lived with a form of arthritis, Mr Hutchings described his daughter as "a very health-conscious person".

"She had her own home gym and did half an hour on that each morning before she went to work and an hour when she got home and she also did pilates," he said.

Indeed, when Ms Camisa first became ill she and those around her attributed it to her arthritis, which she had been taking medication for.

On December 2, Mr Hutchings wife urged Ms Camisa to see a doctor when she began vomiting.

Ms Camisa's boss at Chicken Treat joined Mr Hutchings and his wife in pleading with her to visit the hospital when, several days later, her condition deteriorated.

On December 9, Mr Hutchings received a phone call from Ms Camisa, who was in agony, asking him to come over. He half carried her to the car then drove her to Collie Hospital, where she was admitted for pain management.

"They thought it might have been a negative reaction to her arthritis medication," Mr Hutchings said.

"They contacted her specialist and she was put on new medication. That didn't fix the problem."

On December 15, following an x-ray, Ms Camisa was diagnosed with pneumonia and transferred to Bunbury Hospital, where she was placed in an induced coma and airlifted to Sir Charles Gairdner Hospital and placed on life support.

"That's when they did a cultures test and found out she had Legionnaire's disease, a strain linked to potting mix."

It was early to mid-November that Ms Camisa had begun re-potting plants, Mr Hutchings recalled.

"She put all the potting mix and fertiliser and everything on a blanket and sat there under the verandah and did a whole lot of potting in her backyard," Mr Hutchings said.

"She was experimenting with a range of potting mixes and fertilisers. It's irrelevant what type, it (the legionella bacteria) could have been in any of them".

Mr Hutchings said he had heard of Legionnaire's disease, but associated it with water towers and air conditioners.

"I looked up the warning on the front of one product and it said 'more details on the back', I just read that there were microorganisms inside and I thought, well, of course there are microorganisms in the soil," Mr Hutchings said.

"I didn't read the more details on the back. I didn't realise it was Legionnaire's. It was only afterwards that I looked in more detail and they do specify it on the packets. They've done the right thing and put it on the packets, but we didn't see it.

"Sharon's problem was that she left it too long to see a doctor and therefore she wasn't diagnosed straight away.

"If she had gone in when we first begged her to, and her boss begged her to, she would have gone in with flu symptoms and it would have been diagnosed quickly. She wouldn't have got the wrong antibiotics and she would have almost certainly lived, she was young and healthy.

"Even if she had gone in a day earlier than she did, she wouldn't have been in so much pain and there may have been greater emphasis on the flu symptoms and they could have diagnosed it."

There was a frightening lack of awareness about the risk of contracting Legionnaire's disease from potting mix, Mr Hutchings said, but simple solutions could save lives.

"We could be talking about hundreds of deaths a year in Australia if you put it all together," he said.

"I'd like to see flat surgical masks attached to the outside of potting mix bags.

"The fact that the mask is supplied will help people realise the dangers and use that mask. We might not be able to convince everyone to use it, but even if half of them did it could make a huge difference.

"Even if they were sold near the potting mix, instead of the packs just recommending they be used, it would help.

"Some supermarkets sell the dust masks but some don't and they're not always near each other (at the point of sale).

"If the government made it law that they were sold together, it would help draw people's attention to the need to wear a mask when using potting mix."

While still very much in mourning for his daughter, Mr Hutchings is determined to get his message out there so her death will not be in vain.

"It has really affected the family - no one's been coping well," Mr Hutchings said.

"Sharon's daughter was getting married in April, but her wedding has been deferred until next year now.

"Everything's just fallen apart so badly. We love Collie but we're now questioning whether we should stay."

Mr Hutchings said he was horrified when he recently watched a television lifestyle program where children were potting plants without protective gear.

"It's too late to help Sharon, but hopefully we can help someone else," Mr Hutchings said.

"If reading her story saves one life, telling it will have been worth it."

GBCBrasil

SMART WATER LEADERSHIP SUMMIT - 2014 - PHIGENICS

          A SETRI participou em 2013 do encontro em Chicago

      http://www.smartwaterleadership.com

Gran’s Legionella hell linked to compost - Legionella longbeachae

Edinburgh News 13/02/2014

A GRANDMOTHER today told for the first time how she was left fighting for her life after falling victim to a deadly bug linked to humble potting compost.


At one point 72-year-old Margaret Malcolm deteriorated so badly that her family was warned she faced being placed on a life support system. She spent three weeks in hospital – mostly in intensive care – drifting in and out of consciousness as her lungs failed and concerns grew that she might not pull through.
Now home in Prestonpans, the frail grandmother-of-ten says she is still suffering lingering and debilitating after-effects of potentially deadly Legionella longbeachae, usually linked to inhaling dust from man-made potting compost.
She is now preparing to launch a legal fight for compensation and has appealed for warnings on compost bags to highlight the risks.
“I never knew that there was a chance of catching something like Legionella from a bag of compost and I don’t think many people do,” she said. “People need to know.
“It’s changed my life,” she added. “I get so breathless now. I used to be able to get about, walk to the bus stop and go to Tesco – now there’s no way I can do that. I have to rely on my daughters to do all my shopping for me.
“I even struggle to get up and down the stairs in my house. My confidence has been shattered by it. I’m constantly tired. I’ve been told I could be feeling like this for a year.”
Mrs Malcolm was one of six Scots to fall ill with potentially lethal Legionella longbeachae last September. Five cases were in Lothian and another one in Tayside. All needed hospital treatment and the cases were linked by health officials to gardening compost.
However, six months later, laboratory tests have only just been completed. And it will be a further two months before a report on the outbreak is likely to be published – raising concerns that others may have similar products and are unaware of the potential risks.
Today Mr and Mrs Malcolm’s lawyer Mark Gibson, a product liability law specialist based at Digby Brown solicitors, pointed out some other countries have put in place compulsory hygiene warnings and safety instructions to alert users to the Legionella threat posed by compost.
“The shocking part of this is that it involves such a 
mundane, everyday packaged product and users, quite rightly, do not expect to be exposed to potentially fatal strains of bacteria,” he added.
“The demographic of compost users includes many older people with underlying health issues which make them vulnerable. The dangers associated with the use of compost have been known to trade associations for some time and British standards ought to have been developed and followed. There were simple and cost-effective measures which could have prevented these very serious infections such as heat treatment of the product and the use of face masks.”
Mrs Malcolm had been working in her back garden in Northfield Gardens, Prestonpans, one day last summer. Within 24 hours her health had dramatically deteriorated.
“I had been repotting some plants,” she recalled. “Next day I was sitting with my neighbour having a wee blether when I got up and felt funny and a bit sick. I just flaked out.”
She was rushed to the Western General Hospital by ambulance with husband David, 78, by her side. “I didn’t know what was going on,” he said. “She was unconscious and the longer it went on, the worse I was starting to feel about what was happening. When the hospital staff said she was going into intensive care, I just thought ‘Oh my God’. Eventually we were told it was Legionella and it was like a pneumonia attacking her lungs.”
She was given antibiotics and oxygen but her condition failed to improve. “When they started to talk about her going on life support, our daughters were in tears. Thank goodness it didn’t come to that. When I heard there were other cases at the same time and that it was being linked to potting compost, I really couldn’t believe it. Who would think potting compost could do that?”
Mrs Malcolm had bought three 56-litre bags of J Arthur Bowers Multi-Purpose Compost from Strawberry Corner in Musselburgh and opened one to pot her plants. The only warning on the bag suggests users wear gloves.
A recent letter to the couple from Eleanor Smyth, Acting Principal Environmental Health Officer for East Lothian Council confirmed the Glasgow-based Legionella Reference laboratory was still testing the compost. However she confirmed: “The major source of human infection [from Legionella longbeachae] is considered to be commercial growing media and other composted materials such as bark and sawdust.
“As there has not been concerns from industry with regards the specific brand of compost associated with cases of Legionella, the product has not been withdrawn from market.”
Last October a Strathclyde University study into the 22 different compost brands sold in the UK revealed 14 contained a variety of Legionella species. Four were found to have L. longbeachae.
It is believed changes in how compost is manufactured, from being mostly peat to now including sawdust and bark, have created a breeding ground for the bug to thrive. When users open the bag and breathe in the spores – or inhale droplets of water dripping from hanging baskets – infection can occur.
It’s understood Mrs Malcolm’s compensation claim could focus both on the manufacturer of the compost and the Musselburgh garden centre which sold it.
Dr Syed Ahmed, Consultant in Public Health, Health Protection Scotland said a report on the outbreak is likely in the next few months: “It is important that all members of the National Incident Management Team have an opportunity to review the report before it is finalised.
“The risk of becoming unwell from gardening activities (such as working with compost) remains very low. However, we would recommend good hygiene in relation to gardening – wearing gloves, a mask, and washing hands immediately after use.”
J Arthur Bowers compost is made by Lincoln-based William Sinclair Horticulture Ltd. A spokesman for the company said: “William Sinclair has committed to ensuring advice with regard to good hygiene practice will be included on all labelling. We believe this response is proportionate to the very low level of risk involved.
We were sorry to hear of the illness that the lady from Edinburgh suffered, and we hope she has made a full recovery”.
Neil Duffield, a director at Strawberry Corner garden centre, said: “We take advice from our suppliers. There are warnings on the bags to wash your hands and I have seen some bags which give instructions on opening them in well ventilated places. We are guided by that.”

Number of cases is on the increase

Once unheard of in Britain, Legionella longbeachae cases have increased in recent years.
The main source of infection is commercially made compost. Between 2008 and 2012 there were nine cases of L.longbeachae notified to Health Protection Scotland. Two people died and all others were seriously ill. All had links with gardening.
In the same period there was only one case in England and Wales. Concern at Health Protection Scotland prompted an investigation last year by its National Incident Management Team. It probed similarities with high incidences of the illness in Australia – where compost is made using mostly sawdust and bark, materials which are being used to replace traditional peat in many UK manufactured composts.
Australian composts carry a manufacturer’s warning and advice to wear gloves and a facemask while handling. Heat treating the compost during production can kill the legionella bacteria. The HPS report concluded: “There is a definite but very small risk of L.longbeachae infection from using growing media in those undertaking gardening activities in Scotland.”
And it warned: “Given the increasing popularity of gardening as a hobby and the growing number of over-65s with a higher prevalence of at-risk conditions in the population likely to participate in it, further cases of Legionnaires’ disease due to this cause can be expected.”

Fatal Edinburgh Legionnaires' outbreak to be probed by Crown Service

Legionnaire's Disease: Legionella bacteria on a microscope slide.Centres for Disease Control/James Gathany

Prosecutors are to consider a report into a fatal outbreak of Legionnaires' disease two years ago.
Four people died and 45 others needed hospital treatment after contracting the disease in Edinburgh in June 2012.
Following an investigation, the Health and Safety Executive (HSE) has submitted its findings to the Crown Office and Procurator Fiscal Service (COPFS).
A dedicated health and safety unit will consider the report.
Cooling towers in the south-west of Edinburgh have previously been identified as a possible source of the Legionella bacteria.
A total of 92 people were affected by the outbreak, which cost NHS Lothian £725,800.
An HSE spokeswoman said: "HSE has submitted some reports to the Crown Office and Procurator Fiscal Service and there are others in the process of being sent. HSE's investigation continues."
A spokesman for COPFS confirmed the HSE was in the process of submitting a number of reports on the circumstances of the outbreak to its health and safety division.
He said: "As in all cases, the COPFS will give full and careful consideration to all of the facts and circumstances.
"Where there is sufficient credible evidence of a crime, the matter will be thoroughly investigated and prosecuted."
Legionnaires' disease is a potentially fatal form of pneumonia and is caught by inhaling small droplets of water, suspended in the air, containing harmful levels of Legionella bacteria.
The bacteria is common in rivers and ponds but exposure is more likely from water systems such as cooling towers and spa pools.

The symptoms of Legionnaires' disease are similar to those of flu and include high temperature, a cough, muscle pain and headaches.

Surtos relacionados à água nos EUA (2009-2010): Legionella é grande causa

http://www.legionella.blog.br/2014/02/03/legionella-e-grande-causa/

Pyramids Reopens After Detection of Legionella Bacteria Forced Closure

The Pyramids in Southsea has reopened today following the detection of Legionella Bacteria on Thursday.
The centre had been closed for two days for further investigation and deep chlorination of the water.
A spokesperson from the Pyramids, now managed by BH Live, announced this evening, "The Legionella bacteria has  now been eradicated and the team is continuing to monitor the water quality on an ongoing basis."
The gym, pool and soft play area has reopened today (Saturday 1st Februray) but the spa and showers remain closed as a precautionary measure.

Customers are advised to check the centre's website at social media channels. Planned events at the venue are not affected.

Health officials implicate cooling towers in Legionella outbreak

The City of Milwaukee Health Department reported 58 clinically diagnosed cases of Legionnaires’ disease in Milwaukee County from June 1 to Sept. 30, 2013, according to a report in MMWR.
This is more than double the normal number of annual cases from the previous 5 years, according to the report. Most of the cases (78%) were in the city of Milwaukee. All but one of the cases in the county were hospitalized. The health department received one report of a death related to legionellosis.
The health department conducted environmental sampling for detection of Legionella at 11 sites throughout the city. They collected 39 swab and bulk water specimens. Three cooling towers were positive for L. pneumophila. Investigations using pulsed-field gel electrophoresis on lower-respiratory specimens from cases and tests at the 11 sites found six distinct strains of L. pneumophila, but no patient strains matched strains from environmental samples.
Thirty-one of the patients (53%) lived within 3 miles of one of the positive cooling towers. The investigators found an RR of 1.6 (95% CI, 0.9-2.7) for Legionella exposure within one of these towers, but the association was not significant. Investigators with the health department met with cooling tower contractors and identified a gap in maintenance due to weather conditions.
“This investigation underscores the need for local public health authorities to be prepared to rapidly enhance surveillance, deliver appropriate public risk messaging and coordinate with the private sector to mitigate environmental transmission of Legionella within a community,” they wrote.

LIVRO = LEGIONELLA NA VISÃO DE ESPECIALISTAS

Este pode ser o título do livro que vamos publicar possivelmente em março deste ano.
Este será o segundo livro que aborda o tema Legionella no Brasil, sendo que o primeiro foi da Dra Mirian Dilguerian " O MAL DOS LEGIONÁRIOS: DIÁLOGO ENTRE O DIREITO AMBIENTAL E O DIREITO SANITÁRIO".
No nosso livro, vamos contar com a colaboração de mais de 22 especialistas, médicos, juristas, advogados, biólogos, pesquisadores, avaliadores de risco, CDC (USA), Covisa entre outros.
O objetivo será promover o maior conhecimento desta bactéria para os responsáveis por sistemas que promovem a proliferação da mesma. Quais doenças são provocadas pela Legionella e medidas para minimizar os riscos. 
Lembramos que em 2013 já promovemos o primeiro seminário internacional sobre a Legionella, que foi sem dúvida o que nos motivou a trabalhar na publicação deste livro.

Seminário de ABRIL/2013

Saúde em edifícios Facility managers têm papel primordial na prevenção e combate à Legionella, dizem especialistas
O 1º Seminário Internacional sobre a Bactéria Legionella, realizado em 16 de abril último, em São Paulo, contou com a presença de importantes órgãos do setor da saúde, como a Agência Nacional da Vigilância Sanitária (ANVISA), a Coordenação de Vigilância em Saúde (COVISA/SP) e o Ministério da Saúde.
Durante o evento, foram apontados dados interessantes e preocupantes sobre a Legionella, bactéria que ataca o sistema respiratório (por meio de partículas de água contaminadas que são aspiradas) e que está presente em sistemas de água comuns em instalações prediais, como torres de resfriamento, chuveiros, aquecedores de água, fontes, transportes de água (caminhões pipa, por exemplo), caixas de água expostas, irrigação por aspersão, entre outros. A bactéria também pode ser encontrada em rios, lagos, represas e até mesmo no solo.
Segundo o Dr. Szymon Gartenkraut, Subgerente de Vigilância em Saúde do Trabalhador da COVISA/SP, a pneumonia é a quarta maior causa de óbitos no país, segundo dados do Sistema Único de Saúde. A legionelose, uma derivação atípica da doença, está inserida nesses números, porém não é possível ter o número exato de casos no país, pois o SUS não conta com dados específicos da doença. “Os óbitos por pneumonias atípicas vêm crescendo desde 2005”, afirma o Dr. Gustavo Graudenz, do Departamento de Ciências Médicas, Gestão Ambiental e Sustentabilidade da Universidade Nove de Julho.
“Não há desculpas, é fácil de se controlar a Legionella nos sistemas de água dos prédios”, destaca o Dr. William McCoy, membro do Comitê da ASHRAE. Para ele, o foco na prevenção é essencial e é papel dos Facility Managers criar uma equipe para combater os riscos da doença. Verificar como a água é processada e usada no prédio, analisar potenciais locais de infecção, determinar e combater pontos críticos são metas a serem cumpridas. O monitoramento da qualidade da água e dos resultados também são primordiais.
O encontrou serviu também para comemorar uma década da Resolução 09 da Anvisa, de 16 de janeiro de 2003, que estabelece padrões referenciais de qualidade do ar interno em ambientes climatizados artificialmente de uso público e coletivo. Também foi citada a Portaria 1429, do Ministério da Saúde, que apresenta um Plano de Segurança do Uso da Água, As duas medidas são de fundamental importância para oferecer um ambiente mais seguro e saudável aos usuários.

O Phygenics Validation Test (PVT), ação que conta com planos de segurança e métodos de diagnóstico da água, trazido pelo Dr. William McCoy, também pode ser uma ação importante para os gestores dos edifícios. Segundo McCoy, o método oferece maior precisão na detecção de bactérias, além de apontar os resultados até 80% mais rápido do que os métodos tradicionais e criar um histórico sobre os diagnósticos e resultados sobre a qualidade da água de cada instalação.