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.”

By Nicole Ostrow 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:

www.smartwaterleadership.com

15 de mai. de 2014

FUNDAÇÃO VANZOLINI - LEGIONELLA NA VISÃO DE ESPECIALISTAS

http://vanzolini.org.br/noticias-aqua.asp?cod_site=104&id_noticia=635

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.

7 de mai. de 2014

Lançamento do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS - Washington DC. USA

O lançamento do livro foi um grande sucesso, durante o Smart Water.

www.legionellaespecialistas.com.br

2 de mai. de 2014

Legionella bacteria found in hospital ice machines at UPMC Presbyterian

Published: Friday, May 2, 2014, 12:01 a.m.Updated 6 hours ago

Legionella bacteria in ice machines at UPMC Presbyterian contributed to one patient's death and sickened two others, hospital officials disclosed on Thursday, calling it an unusual episode uncovered because a patient aspirated ice chips.

The deadly bacteria in ice machines prompted a huge overhaul and sterilization of about 500 machines in UPMC's 20 hospitals, including flagship Presby in Oakland. Machines that tested positive for Legionella were removed. Those remaining are being sterilized and fitted with filters, officials said.

Hospital workers discovered the problem when a patient tested positive for Legionnaires' disease and workers tested the water system. They were stunned to find negative tests results for the bacteria, which thrive in warm water and can cause the severe form of pneumonia.

Medical records disclosed the patient had been restricted to eating ice chips and aspirated a chip, allowing bacteria into the lungs, officials said.

“When we realized that clinical connection, we said, ‘Ahh, the ice machines!' and we went and tested the ice machines, and we found Legionella,” Tami Minnier, UPMC's chief quality officer, told the Tribune-Review.

UPMC officials declined to identify the person who died or the other victims, saying only that the cases occurred in late 2013.

Testing revealed Legionella in less than 20 percent of ice machines at Presby, officials said.

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

UPMC officials notified state and Allegheny County health departments and the federal Centers for Disease Control and Prevention. The CDC did not comment on the matter, though a spokesman confirmed the agency knew that Legionella can contaminate hospital ice machines.

“I believe a revision of CDC guidelines is long overdue for this,” said Dr. Joseph S. Cervia, a Legionnaires' expert and clinical professor of medicine at Hofstra North Shore-LIJ School of Medicine in Hempstead, N.Y.

He said isolated cases of Legionnaires' linked to hospital ice machines have happened for two decades but generate little scrutiny.

Cervia knows of no uniform standards to prevent Legionella in the machines. Only a fraction of hospitals nationwide use special ice machine filters to strain out the bacteria, he said. Others rely on building-wide treatment systems to safeguard water.

Cases of Legionnaires' disease are not entirely rare in the nation's hospitals, especially in units housing very ill and highly susceptible patients. An outbreak disclosed in November 2012 at the VA Pittsburgh Healthcare System killed at least six veterans and sickened at least 22 people. The CDC blamed that outbreak, from February 2011 to November 2012, on Legionella-tainted tap water at VA campuses in Oakland and O'Hara.

Minnier said the problem at UPMC is not at all similar to what happened at the VA campuses, and she expressed confidence in UPMC's water supply.

“We know our water is in good shape. We've been ahead of that curve for a long time,” she said.

The patient who died was hospitalized for some time, had multiple diseases and was described as “severely immunocompromised.” Minnier said officials notified the victim's family about the ice machine problem.

In addition to the three hospital-acquired Legionnaires' cases, four patients diagnosed with Legionnaires' at Presby in 2013 picked up the infection outside the hospital, officials said.

The task of sterilizing ice machines is complicated, because different manufacturers made them, said John Innocenti, president and CEO of Presby. He declined to release the company names but said they had been notified about the problem.

“The way we disinfect one machine might not work in another,” Innocenti said.

He said UPMC engineers were stumped by Legionella in ice machines because the machines function with a cold water line. The bacteria grow best in warm water, according to the CDC.

But Innocenti said UPMC's inspection found a reservoir within the ice machines that holds water.

“That alone would be fine, but in the ice machine, you have compressors that get warm, and in essence, they heat the water that's in the ice machines, allowing Legionella colonies to form,” he said.

Workers sampled all the machines, and microbiologists, infection control experts and engineers decided to install filters to prevent the bacteria from entering.

When positive samples surfaced despite the fix, that led to a second, ongoing remedy of sterilizing the machines, Innocenti said.

“We found that if you sterilize the machine first, then put on the filter, the probability of minimizing any Legionella colony would be significantly improved,” he said.

Dr. Karen Hacker, director of the county health department, praised UPMC for disclosing the problem.

“(An ice machine) is not something others may consider,” Hacker said. “Whenever you have an outbreak in an unusual scenario, you really want to get that information out so other institutions can learn from it. They went above and beyond to get at the source of the problem.”

Hacker said health care facilities should ensure that ice machines are properly cleaned. Those machines differ from equipment that restaurants use, she said.

Healthy people exposed to Legionella don't necessarily become ill, said Dr. Margaret Reidy, senior vice president of medical affairs at Presby.

“The danger is when a patient takes some water into their lungs,” she said.

Doctors warn that people with weak immune systems are at highest risk of infection when they breathe in Legionella-tainted water, which can happen when they cough up contaminated beverages or ice.

Minnier said UPMC will share its findings with researchers and regulatory agencies to help other hospital systems prevent the bacteria from growing in ice machines.

“We feel a very strong ethical, organizational and patient-driven responsibility to start to share this,” she said.

Luis Fábregas is Trib Total Media's medical editor. Reach him at 412-320-7998 or lfabregas@tribweb.com. Reach staff writer Adam Smeltz at 412-380-5676 or asmeltz@tribweb.com.

29 de abr. de 2014

LEGIONELLA BOOK

The Project

The subject of this project is Legionella, a bacterium responsible for some respiratory illnesses. Legionnaires’ Disease is the most severe form of infection that is characterized by an atypical pneumonia. Legionella is an environmental hazard of great importance for public and environmental health that deserves attention from various fields.

This book was designed and published by SETRI that covers topics such as environmental law in Brazil, public health, risk assessment, environmental risk, microbiological analysis, clinical analysis, risk mitigation, risk prevention and ecological aspects of these bacteria, among other things. This book has the participation of several professionals and experts in different areas of work where Legionella is an issue of concern.

All texts in this book are of responsability of their authors:

Presentation

André Luiz Lopes Sinoti

Presentation

Aaron A. Rosenblatt

Preface

Marcos d’Avila Bensoussan

Chapter 1

Como a Legionella ficou conhecida

Marcos d’Avila Bensoussan

Chapter 2

Legionella Pneumophila e a Doença dos Legionários para leigos: uma introdução