LEGIONELLA NÃO SAI DE FÉRIAS

- Como adelantamos el pasado 10 de julio, compartimos la actualización de la circular de la Comunidad de Madrid cuyo fin es controlar y disminuir la peligrosidad que generan los sistemas de pulverización/nebulización de agua, presentes en espacios abiertos (terrazas, parques, etc.) y en establecimientos de productos frescos (pescaderías, fruterías, etc.) con el objetivo reducir lo máximo posible el riesgo sanitario generado por la Legionella.

El funcionamiento de estos sistemas de refrigeración les hacen ser considerados por el RD 865/2003 como instalaciones de riesgo de proliferación y diseminación de Legionella, y se relacionan con los brotes sucedidos en los últimos años coincidiendo con la llegada del verano y el aumento de las temperaturas.

Estas instalaciones albergan agua a temperatura ambiente pueden llegar a generar gotas de muy pequeño tamaño en zonas de importante afluencia de público, siendo además la distancia entre las personas y el punto de pulverización muy escasa, cumpliendo así todos los requisitos para convertirse en instalaciones de riesgo.

Los niveles de Legionella dependerán, fundamentalmente, del tipo de captación de agua y del tratamiento desinfectante al que sea sometida el agua en cuestión, ya que evidentemente, si no puede asegurarse la desinfección del agua utilizada, no puede asegurarse la falta de presencia de Legionella en la misma.

ESPANHA.

WATER STEWARDSHIP = PLANO DE SEGURANÇA DA ÁGUA

O AWS sem dúvida é o futuro das grandes organizações e paises que realmente se preocupam com a água.

http://www.allianceforwaterstewardship.org/become-a-water-steward.html#aws-standard

Legionella cases caused by compost

BAGS of compost sold in the Lothians and east of Scotland have been identified as the likely source of a cluster of legionella cases last year, a report has found.

Between August and October 2013, six confirmed cases and one probable case of Legionella longbeachae were reported in the Lothian and Tayside areas, as the Evening News revealed in September last year.

The major source of human infection with Legionella longbeachae is considered to be commercial growing media, such as soils and composts sold through garden centres, and other composted materials such as bark and sawdust. Older people are more at risk.

A new report by Health Protection Scotland has now found that all seven patients had spent time in the garden or outdoors in the two weeks prior to their illness, and six had recently bought compost.

But the investigators found that the products used by the patients were bought at different times at different premises.

The compost was found to originate in five different manufacturers at five different sites in England, Scotland, Ireland and Northern Ireland.

There have been only 19 cases of legionella since 2008 in Scotland

IWA WORLD WATER CONGRESS - LISBON - SET/14

A delegação do Brasil até o momento é bem representativa. A SETRI especialista em Plano de Segurança da Água (Water Safety Plan), estará presente.

http://www.iwa2014lisbon.org/registration-hotels-travel/delegate-list/

Shower ban after Legionella bacteria found at Leicester General Hospital

Patients on two hospital wards have been banned from showering after the Legionella bacteria was found at Leicester General Hospital.

They have also been issued with bottled drinking water.

The measures were introduced on wards 28 and 29, used for surgical patients.

One patient, who asked not be to be named, questioned whether the hospital should admit patients while work to clear the bacteria – which can cause the potentially fatal Legionnaires' disease – was carried out.

But officials at Leicester's hospitals said patients were safe and the risk of Legionnaires' disease was low.

The patient said: "We were all given letters about the situation, given bottled water and told we couldn't shower or wash our faces for fear of Legionnaires' disease.

"We also had to use the bottled water for brushing our teeth and were given wipes for our face and hands."

The patient added: "I know the hospital is short of beds, however, I don't think you should open wards like this where many of the patients are elderly and quite frail.

"The doctors and nurses were fantastic, but I do think that having the wards open was putting patients at risk and of course the very words Legionella puts fear into people."

The disease is spread by small water droplets that evaporate very quickly from a contaminated water supply.

Legionnaires' disease is a severe pneumonia, an uncommon but serious illness, particularly for those who have weakened immune systems.

The presence of the bug was found during routine checks carried out on June 20. Restrictions are still in place while chlorine dioxide is added to the water supply to kill the bacteria.

Taps and showers are being regularly flushed and the water temperature checked as part of the cleansing process but officials are not yet sure when the system will be back to normal.

Dr David Jenkins, consultant medical microbiologist and deputy director of infection prevention and control at Leicester's hospitals, said: "Recent tests on wards 28 and 29 at Leicester General Hospital have triggered our safety plan, meaning showers on these wards will be out of use until further notice. Alternative body washing arrangements have been introduced.

"Bottled drinking water is also being provided for patients and staff but boiled drinks such as tea and coffee remain safe to drink."

He added: "We would like to reassure our patients that the risk of Legionnaires' disease for our patients remains low and they are safe.

"We would like to emphasise that the measures being taken are precautionary and there are no known cases of infection linked to this incident."

Dr Jenkins said the bacteria had been found in a routine safety check on water supplies.

He added: "Low levels of Legionella are not a cause for concern, however high levels can cause a form of pneumonia called Legionnaires' disease so we undertake routine testing to ensure the risk is kept low."

Legionnaires' disease is the result of legionella bacteria infecting a patient's lungs. It is usually caught by breathing in small droplets of contaminated water. It is not contagious and cannot be spread directly from person to person, according to the NHS Choices website.

Legionella bacteria is commonly found – usually at levels which are not harmful – in water sources such as rivers and lakes.

However, the bacteria can rapidly multiply if it finds its way into any artificial water supply systems or into air conditioning systems.

Legionella detected at Wellington jail

The bacteria which can develop into the potentially fatal legionnaires disease has been detected at the Wellington Correctional Centre.

The Department of Corrective Services says immediate action has been taken to flush out the water system to remove the legionella bacteria.

A spokesman says legionella was detected during routine water sampling in the shower area.

He says there is no risk to public health and the ABC understands no staff or prisoners have legionnaires disease.

Legionnaire’s more fatal with biologics

Patients on biologic therapies are at increased risk of Legionnaire’s disease and considerably more likely to die from it if they are infected, say Australian researchers.

Their review of over 100 cases ofLegionella pneumonia in patients taking biologics showed 19% of those who contracted the disease died of it, compared with reported figures for the general population of just 2% to 6%.

Twelve percent of the survivors needed treatment in an intensive care unit.

Over 70% of infected patients were being treated with biologics for rheumatologic diseases and 16% for inflammatory bowel disease, the authors from the University of Queensland Centre for Clinical Research said.

Infliximab was the biologic most frequently related to Legionella infection, followed by adalimumab and to a lesser extent etanercept.

Most of the patients were also on other immunosuppressant therapies, in particular systemic corticosteroids, methotrexate and azathioprine. Combining therapies may play a role in the added risk and severity of infection, the study authors suggested.

Infections occurred mostly in the first six months of biologic treatment, a finding the authors said was in line with other research showing a decline in the infection risk over time with biologics.

Reporting in Respiratory Medicine, the authors said previous research had shown people taking anti-TNF-alpha medication were 16 to 21 times more likely to contract Legionnaire’s disease compared with the general population.

“Physicians should be aware of this potentially severe association. Early recognition and treatment would likely result in reduced mortality and morbidity,” the authors concluded.

Respiratory Medicine 2014; online

Food and Water Quality an Ongoing Challenge for Hotels - NSF StaySafer

From the buffet salad bar greens to the ice clinking in drinks served poolside, hotel administrators are finding that protecting guests from food and water illness outbreaks is a continuous challenge.

It’s also a necessary undertaking to demonstrate the hotel’s commitment to its patrons’ well being. Travelers won’t soon forget the awful stomach cramps if they experience a sickness during their stay, and such episodes can cause nearly irreversible damages to a hotel’s reputation.

The global public health and safety organization NSF International launched a new certification program this year to assist hotels and resorts in preventing contamination at its source. It combines inspection and testing of hotels’ water systems and food service operations.

“By adhering to the requirements of the program, a hotel with NSF StaySafer certification will protect both its guests and its brand,” said Sonia Acuña-Rubio, managing director of NSF International’s food division in Latin America who oversees the NSF StaySafer program. “We hope this added assurance will assist hotels in their customer satisfaction efforts and ultimately increase the rate of returning guests while also providing a helpful guide for consumers, tour operators, agencies, and travel sites.”

The Centers for Disease Control estimates that more than 10 million international travelers annually acquire illness from contaminated food and drinking water, such as Escherichia coli infections. Other diseases associated with contaminated food and drinking water include shigellosis or bacillary dysentery, giardiasis, cryptosporidiosis, norovirus infection, hepatitis A, and salmonelloses, including typhoid fever. Unsafe food and water also can pose a risk of cholera and a variety of conditions caused by protozoan and helminthic parasites.

While a wide variation of food and water quality practices exists from country to country, it’s a misconception that safety concerns are limited to poor areas in developing regions. Many germs have no boundaries, so the NSF StaySafer program will play an important role in establishing a universal set of standards that can be used as a benchmark and complement local requirements.

“Travelers should expect the same level of food and water safety at any NSF StaySafer certified hotel in any country of the world,” Acuña-Rubio said.

A starting point for hotel administrators who want to improve their quality efforts is to review their written policies and procedures for their food service operations and water systems. Focusing on programs, training, and interventions that target these areas will increase hotel employees’ health consciousness.

Once these processes are in place, the next step is to ensure that they are put into practice consistently through onsite facility inspections. The NSF implements two approaches—the NSF DineSafer program and the NSF DrinkSafer protocol—to accomplish this.

NSF evaluates foodservice operations against the U.S. Food and Drug Administration’s model food code to verify that proper food safety systems and personnel training are in use. According to the food code, epidemiological outbreak data repeatedly identify five major risk factors related to employee behaviors and preparation practices in retail and food service establishments as contributing to foodborne illness: improper holding temperatures; inadequate cooking, such as undercooking raw shell eggs; contaminated equipment; food from unsafe sources; and poor personal hygiene.

When evaluating water distribution and treatment systems, the NSF uses its Water Safety Standard for the Global Hotel Industry. This inspection includes the safety design and maintenance of the hotel or resort’s water and ice systems, and water and ice samples are tested for chemical and microbial contaminants. Annual facility audits and testing ensure ongoing compliance.

Once a facility meets these standards, it receives NSF StaySafer certification. Certified hotels will be listed in the NSF’s online listings database and earn use of the NSF StaySafer mark on marketing materials. This can generate new opportunities for hotels to create a strategic difference and a competitive advantage that is of value to consumers.

The response from the hotel industry to the program has been positive, especially in countries overseas, according to Acuña-Rubio. “There is a growing interest from hotels to improve and verify their quality efforts, but also to let their customers know that they are investing in protecting their health,” she said.

Photo Credit: Water in Glass via Bigstock

Legionella fears close hydrotherapy pool

Ballarat Health Services has closed a hydrotherapy pool after tests for legionella returned a suspected positive reading.

It will take another week to confirm whether the bacteria is present in the water collected from a water pump system at the Queen Elizabeth Centre.

The bacteria can causes flu-like symptoms associated with legionnaires' disease.

The centre's Wendy Hubbard says it will dose the pool with extra chlorine today and may individually contact the 200 people who used the pool in the past week.

"We have this testing done every month and in all the time the pool has been open, we've never had a positive test," she said.

"The pool actually has chlorine levels which are set by a computer and they're tested every day.

"It wouldn't be surprising if at the end of 14 days it isn't legionella that's grown but we're erring on the side of safety.

"We actually are very, very careful because we're part of a hospital and the people who go into our pool are sometimes frail and have disabilities.

"We are very meticulous about our testing regime, if we need to increase our testing then that's what will do but it is much, much more monitored than certainly a home pool because our clients are much more vulnerable."

Leadership Initiatives In Building Water Safety By NSF International

http://www.youtube.com/watch?v=_BfVF0-lzX8

LEGIONELLA - Artigo revista Hydro de Junho

http://www.arandanet.com.br/midiaonline/hydro/2014/junho/index.html

Mulher perdeu as duas pernas e uma mão ao inalar bactérias mortais em uma viagem na Toscana, Itália (Legionella)

Alethea Parker, de 51 anos, quase morreu, perdeu as duas pernas e uma mão depois de inalar bactérias mortais, enquanto estava em Toscana, na Itália, passando as férias com sua família e amigos.

Aparentemente, ela entrou em contato com bactérias Legionella enquanto tomava banho no hotel. Suas férias felizes na Itália se transformaram em um pesadelo e ela teve de ser internada durante meses.

Denominada “doença do legionário”, ainda possui um status quase mítico por conta dos poucos casos. Porém, a bactéria Legionella pneumophila continua contaminando o fornecimento de água e pode ser um perigo fatal.

Na semana passada, o responsável pelo sistema público de saúde inglês emitiu um alerta urgente depois de um recém-nascido ser internado com a doença, que foi adquirida com as águas de uma banheira da casa de parto.

Até 15% das pessoas que contraem esse tipo de infecção pulmonar, causada pela inalação de gotículas de água contaminada com as bactérias, morre. E aqueles que sobrevivem podem ficar com sequelas graves para o resto da vida como Alethea.


"Eu fiquei com dor de cabeça e estava constantemente com sede. Senti-me apática, mas associei isso ao estresse do trabalho que tinha vindo antes das férias. Então, no final da viagem foi quando eu realmente comecei a ficar doente e até pensamos que fosse intoxicação alimentar”, relembra Alethea.

Chegando em casa, no Reino Unido, seu estado piorou consideravelmente. Ela teve de ser induzida ao coma enquanto eles faziam mais exames, e foi quando informou ao marido e aos amigos que ela havia contraído a doença do legionário.

O médico disse que o único tratamento possível era uma ECMO (oxigenação por membrana extracorpórea), que funciona como um pulmão artificial, retirando o dióxido de carbono do corpo e depois inserindo o oxigênio limpo de volta. Entretanto, as coisas não melhoraram.

Mesmo usando vários medicamentos, nada parecia funcionar. Nesse momento, ela teve de retirar as duas pernas e a mão, pois gangrenaram no processo. A noradrenalina, injetada em seu coração para reduzir o tamanho dos vasos sanguíneos, era o que ajudava a mantê-la viva.

Na segunda semana, Alethea foi retirada do ECMO, transferida de volta para a UTI e lentamente foi retirada do coma. “Eu estava realmente chateada porque eu não sabia como iria trabalhar de novo sem uma das mãos. Eu teria de seguir em frente e fazer o melhor possível".

Atualmente, ela é capaz de dirigir, graças a um cabo especial colocado no volante do seu carro e recuperou a sua licença. Ela ainda visita uma unidade de reabilitação para manutenção de suas pernas protéticas e da mão, mas agora está clinicamente bem, sem problemas duradouros com seus órgãos. "Você se acostuma", diz ela. "Me dá nos nervos precisar de alguém comigo o tempo todo. Eu quero voltar à vida da maneira mais normal possível”.

http://www.cenariomt.com.br/noticia/367614/mulher-perdeu-as-duas-pernas-e-uma-mao-ao-inalar-bacterias-mortais-em-uma-viagem-na-toscana-italia.html

NHS England has issued an urgent health alert after an infant was admitted to intensive care suffering from a confirmed case of Legionnaires’ disease.

In light of the case, experts at leading legionella risk management company, Legionella Control International are now working closely with their own NHS and health sector clients to investigate the conditions surrounding the case and rapidly implement measures to control the risks of further contaminations.

Legionnaires' disease in baby is linked to heated birthing pool

Public Health England and NHS warn of hazard as newborn needs intensive care after birth in pool infected with bacteria

Expectant mothers have been warned not to use certain types of heated birthing pools at home after a baby born in one acquired legionnaires' disease.

Public Health England and NHS England issued the warning for pools which have built-in heaters and recirculation pumps and can be filled with water two weeks in advance of the birth.

The alert comes after a case of legionnaires' lung disease was identified in a baby born in a home birth in one of the pools. Water samples confirmed the presence of legionella bacteria.

The child is now in intensive care in hospital. It has been the first reported case of legionnaires' disease linked to a birthing pool in England, PHE said.

Experts are working to establish whether or not the bacteria from the tested home pool is the same strain as that which infected the baby.

Prof Nick Phin, head of legionnaires' disease at PHE, said: "This is an extremely unusual situation, which we are taking very seriously.

"We advise that heated birthing pools, filled in advance of labour and where the temperature is then maintained by use of a heater and pump, are not used in the home setting while we investigate further and until definitive advice on disinfection and safety is available."

NHS England issued a patient safety alert to notify the healthcare system, and midwives in particular, of the possible risk associated with the use of the heated birthing pools at home.

The alert recommends that heated birthing pools are not used for labour or birth. A full risk assessment is being carried out in the meantime.

Heated pools from the supplier involved in the incident had been recalled, PHE said. About 10 firms supply the specific pools and each firm keeps between two and 14 pools. The pools are typically delivered about two weeks before delivery date and filled from the domestic hot water supply. The temperature is maintained by a pump and heater until labour and delivery, with the companies recommending various disinfection regimes.

A spokeswoman for PHE declined to give any further information about the sick baby, including when and where the child was born.

The NHS patient safety alert described the child as "severely ill". The company that supplied the pool has not been named.

PHE said that most birthing pools used at home were filled from domestic hot water systems at the time of labour and these did not pose the same risk and were not included in the alert.

Phin said: "PHE and relevant local authorities are investigating the infection control measures required for this type of birthing pool. Local authorities will be working with the small number of companies who supply these heated birthing pools for use at home."

Legionnaires' disease is extremely rare in children, with only one case in youngsters aged up to nine in England having been identified between 1990 and 2011.

Although there were two cases reported in Italy and Japan several years ago, this is the first reported case of legionnaires' disease linked to a birthing pool in England.

Patients become infected with the bacteria through inhalation of contaminated water droplets. The infection does not spread from person to person.

The disease is a severe form of pneumonia which affects about 350 to 400 people each year in England and Wales. The majority of cases involve older patients.

NHS information about the condition says that most people make a full recovery but "in some cases it can lead to further, life-threatening, problems".

Midwives and all local authorities in the UK are being contacted to see if they use the specific pools provided by any of the companies supplying them. A PHE spokeswoman said that if the pools were out for use by the public, councils and midwives should take steps to retrieve them.

4 cases of Legionnaires' Disease found in Wilson

The Associated Press

WILSON, N.C. — 

Health officials have confirmed four cases of Legionnaires' Disease at a Wilson County facility.

The Wilson Times reported (http://bit.ly/1kYaHih) two more possible cases are being tested at Wilson Pines Nursing and Rehabilitation Services.

The home's administrator, Peggy Bulluck, says she and her staff are working with the Wilson County Health Department and the Centers for Disease Control to monitor the situation and prevent the spread of the illness.

Legionnaires' is a form of bacterial pneumonia. A person may develop Legionnaires' if exposed to legionella through breathing contaminated mist or vapor. It cannot be transmitted from person to person.

Health department officials say the four people are recovering.

Department spokeswoman Joyce Wetherington says samples from waterlines have been taken. The results are expected later this week.

Hoteis que a FIFA recomendou em São Paulo tem até Legionella

Este tema a SETRI já vem alertando a muitos anos e o problema é gravíssimo em muitos locais no Brasil.
Até o lançamento do Livro Legionella na Visão de Especialistas foi feito para alertar a todos.
A situação no Brasil deve ser avaliada com urgência, pois são mais de 5.000 pessoas que vão a óbito pela bactéria LEGIONELLA.

www.legionellaespecialistas.com.br

Este 

Tenth person tests positive for legionella at UAB Hospital, precautionary masks requirement lifted

BIRMINGHAM, AL -Another patient on the hematology/oncology unit at UAB Hospital tested positive for legionella bacteria.UAB released a new statement this morning on the bacteria regarding remediation efforts and water testing results.

The statement reads, in part:

"After extensive testing, review and close consultation with the Jefferson County Department of Health, the Alabama Department of Public Health and the CDC, UAB Hospital has lifted the precautionary recommendation that everyone on floors 5, 6 and 7 of the Women and Infants Center wear a mask when flushing the toilet. This precautionary measure was implemented after patients on a single unit on one floor tested positive for legionella, a bacteria that can lead to a type of pneumonia called legionellosis."

RELATED: UAB Hospital investigating legionella outbreak after two patients die

Hospital officials say they have received preliminary results from the water testing conducting on June 4 that serves the affected unit and have confirmed those tests showed no presence of legionella bacteria. 

"Those tests were conducted to confirm the effectiveness of the chemical shock that was successfully completed on May 31," the statement reads. 

Thursday UAB also confirmed an additional patient has tested positive for legionella.

RELATED: UAB continues efforts to kill traces of legionella

As we've reported, eight patients initially tested positive for legionella. Two of the patients died. But, the cause of death for the two patients has not been determined.

The Jefferson County Health Department also confirmed another person, who was a visitor at the hospital, also tested positive for the bacteria.

The latest patient, announced Thursday, marks the tenth person to test positive.

"This patient was admitted to the unit several days before special filters that remove legionella from water were installed throughout the building on May 25," said a UAB spokesperson. 

"The patient is receiving appropriate treatment. Based on the incubation period of legionellosis and the preliminary test results that show no presence of legionella in the water system, the county and state health departments and the CDC agree that the onset of the patient's symptoms suggest that exposure occurred prior to the installation of the water filters on the unit."

The hospital says water filters will remain in place.

RELATED: State says UAB prevented future legionella outbreaks

We're told planned testing and remediation will also continue with the guidance of public health authorities.

The CDC and Jefferson County Health Department have both assisted UAB with the cases.

 Ashley Roberts interviewed attorney Jason Shamblin with the firm "Cory Watson Crowder and DeGaris" 

The firm is representing the family of one patient who died and one patient they say visited UAB and contracted legionella.

Hear from the attorney at 5 and 6.

Woman who tested positive for Legionella died days after taking shower in impacted unit

BIRMINGHAM, Ala. (WIAT) – A Birmingham lawyer says a patient who died after testing positively for Legionella used a shower on May 7 and May 8, which is within the period of days that the hospital says it administered a chemical shock to the water system.

WIAT 42 News spoke with attorney Ernie Cory. He says the planned chemical shock of the water system was set for May 7 through May 9.

Two different law firms representing patients or families spoke with WIAT 42 News. So far, no lawsuits have been filed.

Can kissing give me Legionnaires' disease? And 6 other Legionnella FAQs

In the wake of an outbreak of Legionnaires' disease at UAB Hospital last month, we've put together some questions and answers regarding this uncommon but not rare disease.

The Centers for Disease Control and Prevention says the number of infections is greatly underreported and an estimated 8,000 to 18,000 people are hospitalized each year with it.

 In Alabama, 41 people contracted the disease last year, and at least 18 have so this year, including the nine from the UAB outbreak.

Two people infected in the outbreak at UAB have died.

While Legionnaires' disease, a virulent type of pneumonia, is a dangerous and deadly condition, it usually makes sick only those who have compromised immune systems. And its manner of transmission -- through the inhalation of contaminated water -- limits its spread relative to some other disease outbreaks, such as influenza, for example.

 Can I get Legionnaires' disease by kissing or coming into close contact with someone who is infected?
 Highly unlikely. Legionnaires' disease is transmitted when water infected with  the bacteria is aerosolized, or made into a vapor, and breathed deep into the lungs. Mouth-to-mouth contact is not a transmission route for the bacteria.

 Can I get it from a water fountain?
 Yes, there have been cases documented but it wouldn't be from drinking the water. Instead, infection at a drinking fountain would come from inhaling the water vapor or tiny droplets from the fountain. Let's say you are drinking from a fountain that has the bacteria and the water goes down the wrong pipe.
 "Aspiration of colonized drinking water into the lungs has been suggested as the mode of transmission in some cases of hospital-acquired Legionnaires' disease," according to the American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE).

 How about taking a shower? Am I safe there?
Not necessarily. Legionella bacteria can grow in showerheads, especially if not in regular use. When the water is turned on, some of that is typically vaporized which can lead to inhalation and infection. "Contaminated potable water sources present the greatest risk when dispersed into the air in a very small droplet size that can be inhaled deeply in the lungs," ASHRAE guidelines state.  Actions that may generate small droplets are those that break up the water stream, i.e. shower nozzles, aerators, spray nozzles, water impacting on hard surfaces and bubbles breaking up."

 What are the most common sources of Legionella bacteria that can lead to illnesses?
    The bacteria forms and spreads in warm water.The CDC lists these common sources in no particular order:

•     Hot tubs
•     Cooling towers;
•     Hot water tanks;
•     Large plumbing systems;
•     Decorative fountains.

Can I get it from car air conditioners or window air conditioner in my house?
 The CDC says:  The bacteria "do not seem to grow in car or window air-conditioners."

What are the symptoms?

The CDC says Legionairres' disease can be difficult to diagnose at first because its symptoms are like many other forms pneumonia, including:

•     Cough
•     Shortness of breath
•     High fever
•     Muscle aches
•     Headaches

The incubation period can be as long as 14 days, which means some may not get sick until up to two weeks after exposure. Those with symptoms should seek a doctor immediately. It is treated with antibiotics.

(Sources: Centers for Disease Control and Prevention, American Society of Heating, Refrigeration and Air-Conditioning Engineers (ASHRAE), Alabama and Jefferson County public health resources.)

Pittsburgh VA settles Legionnaire's suit for $227K

PITTSBURGH — A federal judge has approved a $227,500 settlement of a wrongful death lawsuit brought by the estate of an 83-year-old Navy veteran who contracted Legionnaire's disease at a Pittsburgh Veterans Affairs hospital.

The veteran, John Ciarolla, of North Versailles, died of the severe form of pneumonia — which is spread by bacteria commonly found in water supplies — on July 18, 2011, less than a month after he was admitted to the VA hospital in the city's Oakland section for a urinary tract infection.

A spokesman for the VA Pittsburgh Healthcare System referred questions about the settlement to the Justice Department, which declined to comment on the award approved Thursday by U.S. District Judge Arthur Schwab.

The family's attorney, John Zervanos, explained that the settlement amount was driven by Ciarolla's advanced age and otherwise poor health.

The damages in a wrongful death lawsuit hinge on a person's ability to provide for his survivors, as well as the person's pain and suffering. Because Ciarolla was in his 80s and nobody was financially dependent on him, that decreased the family's leverage in mediation, the attorney said.

"If he was 42 years old with a wife and young kids, the case would have been worth significantly more," Zervanos said.

Ciarolla is one of at least six Pittsburgh VA patients who died of Legionnaire's disease contracted due to water treatment problems at the Pittsburgh hospitals between February 2011 and November 2011.

More than 20 patients were sickened during that time, prompting U.S. Rep. Tim Murphy, a Pittsburgh-area Republican, to call for hearings on the outbreak.

Robert Petzel, the VA's undersecretary for health, testified the problems in Pittsburgh prompted changes about how the agency treats its water supplies at hospitals, and other protocols. But Petzel was criticized for, among other things, refusing to rescind a $63,000 bonus that Michael Moreland, a regional VA director and former CEO of the VA Pittsburgh system, received in 2012 before the Legionella problems were publicized.

Moreland has since retired and kept the bonus, which he was awarded for more than 30 years of service. Petzel has since resigned.

The Ciarolla family argued that Pittsburgh VA officials were negligent both in how they treated Ciarolla's illness and for allegedly failing to take extra precautions once they learned there were Legionella bacteria in the water.

The family will receive about $159,600 from the settlement, with Zervanos' firm receiving the rest to cover legal fees and expenses.

Read more here: http://www.bradenton.com/2014/06/05/5190468/pittsburgh-va-settles-legionnaires.html?sp=/99/153/#storylink=cpy

Legionella no Brasil