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A palestra teve uma grande aceitação e sem dúvida a Indústria Química terá um novo olhar para os riscos da água, incluindo a bactéria Legionella.

Visiting athletes, parents sickened by Legionella bacteria in Elmore Co.

MONTGOMERY, AL (WSFA) -

When calls started coming in to the Alabama Department of Public Health from concerned parents who reported illnesses in adults and children after a local softball tournament, the state launched an investigation into the outbreak. 

The group of more than 40 people were in the Elmore County area the second weekend in July and 14 people got sick, experiencing varying symptoms- from fever, cough and congestion to nausea, vomiting and diarrhea.

In clinical tests, three people tested positive for Legionella, a bacteria found naturally in the environment, usually in water. 

Legionella is a bacteria that can cause a form of pneumonia called legionellosis, or Legionaire's disease.

Most people are exposed to legionella regularly and usually don't get legionellosis, but people with weak immune systems are typically more susceptible to the disease. 

Most people get infected by inhaling the bacteria. It can't be transferred by person to person contact.

"It can be found in the water in systems like swimming pools, hot tubs, cooling towers, fountains, especially the ornamental fountains that spray water. It can even be associated with people doing stuff in their yards with hoses and sprinklers," explained Dr. Mary McIntyre, State Epidemiologist.

The state health department is still working to pinpoint exactly where the bacteria came from. Officials say the common link between the people who tested positive for Legionella is a hotel in Elmore County.

While they couldn't reveal the name of the hotel at this point in their investigation, they tell 12 News that water samples from the hotel's pool, hot tub and filtration system are being tested as well as samples from the hotel's entire water system and coolant system- what McIntyre referred to as environmental samples.

"There is no definitive link because we do not have positive environmental samples yet. We do have an association with a hotel in the Elmore County area but because there have been no positive environmental samples, there's no way to say that this is actually the cause," she told WSFA.

There are no statewide requirements for specific testing when it comes to public pools and only eight counties in Alabama have local pool regulations. 

"We know if we keep the chlorine levels at a certain level, we can keep the micro-organisms down to a certain level and the recirculation plays into that because then you get even distribution with the sanitation with the chemicals so it's all working together," said Mark Sestak, Alabama Department of Public Health.

"Even if there is proper maintenance, issues can occur if the system is overburdened with too many people in the water," Dr. McIntyre added.

Meanwhile, the state continues its Legionella investigation. State health officials say the probe could take months. 

The state health department has not gotten reports of any new cases tied to this outbreak.

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Legionella bacteria in water at 2 Alabama VA hospitals

MONTGOMERY, Ala. -- High levels of legionella bacteria have been found in the water at the Montgomery and Tuskegee campuses of the Central Alabama Veterans Health Care system, posing a health threat to patients.

There have not yet been any reported cases among staff or patients of Legionnaires' disease or Pontiac fever, which are respiratory infections caused by the bacteria, according to a report and emails leaked by CAVHCS staff to the Montgomery Advertiser.

Annual testing of the two campuses' water distribution system on July 9 and 10 found that eight of the 12 sites, or about 67 percent, tested positive for legionella pneumophilia, according to the report.

The July 25 results showed that four sites at Montgomery and four at Tuskegee tested positive for the bacteria, the report said.

According to the emails, patients from one room at the Montgomery facility and two mental health rooms at Tuskegee were relocated. An employee said all patients who have been in those areas for the past six months will need to be tested for the bacteria.

A formal corrective action plan is required when 30 percent of the samples collected contain the bacteria, according to the memorandum. The plan includes close monitoring of water tanks and detailed plans to eliminate the bacteria.

A statement from the VA Southeast Region said CAVHCS reported that the water supply in each of the rooms is being heated to remove the legionella, and filters are being installed on the faucets to protect patients from the bacteria.

The statement said they are also treating their water holding tanks to enhance the quality of the water, and will continue to test the system.

Tina Pippin, an Alabama Department of Public Health manager, said legionella disease outbreaks are reported when two or more individuals who live in separate households have symptoms, which include pneumonia, cough, fever and chills. Legionnaires' disease is a severe form of pneumonia, whereas Pontiac fever is milder, flu-like and does not affect the lungs, according to the Mayo Clinic's website.

The bacteria, which is found naturally in water, can cause disease when mist or water vapor is inhaled, not by drinking the contaminated water, according to the Centers for Disease Control and Prevention. The bacteria can incubate inside a human for two to 14 days.

Legionnaire's disease and Pontiac fever are associated with contamination within building water distribution systems.

Scott Hughes, a spokesman for the Alabama Department of Environmental Management, said there's no maximum contaminant level for legionella that establishes thresholds for harmful levels.

Hughes said ADEM regulates public drinking water plants and distribution with chlorine contact requirements. Chlorine kills any harmful bacteria before it reaches water customers, he said.

He said ADEM got in touch with water companies in Montgomery and Tuskegee, and neither have had any problems with legionella.

"We've sampled water in that area and we don't have a problem," said Buddy Morgan, general manager of the Montgomery Water Works and Sewer Board. "We run about 40 to 50 samples a day from all throughout the city."

CAVHCS physicians are monitoring the situation, according to the statement.

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Water coolers caused infections: CDC - LEGIONELLA

The Centers for Disease Control (CDC) yesterday urged the public to regularly clean and replace the water filters in their drinking-water dispensers, after it identified a water cooler as the source of two newborns’ Legionnaires disease infection last year.

CDC Deputy Director-General Chuang Jen-hsiang (莊人祥) said these were the first two cases ever of newborns contracting the water-borne disease by drinking water from a water cooler, and that the findings were to be published in the Emerging Infectious Diseases journal.

“Both of the newborns resided in central Taiwan and started exhibiting symptoms of pneumonia seven days after their birth. They were diagnosed with Legionnaires’ disease — a serious type of lung infection — in April and October last year respectively, after their phlegm tested positive for the Legionella bacteria,” Chuang said.

The pair did not live near each other, nor were they delivered at the same hospital, Chuang added.

Chuang said the centers came to the conclusion that the newborns had been infected with the disease after drinking Legionella-laced infant formula, after the same strains of bacteria they were infected with were found around the rims of the outlets for chilled and warm water of the drinking-water dispensers at their homes.

“Luckily, they have both recovered,” Chuang said.

The centers said the disease is extremely rare among children and that the majority of the 115 people infected with the disease last year were aged between 50 and 60.

The disease is not transmitted from person to person and is primarily contracted by inhaling water droplets containing Legionella bacteria, the centers said, adding that symptoms included a loss of appetite, muscle pains, headache, fever and aversion to cold.

LEGIONELLA um grande problema e números cada vez maiores

Legionnaires' disease in LTC facilities: A hidden threat

In the summer of 2013, the Wesley Ridge Retirement Community inReynoldsburg, Ohio, experienced the largest and deadliest Legionnaires' disease outbreak in state history. Six people died at the assistedand independent-living facility, and another 33 become seriously ill. The victims ranged in age from 63 to 99 years and included residents, visitors and one employee.

For most people, Legionnaires' disease is something from the history books, a vague memory of Philadelphia conventioneers falling ill in the 1970s. In fact, outbreaks of this often-fatal form of pneumonia, including in long-term-care (LTC) facilities, have been increasing for several years in the United States. In just the past three years, nursing home and senior living outbreaks have occurred in Baltimore; Pittsburgh; Cleveland; Clearwater, Fla.; Jacksonville, Fla.; and Florence, Ala. The worst outbreak in an LTC facility in North Americaoccurred in 2005 at the Seven Oaks Home for the Aged in Toronto, Ontario, where 23 residents died and 112 other people fell ill.

A LITTLE BACKGROUND

Legionnaires' disease-clinically known as legionellosis-is a form of pneumonia caused by waterborne bacteria of the genus Legionella. It carries a mortality rate of 40 percent when acquired in hospitals.

More than 50 species and subspecies of Legionella exist, several of which can infect people. By far the most common is Legionella pneumophila serogroup 1. The bacteria are ubiquitous and usually harmless in the environment, but they easily can grow in warm, stagnant water. In certain circumstances, especially in institutions housing the elderly or in those with chronic illness, Legionella can multiply and cause pneumonia when people aspirate tiny particles while drinking water or showering.

Since 2001, Centers for Disease Control and Prevention (CDC) surveillance reports have stated that Legionella is the single most commonly reported pathogen associated with drinking water outbreaks in the United States. Voluntarily reported cases of Legionnaires' disease tripled from 2000 to 2009, to 3,522 annually. This amount, however, is now known to be a vast underestimate, and some estimates of incidence exceed 10,000 cases per year. As many as 70 percent of all water systems in buildings taller than three stories are contaminated with Legionella. Because it takes specialized laboratory testing to diagnose it, the disease is severely underdiagnosed in long-term care.

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Risk Assessment for Legionella - Avaliação de Risco da bactéria LEGIONELLA

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New bug warning over heating birth pools as more cases found - LEGIONELLA

Exemplo do Birth Pools

Health officials investigating a case of Legionnaires’ disease in a baby linked to a home birthing pool have found more contaminated pools.

Public Health England (PHE) has reiterated advice not to use pre-heated home birthing pools after more pools tested positive for Legionella, the bug which can cause Legionnaires’ disease.

Experts last month cautioned against the use of the pools after a baby contracted Legionnaires’ disease. The “severely ill” baby was being treated in intensive care but officials yesterday refused to give any update on the child’s health, saying the case was “now subject to a police investigation”.

As a result of the baby’s infection, the authority advised against the use of pools which have built-in heaters and recirculation pumps filled in advance of labour or birth at home.

PHE tested 10 heated birthing pools, from several suppliers. Results for six revealed four testing positive for Legionella. Three also tested positive for other potentially harmful organisms.

Prof Nick Phin, PHE’s head of Legionnaires’ disease, said: “These latest results have strengthened already serious concerns about the safety of heated birthing pools in the home setting and the potential for contamination from a number of organisms which are recognised causes of infection, and pose particular risks to newborn babies. We do not have concerns about purchased or hired pools that are filled from domestic hot water supplies at the onset of labour, provided that any pumps are used solely for pool emptying.”

Louise Silverton, of the Royal College of Midwives, added: “Women planning birth at home using a traditional pool that is filled when the woman is in labour or using a fixed pool in an NHS unit are not affected by this alert and should not be concerned.”

http://www.yorkshirepost.co.uk/news/main-topics/general-news/new-bug-warning-over-heating-birth-pools-as-more-cases-found-1-6750948

CDC Errs On Policy As Well As Handling Dangerous Pathogens (LEGIONELLA)

The agency’s reactive approach to Legionnaires’ disease causes thousands of preventable infections every year.

Recent revelations about several instances of scientists’ mishandling of dangerous pathogens—including potentially lethal anthrax bacteria and H5N1 bird flu–at the federal Centers for Disease Control and Prevention (CDC) were bad enough. But testifying before a subcommittee of the House Energy and Commerce Committee last week, CDC Director Thomas Frieden confirmed that these were not isolated incidents. He admitted that in spite of a spate of other similar incidents, “We missed the broader pattern.”

Fortunately, no illnesses or fatalities resulted from these mishaps, but the same cannot be said for other, more deliberate actions of the CDC. Deaths have resulted from a conscious, long-standing policy on how to address a common, potentially life-threatening infection, Legionnaires’ disease, a type of environmentally acquired pneumonia. There have been a number of recent fatalities: Six U.S. veterans at the VA Hospital in Pittsburgh, six patients at an assisted living home in Ohio, three hotel guests at a hotel in downtown Chicago and two patients at a major university hospital in Birmingham, Alabama.

Legionella, the cause of Legionnaires’ disease, was originally identified after an outbreak at an American Legion Convention in a Philadelphia hotel in 1976 that killed 34 and sickened 221. The bacterium lurks at low levels in natural fresh water sources (such as rivers, lakes and streams) in virtually every part the world, most often with little impact on humans. It becomes hazardous when it survives municipal water treatments and subsequently contaminates and grows in man-made building water systems such as hot tubs, decorative fountains, shower heads and cooling towers. Left undetected in these locations, it can multiply to high concentrations. People become sickened after inhaling contaminated aerosol droplets generated from these sources.

Unlike most other pneumonias caused by microorganisms, this disease is not transmitted person-to-person; it is purely of environmental origin.

The only way to determine whether a water source is a high-risk Legionella-contaminated system is to take samples of the water to see whether the bacteria grow in a simple and inexpensive culture test in a laboratory.

Although they receive little attention, outbreaks are not uncommon. By far, however, most cases of Legionnaires’ disease are individual sporadic cases that are not known to be associated with larger outbreak clusters, although this may be due to the fact that most sporadic cases are never thoroughly investigated. (Legionnaires’ disease symptoms are similar to other pneumonias and can only be diagnosed by specific laboratory tests.) Estimates of the number of cases annually in the United States range from 8,000 to more than 25,000.

An obvious question is what federal health officials are doing to protect Americans from this disease. The answer is both complicated and puzzling. The approach of the CDC’s National Center for Immunization and Respiratory Diseases (NCIRD), which has the responsibility for Legionnaires’ disease prevention, is flawed. Perhaps that is not surprising, given that prevention appears not to be NCIRD’s strong suit; its officials also recommended eliminating the fourth booster dose for the childhood pneumococcal vaccine although that would reduce the efficacy of vaccination and result in the death of children (the subject of a previous Forbes article).

The CDC’s recommendations for preventing Legionnaires’ disease have been predominantly focused on what might termed a disease surveillance strategy–a reactive process that relies on screening for disease after cases are detected, at which time a response is quickly undertaken to prevent further infections. Although this strategy works well for person-to-person transmissible diseases where the source of the disease is another infected individual, it is not well suited to situations in which the source of disease is in the environment.

Former Assistant U.S. Surgeon General Dr. J. Donald Millar, who used the disease surveillance approach successfully as the head of CDC’s renowned Smallpox Eradication Program, has long been critical of CDC’s approach to Legionnaire’s disease. In 1997 he warned that disease surveillance was being misapplied to the prevention of Legionnaires’ disease because it is not transmitted from person to person but is contracted solely by exposure to bacteria-contaminated aqueous sources. For such diseases of environmental origin, proactive environmental surveillance, rather than reactive disease surveillance, is the appropriate prevention strategy. 

Others have echoed Millar’s views, but for decades CDC’s position has remained unchanged.

Another indicator that CDC was on the wrong track was the outcome of a 1991 lawsuit in which the U.S. Government was sued following an outbreak of Legionnaires’ disease at a Social Security Administration (SSA) building in Richmond, California. The U.S unsuccessfully relied on defense testimony from CDC experts for its defense and was subsequently forced to pay an out of court settlement. Clark W. Patten, the lead plaintiff attorney in the case,recounted that his winning strategy was based on the premise that the U.S. Government (specifically the CDC) should have known how to prevent the outbreak at the federal building.

A closer look at CDC policy over the years reveals the ways that a reactive approach is illogical and ineffective. A recurring theme is that CDC discourages environmental testing until an outbreak occurs. At that point, however, CDC demands testing to demonstrate that all evidence of Legionella is gone for up to a year after the outbreak. Inexplicably, CDC’s current recommendation is still that “an epidemiological association with a probable source should be established before intervention methods, such as disinfection, are undertaken” [emphasis added].

This contradiction–environmental surveillance not needed before an outbreak, but required afterwards–in effect uses people as “canaries in the coal mine” to detect high-risk water sources.

CDC claims that a reason for not performing environmental surveillance is that Legionella test results are uninterpretable in the absence of disease because the concentration of Legionella in a water sample required to cause disease is not fully understood. But Dr. David Krause, the former State Toxicologist for the State of Florida, dismisses this claim: “one does not need to know the concentration of Legionella required to cause disease to prevent it, one just needs to know if amplification is being controlled in the system and a simple periodic Legionella laboratory culture test can provide an answer.” Dr. Krause added that “useful guidance to help building operators interpret Legionella concentrations in water samples has been published for over 20 years by a laboratory in the private sector and have [sic] long been cited in theOccupational Safety and Health Organization (OSHA) Technical Manual.” Dr. W. Dana Flanders, Professor of Epidemiology and Biostatistics at Emory University, wrote, “I am concerned CDC seems to be discouraging environmental Legionella testing based on flawed assumptions…when I looked more closely at references they use to support their position, I found that some of them instead actually supported the opposite position concerning benefits of environmental testing.” The problem, Dr. Flanders explained, is, “When CDC discourages proactive, routine environmental testing, the result is that hazardous sources in building settings with high counts may persist and go unrecognized until after an association with disease.” CDC’s posture is puzzling. The number of cases since Legionnaire’s disease was discovered is staggering–on the order of 900,000, and the number of reported cases continues to increase each year. The yearly costs for hospitalizing Legionnaires’ disease patients exceed $400 million, and yet CDC still recommends through their website and scientific publications that concerned parties wait for an outbreak before monitoring and disinfecting building water sources.

Perhaps in CDC’s adherence to this approach we are seeing a syndrome that is common, especially among bureaucrats: the unwillingness of people to admit that they’ve been wrong.

In 1992 Congress changed the official name of the CDC to the “Centers for Disease Control and Prevention,” but at least for the Legionella Program within the NCIRD, that addendum doesn’t seem to have made an impression.

In the aftermath of the recent mishaps with dangerous pathogens at CDC, Director Frieden said at a press conference, “Events like this should never happen, and that’s why I will do everything in my power to make sure that nothing like this happens again.” While he’s reviewing his agency’s miscues, Dr. Frieden should pay some attention to his agency’s misguided approach to Legionnaires’ disease.

http://www.legionlawjournal.com/2014/07/23/cdc-errs-on-policy-as-well-as-handling-dangerous-pathogens/

LEGIONELLA - 38 ANOS (JULHO 1976)

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Forsyth County Health Officials Update Citizens on Legionnaires’ disease in a Winston-Salem Nursing Home

According to a press release from the Forsyth County Department of Public Health is continuing their work with the staff at Oak Forest Health and Rehabilitation and with state health officials in order to to investigate an outbreak of Legionnaires’ disease among residents of the facility. Six cases of Legionella infection have been identified to date. All of affected residents are improving or have fully recovered.

legionellea bacteria

As part of this investigation, environmental samples were taken from various locations within the Oak Forest facility. Testing of these samples identified low levels of Legionella bacteria.

In response to this outbreak and in consultation with the Forsyth County Department of Public Health and the North Carolina Division of Public Health, Oak Forest Health and Rehabilitation has complied with all recommended control measures to protect residents, visitors, and staff. No new Legionella infections have occurred in facility patients since control measures were instituted.

According to county officials Oak Forest Health and Rehabilitation has hired an environmental engineering firm to assist in remediation of their water system and to help eradicate Legionella bacteria from the facility. Remediation has included superheating, flushing, and hyperchlorination of the facility’s water system. To ensure the continued safety of residents, visitors, and staff, water restrictions will remain in place until Legionella bacteria are no longer identified at the facility through follow-up environmental testing.

Hoje dia 21/07 faz exatamente 38 anos......

No dia 21/07/1976 na Philadelphia tinha início a convenção dos Legionários. No dia 27/07/1976 foi a óbito a primeira vítima da bactéria LEGIONELLA. Foi nesta época que tudo começou.

Caso da Philadelphia faz exatamente 38 anos.

Para saber mais sobre a bactéria LEGIONELLA, visite o site www.setri.com.br.

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EXPO ARQUITETURA SUSTENTÁVEL - PALESTRAS SOBRE VÁRIOS TEMAS LIGADOS A CONSTRUÇÃO SUSTENTÁVEL

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Legionella Found at UPMC Hospital

PITTSBURGH - A Pennsylvania hospital moved 11 patients from a unit yesterday when Legionella bacteria was found in several sinks. A UPMC spokesperson says infection control staff identified the contamination on the 10D unit in UPMC Presbyterian Hospital.

The health system says there are no confirmed cases of Legionella infections on the pulmonary medicine unit where the bacteria was found. UPMC  says it's following normal Legionella monitoring and prevention protocols and expects the unit to reopen after remediation measures are taken.

According to a statement from UPMC, "it is not uncommon for Legionella bacteria to appear in water sources in hospitals or any other facility. That's why we continuously follow rigorous monitoring and prevention measures to ensure the safety of our patients. "

Legionella bacteria can cause a severe form of pneumonia.

Compost said to be most likely source of Angus legionella cases - Este tipo de caso está ficando comum

Bags of compost have been identified as the likely source of two legionella cases in Angus, a report has found.

Just eight months on from a nationwide outbreak of Legionnaires’ disease, Scottish health officials have finally determined that the majority of infections came from an overexposure to compost and incubating soil.

Health Protection Scotland has 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.

Some strains of legionella are found in soil and potting compost, but investigators found the products used by the patients were bought at different times from different premises.

In all, seven individuals in the Tayside and Lothian areas came down with the illness last autumn — two of whom required treatment at Ninewells Hospital in Dundee.

The first case came to light on September 9, and was a 50-60-year-old woman, who was a keen gardener and was admitted to intensive care with pneumonia.

Little over a week later a second patient with pneumonia was admitted to intensive care at Ninewells. The man, aged 70-80, also required ventilation.

He was not a keen gardener, but had taken ill after helping his wife in the garden.