http://www.youtube.com/watch?v=Z0nN99JK5Bk&feature=youtu.be
14 de mai. de 2014
9 de mai. de 2014
Ice machines were source of Legionnaires'
After one patient died and two were sickened by Legionnaires' disease in November and December at UPMC Presbyterian, where they contracted the disease, UPMC has a message for hospitals nationwide."Hospitals in the U.S.: If you have not been looking in ice machines for Legionella, please look," Tami Minnier, UPMC's chief quality control officer, said Friday. "That's the message."The three hospital-acquired Legionnaires' cases were the first to occur in more than two years at UPMC Presbyterian, she said, and led to a thorough cleaning and disinfection of all of the hospital system's 500 ice machines in 20 hospitals -- including 80 machines in Presbyterian.Although the cases occurred about five months ago, Ms. Minnier said that UPMC began talking publicly about it this week because it had a difficult time finding existing hospital protocols on Legionnaires' disease and ice machines and little discussion about the issue around the country.The second goal of going public, she conceded, was to make sure the public did not put UPMC in the same boat as the Veterans Affairs Pittsburgh Healthcare System. The VA was lambasted with criticism over the past 1½ years for how it dealt with an Legionnaires' outbreak here that infected at least 22 veterans, six of whom died over a 16-month period in 2011 and 2012.She said the UPMC outbreak began in mid-November when an older woman who was immuno-compromised was in the hospital and contracted what was thought to be pneumonia.Several days before the woman died in mid-November, doctors confirmed that she had contracted Legionnaires' disease, Ms. Minnier said.The staff remembered that the woman had aspirated while sucking on ice chips in the hospital.Tests confirmed that the ice machine the ice chips had come from was contaminated with Legionella bacterium.But a question remained: How did Legionella bacterium, which typically grows best in warm water, grow in the cold water used in the ice machine?After tearing apart the machine, Ms. Minnier said, staff discovered that ice machines contain a water reservoir located next to a compressor, which can heat up enough to warm the water in the reservoir and allow the growth of Legionella.Presbyterian then began testing for Legionella in all of its ice machines, starting with those in areas where immune-compromised patients were treated.Before it could test all of the machines in the hospital, during the first two weeks of December, two more patients in other parts of the building tested positive for Legionnaires' disease.Further testing of ice machines near those patients' rooms found Legionella as well, and testing of all of the machines found about 20 percent of Presbyterian's 80-plus ice machines were infected.
Read more: http://www.post-gazette.com/news/health/2014/05/02/UPMC-Pittsburgh-hospital-ice-machines-Legionella-patients/stories/201405020165#ixzz31G5zisWn
7 de mai. de 2014
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
www.legionellaespecialistas.com.br
2 de mai. de 2014
Legionella bacteria found in hospital ice machines at UPMC Presbyterian
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
Presentation
Preface
Chapter 1
Como a Legionella ficou conhecida
Chapter 2
Legionella Pneumophila e a Doença dos Legionários para leigos: uma introdução
Chapter 3
Características gerais da Legionella ssp
Chapter 4
Legionella na área médica, a falta de diagnóstico nos hospitais
Chapter 5
Legionelose como doença profissional
Chapter 6
Legionelose – Aspectos laboratoriais na área clínica
Chapter 7
A legionelose e a vigilância sanitária de alimentos
Chapter 8
HACCP-based Building Water Management Programs
Chapter 9
LEGIONELLA – Our CHOICES have CON SEQUENCES…Always!
Chapter 10
Legionella e o ar condicionado
Chapter 11
Legionella na certificação AQUA -HQE para projetos sustentáveis
Chapter 12
Legionella, importante discussão em matéria de movimento global de construção sustentável
Chapter 13
Legionella, un enemigo desconocido en edificaciones sustentables
Chapter 14
O Cuidado com a Legionella dentro da Indústria Hoteleira
Chapter 15
Análise da Legionella na água
Chapter 16
Detecção de Legionela sp. por meio de amplificação de DNA
Chapter 17
Controle de Legionella por processo de desinfecção
Chapter 18
Legionella Risk Reduction in the UK - does legislation and guidance reduce the number of cases of Legionnaires’ Disease
Chapter 19
Legionella em Portugal
Chapter 20
Legionella and Legionellosis
Chapter 21
A importância das Políticas Públicas e da informação para se enfrentar a Legionella
Chapter 22
A Legionella e os aspectos jurídicos no Brasil
Chapter 23
Negligência com legionella implica em riscos também ambientais: Meio ambiente urbano ameaçado
Chapter 24
Avaliação de risco de Legionella: A ferramenta contra uma epidemia
Caso de Legionella : Legionnaires outbreak at local senior living facility
JACKSONVILLE, Fla. -- First Coast News has learned of an apparent outbreak of Legionnaires' disease at an elder care facility.
The Duval County Health Department issued a Health Advisory after three residents of Camellia at Deerwood contracted a type of pneumonia caused by the Legionella bacteria.
Legionnaires' disease is not spread by human contact, rather is typically caused by breathing in contaminated vapor from fountains, hot tubs or spas. It can be dangerous, or even fatal in older people. According to the Centers for Disease Control and Prevention, when it comes to Legionella bacteria, outbreaks occur "when two or more people become ill in the same place at about the same time."
The Department of Health notice was issued on April 18, but some residents' family members say they weren't notified until several days later. One family said their loved one with dementia didn't receive the notice until after 6 pm on April 24.
We spoke to Perry Brown, the facility's general manager. He declined to say whether any additional residents have gotten sick since the notice went out, but he did say "we are working directly with the Health Department to keep our residents safe."
Health officials have collected water samples from the facility, and are waiting on results.
25 de abr. de 2014
Smart Water Leadership Summit - Washington,DC = LEGIONELLA NA VISÃO DE ESPECIALISTAS
Você pode se inscrever para todo o seminário que será apresentado ao vivo via internet.
http://www.smartwaterleadership.com/requestinvite.aspx
Dia 5 de Maio lançamento do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS.
http://www.smartwaterleadership.com/agenda.html
Legionnaires’ disease bacteria lurk in tap water
Of 68 water taps that scientists sampled across the United States, 47 percent harbored traces of Legionella pneumophila. The bacterium causes Legionnaires’ disease, a severe form of pneumonia and flulike Pontiac fever — collectively referred to as legionellosis.
Though legionellosis is relatively rare with an estimated 8,000 to 18,000 infections annually nationwide, the vast majority of cases are not linked to an outbreak and monitoring for L. pneumophila can be difficult.
Chemist Maura Donohue of the Environmental Protection Agency in Cincinnati and colleagues collected 272 samples over two years from 68 water sources, including kitchen sinks, bathroom sinks, drinking fountains and a refrigerator water dispenser.
By probing for the bacterium’s genetic material, the researchers found that 32 taps contained L. pneumophila traces in at least one sample. Of those 32 taps, 11 contained the bacterium in multiple samples.
The small study, which appears February 18 in Environmental Science & Technology, is one of the first to chart the national prevalence of L. pneumophila in water taps. The authors suggest that further research should investigate how the bacteria arrive in people’s sinks.
22 de abr. de 2014
17 de abr. de 2014
Plano de Segurança da Água da Copasa vai intensificar ações pela qualidade da água
O tema Plano de Segurança da Água, a SETRI vem falando e apresentando em vários congressos a importância e a obrigatoriedade deste processo. Conforme a Portaria 2914 o PSA é obrigatório.
O caso da Copasa (vide) é um bom exemplo.
COPASA
A preocupação com a qualidade da água na Companhia de Saneamento de Minas Gerais (Copasa) é pauta frequente no planejamento e nas ações da gerência de informações. O monitoramento é feito em cada ponto do processo, para buscar sempre o melhor resultado do produto que chega aos consumidores.
Pensando em sistematizar seu controle de qualidade, e distribuir aos municípios mineiros abastecidos pela Companhia um eixo norteador para servir de referência nesse processo, a equipe da Copasa está em andamento com estudos e diagnósticos para formulação de seu próprio Plano de Segurança da Água (PSA).
O plano, explica o gerente da Divisão de Pesquisa e Controle de Qualidade da Água e do Esgoto (DVQA), Airis Antônio Horta, é fundamentado nas guias da Organização Mundial da Saúde (OMS), que orientam a elaboração de um documento que organize os processos de avaliação e monitoramento. No contexto da saúde pública, a OMS atenta para a importância de que sejam estabelecidas diretrizes que permitam aferir e assegurar a qualidade da água para o consumo humano.
A elaboração do Plano, observa Horta, “é um trabalho que as empresas de saneamento estão buscando e que será muito importante. A partir do momento em que tudo estiver estabelecido, poderemos contar com uma segurança ainda maior para a qualidade da água. E também, como consequência, num segundo momento, diminuir os custos operacionais", destaca o gerente.
Uma vez finalizado, o Plano de Segurança da Água, que compõe o Planejamento Estratégico da Copasa, permitirá às equipes, de forma mais organizada, não só avaliar os sistemas e realizar a monitorização operacional, mas também construir planos de gestão para minimizar os riscos envolvidos.
Construção do Plano
Para colher os dados necessários para a criação do documento, a Copasa definiu nove de seus departamentos, cada um de uma região do Estado, para servir de pilotos para as avaliações da equipe. Foram selecionados os de: Caratinga e Resplendor (Rio Doce), Nanuque (Mucuri), Visconde do Rio Branco (Zona da Mata), Ipuiuna (Sul), São Gotardo (Alto Paranaíba), Perdigão (Centro-Oeste), Belo Horizonte - sistema do Rio das Velhas (Capital e RMBH) e Montes Claros (Norte).
Em cada uma dessas áreas, a equipe tem realizado o trabalho de diagnóstico, avaliação de perigos e classificação de risco, com o levantamento dos detalhes que envolvem todo o percurso da água. Neste trajeto, há os mananciais, a fase de captação, de adução, de tratamento/produção (com todos os seus processos internos: oxidação, coagulação, floculação, decantação, filtração, desinfecção, correção de pH, fluoretação), até chegar às etapas de reserva e distribuição. "O PSA vai reunir tudo isso em cada cidade, orientando a forma de gestão do sistema", comenta o gerente.
16 de abr. de 2014
LEGIONELLA - Avaliação de risco
A SETRI é a única empresa independente que realiza Avaliação de Risco da bactéria Legionella.
Inovamos a mais de seis anos o processo HACCP para a avaliação de risco.
A SETRI não comercializa produtos e não realiza análises laboratoriais, mantendo uma independência total sobre o tema.
A SETRI também foi a idealizadora do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS, onde reuniu os maiores especialistas sobre o tema, incluindo o CDC (USA).
www.setri.com.br
Inovamos a mais de seis anos o processo HACCP para a avaliação de risco.
A SETRI não comercializa produtos e não realiza análises laboratoriais, mantendo uma independência total sobre o tema.
A SETRI também foi a idealizadora do livro LEGIONELLA NA VISÃO DE ESPECIALISTAS, onde reuniu os maiores especialistas sobre o tema, incluindo o CDC (USA).
www.setri.com.br
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