legionnaires disease death

Third Vet’s Death Tied to Legionnaires’

posted 12.4.2012 by Steven Heisler

His wife blames water from VA hospital in Oakland

The wife of a Vietnam War Army veteran who died Oct. 23 in Erie believes her husband may have died after contracting Legionnaires’ disease from the water system at the VA hospital in Oakland.

If John McChesney, 63, did die after contracting the pneumonia-like disease at the University Drive facility, that potentially makes him the third patient in the past two years to die after getting Legionnaires’ disease there.

It also makes Mr. McChesney part of an expanding investigation into the Legionnaires’ outbreak at the hospital that has caught national attention in part because the hospital used to be home to researcher Victor Yu, who in 1982 first confirmed the connection between the spread of the disease and water systems.

Part of that expanding inquiry is looking into whether Legionnnaires’ cases also originated at the VA’s H.J. Heinz campus near Aspinwall, a site that contains a nursing home for veterans.

VA spokesman David Cowgill on Monday confirmed the VA has detected Legionella, the bacterium that causes the disease, in the water system at Heinz, and that facility still has water restrictions in effect while the water system is being treated with chlorine. Water restrictions were finally lifted at University Drive on Friday after two weeks of cleaning.

Mr. Cowgill said in an email that one of the five cases of Legionnaires’ disease that originated at the VA may have originated at Heinz, though there is a “high probability” that it began at University Drive for that patient.

Mr. Cowgill said he could not comment on Mr. McChesney’s case, though Mr. McChesney’s wife, Evelyn, said she has been contacted three times in the past five days by officials from the VA about her husband’s death and requests to test the water in her Columbus, Warren County, home to see if that was the source of the Legionnaires’ disease he contracted.

“I think he got it at the VA,” she said Monday. “I don’t believe there’s anything wrong with my water.”

Mr. McChesney had suffered from kidney and heart trouble that resulted from contact with the chemical defoliant Agent Orange during his 18-month stint in the infantry in Vietnam.

He died after his wife of 18 years took him to St. Vincent Health Center in Erie on Oct. 1 because he was coughing and wheezing badly. She said an emergency room doctor there said Mr. McChesney tested positive for Legionnaires’ disease.

That was less than 14 days after he had spent six days over two visits to the University Drive facility in late September, where he was being seen for heart problems. Legionnaires’ disease typically has up to a 14-day incubation period.

Mrs. McChesney, who has been following the stories about the outbreak over the past two weeks, was incensed by what she has read.

“Whoever was responsible for this, they should be held accountable,” she said. “I mean, the suffering my husband went through for 3 1/2 weeks [before he died] was needless and it was because they just neglected things.”

“I feel my husband and other soldiers served their country and they deserve the best care possible,” she added.

The outbreak was first revealed by the VA Pittsburgh Healthcare System on Nov. 16, when it said that it had confirmed just four cases of the disease linked to the University Drive hospital, and it said all four patients had recovered.

It later said on Nov. 22 that a fifth person had contracted the disease from the hospital, though it omitted from the news release that the fifth patient had died. It wasn’t until Friday that the VA told the Allegheny County Health Department that that person — whom the VA refuses to identify — had died after contracting the disease.

In addition, the children of a second veteran, John Ciarolla, 83, told the Pittsburgh Post-Gazette that he died last year after contracting the disease following stays at both University Drive and the VA’s H.J. Heinz nursing home.

The U.S. Centers for Disease Control and Prevention is investigating how the outbreak occurred, and U.S. Sen. Bob Casey, D-Pa., has asked Veterans Affairs Secretary Eric Shinseki for a report on why the outbreak occurred.

Dr. Yu and his research colleague, Janet Stout, who both left the VA after a dispute with management in 2006 and 2007, respectively, believe that the outbreak is due to the VA’s failure to properly manage and maintain the water treatment system they first installed at the hospital in 1993. The VA believes the treatment system is what failed.

U.S. Rep. Brad Miller, D-N.C., was chairman of the House Investigations and Oversight Subcommittee in 2008 when it held a hearing into the way that Dr. Yu and Dr. Stout were pushed out of the hospital, and how the VA destroyed 30 years worth of frozen isolates of Legionnaires’ disease that the researchers had collected.

Mr. Miller believed then that the VA seriously erred in forcing Dr. Yu and Dr. Stout out and destroying their isolate collection. Now the actions look even worse, he said, since it was Dr. Stout who oversaw the water treatment system at the hospital.

“At the very least, [losing Dr. Yu and Dr. Stout] compromised that hospital’s ability to deal” with the outbreak, Mr. Miller said Monday. “And they may have lost the people who were best at handling [the water treatment] system.”

Another part of the story that has bothered Mrs. McChesney and others is that the VA knew as early as June that it had a problem with the water treatment system — known as a copper-silver ionization system. The VA called in a consultant then, who recommended in July a series of steps to make it work properly.

But the VA did not do anything in response to the recommendations until sometime in October, when it called the consultant back in and asked the consultant to adjust the copper-silver system to work properly.

“I mean, for them to be that negligent,” Mrs. McChesney said. “They never even warned their patients.”

Because the Legionella bacterium must get into a patient’s lungs, one of the most common ways it infects a person is while taking a shower, when the moist mist from a shower is inhaled. Mrs. McChesney believes her husband took at least two showers during a four-day stay at the hospital from Sept. 18 to Sept. 21. He returned for a two-day visit at the VA Sept. 26 and 27 and then went home after a procedure.

About 8,000 to 10,000 people each year are hospitalized with the disease. But the Centers for Disease Control and other experts believe many more cases occur each year that go undiagnosed as simple pneumonia or other afflictions. Legionnaires’ disease can be fatal in 5 percent to 30 percent of cases, depending on who it strikes and where it is acquired.

After Mr. McChesney was admitted to St. Vincent on Oct. 1, his condition got worse, and it was the heart and kidney conditions he had suffered from for much of his life that were the official causes of death on Oct. 23. But his wife said his doctors acknowledged to her that it was the Legionnaires’ disease that exacerbated them, leading to his death.

Mrs. McChesney said VA officials told her in late October that they would send bottles to her to collect samples of her home water to test.

But she never got the bottles and no one followed up until the past five days, after the outbreak had been publicly revealed.

On Thursday, a VA official called and asked if she could send Mrs. McChesney a kit to test her home’s water. Then, on Friday, Robert Muder, director of the infectious disease section at University Drive, called her and left a message that he wanted to talk to her. And finally, on Monday, another VA official called and asked if the VA could send a social worker to her home to test her water.

“I’m not sure I want them to come, or if I want to talk to them,” Mrs. McChesney said.

Now, she said, she’s focused on getting to the bottom of what caused her husband’s death, to honor his memory.

“I do know that he would not want me to just let this go,” she said.

Original article at: post-gazette.com

 

Italian Woman Dies from Legionnaires Disease at Dental Practice

posted 3.26.2012 by Steven Heisler

A recent death of an Italian woman from Legionnaires Disease is a timely reminder that dental surgeries should be constantly checked for cleanliness and bacterial infection.

It has been found that the 82-year-old woman died from bacteria found in the water line used by her dentist, which shows the need to ensure that patients are not at risk.

Legionnaires Disease causes severe pneumonia, which even healthy people can succumb to. The lady although in her early 80s was apparently very healthy and visited her dentist on 2 occasions. As such, when the cause of death was realised, the only place where they could find the bacterium was at the practice.

Samples were taken from water supplies in the lady’s home but the L pneumophila was not found there. However, samples taken from water supplies at the dental practice showed high levels of the bacterium with the highest levels found in the output from the high-speed turbine.

Legionnaires Disease comes in 2 forms – Legion Fever and Pontiac Fever. The former is more severe and causes pneumonia. The latter is a milder illness that is less likely to be fatal.

Speaking with reporters, Peter Bacon, technical director at a company that supplies a product that helps reduce contamination in dental surgeries said: “We have long understood the risks associated with infections caused by the presence of biofilm in dental unit water lines and have worked to provide an easy to use solution for dentists.”

He added: “This case underpins the duty of care dentists need to demonstrate to patients as well as to the regulatory bodies, to ensure they are minimising risk. This is exactly the reason we offer free, reliable dental unit water assessments to dentists.”

 

Contaminated Dental Surgery Equipment Source of Legionnaire’s Disease Death

posted 2.17.2012 by Steven Heisler

This week’s issue of The Lancet describes a case report of an 82-year-old woman in Italy who died of Legionnaires disease after becoming infected with L pneumophila at her dentist. This case has prompted the authors – led by Dr Maria Luisa Ricci at the Istituto Superiore di Sanità, Rome, Italy, to call for various control measures at dental surgeries to prevent similar incidents.

Suffering with fever and respiratory distress, the woman who was conscious and responsive and had no underlying disease, was admitted in February, 2011, to the intensive care unit of the “G.B. Morgagni-Pierantoni” Hospital, Department of emergency Anaesthesia and Intensive Care Unit, Forlì, Italy.

Results from a chest radiography showed multiple areas of lung consolidation. A Legionella pneumophila urinary antigen test quickly diagnosed the woman with Legionnaires’ disease and she was immediately given oral antibiotics (ciprofloxacin) every 12 hours. However, she sadly died two days later after developing rapid and irreversible septic shock, prompting an investigation to find the source of L pneumophila.

The patient had been at home for the majority of the time during the 2 to 10 day incubation period, leaving only twice to attend dentist appointments.

The investigators took water samples from the dental practice’s tap, the tap and the high-speed turbine of the dental unit waterlines, as well as from the woman’s home (shower and taps) in order to investigate possible L pneumophila contamination. They found that samples from her home tested negative for L pneumophila, but samples from the dental practice tested positive. After laboratory experiments were conducted, results showed genomic matching between L pneumphila in the dental unit waterline and in the women’s respiratory secretion.

L pneumophila is a Gram-negative bacterium found in man-made water systems and is ubiquitous in natural water environments. The bacteria can infect individuals by inhalation or microaspiration of aerosolized water causing Pontiac fever (a flu-like disease) or Legionnaires’ disease (severe pneumonia), mostly affecting immune-compromised patients and the elderly.

Spas, fountains, air-conditioning systems, and hot-water systems, have been demonstrated to be leading sources of infection.

It has been widely documented that dental waterlines are substantially contaminated with Legionella and studies have also demonstrated that the blood of dentists and dental practice staff has a higher prevalence of antibodies to L pneumophila, which indicates that people working in a dental practice environment are potentially at risk. However, prior to this case, the researchers knew no other cases in which Legionnaires’ disease had been linked to this source of infection.

The authors explain:

“The case here shows that the disease can be acquired from a dental unit waterline during routine dental treatment. Aerosolized water from high-speed turbine instruments was most likely the source of the infection. Legionella contamination in dental unit waterlines must be minimized to prevent exposure of patients and staff to the bacterium.

We suggest several control measures: use of anti-stagnation and continuous-circulation water systems; use of sterile water instead of the main water supply in the dental unit waterline; application of discontinuous or continuous disinfecting treatment; daily flushing of all outlets and before each dental treatment; use of filters upstream of the instruments; and annual monitoring of the waterline. Further useful procedures to prevent legionellosis within dental surgeries can be obtained from [already available] dedicated guidelines.”

Original article at: medicalnewstoday.com

 

Family Blames Hospital for Man’s Death from Legionnaires’ Disease

posted 2.9.2012 by Steven Heisler

DAYTON — Miami Valley Hospital is responsible for the death of a 94-year-old Kettering man from Legionnaires’ disease, his family claims in a lawsuit filed Tuesday in Montgomery County Common Pleas Court.

The lawsuit, which includes three other deaths, is the first filed concerning an outbreak of Legionella at the hospital in February 2011, when Charles O. Preston was a patient. Preston’s death certificate states he died March 23 from Legionella pneumonia.

Hospital officials said in March that 11 patients were infected.

It was the largest outbreak in Ohio since 2004, when 13 confirmed or probable cases were reported at a Cuyahoga County worksite. Miami Valley Hospital did report six cases in 2008, 2009 and 2010.

The lawsuit was filed by attorney Dwight Brannon. The families of deceased patients Robert Austin of Springfield and Doris Day of Kettering are also represented. Though their death certificates don’t mention Legionella, medical records and an oral admission by a hospital attorney confirm that they had the infection, according to the complaint.

Additionally, Brannon is seeking information on a patient who died Feb. 21, who also had Legionnaires’ disease, according to the complaint.

A surviving patient, Janis Lowery, is also represented. She “has suffered a significant loss of lung function, other health hazards and emotional distress as a results of contracting Legionnaires’ disease,” the complaint states.

The Dayton Daily News has extensively covered the outbreak and subsequent developments since last March.

The lawsuit names multiple officials with the hospital and Premier Health Partners as defendants, as well as a number of firms involved in the construction of the hospital’s new wing, which opened in December 2010.

Hospital officials said they could not comment on pending litigation and referred calls to attorney Neil Freund, who said on Wednesday that he could not comment.

Preston was hospitalized from Feb. 9 through Feb. 15, 2011, for treatment of severe back pain. He returned to the hospital Feb. 25 with complaints of fever, malaise, fatigue and headache. That same day, he tested positive for the infection.

Preston transferred to Trinity Nursing Home on March 1, then back to the hospital March 15, then returned to the nursing home under the care of Hospice of Dayton, according to the complaint.

Brannon also lists “approximately 127 patients” as unknown plaintiffs, people who were admitted to, treated at or present in the new wing during its first three months of operation, as well as all “visitors, frequenters, invitees, licensees and workmen.”

The complaint claims that the construction was done by a “pre-fabricated method,” in which corridor modules, bathroom pods and patient room headwalls were assembled in leased warehouses two miles away from the hospital.

The defendants performed water pressure tests on those units, then let them sit in the warehouses for months, allowing the Legionella bacteria to develop, the complaint states.

At the time of the outbreak, hospital officials suspected the Legionella bacteria colonized during construction of the $135 million tower. It shut down the patient tower’s water system Feb. 22-25 for sterilization.

Original article at: Dayton Daily News

 

Elderly Man Dies of Legionnaires’ Disease in Howard County

posted 11.8.2011 by Steven Heisler

The Howard County Health Department is reporting the death of an elderly male resident of the Lighthouse Senior Living facility in Ellicott City, Maryland due to Legionnaires’ disease. The death occurred in the past week.

According to Howard County Health Officer Dr. Peter Beilenson, there do not appear to be any other cases among residents at this time.

The Howard County Health Department is working in conjunction with the Maryland Department of Health and Mental Hygiene (DHMH) and Lighthouse Senior Living to assure the safety of other residents at the facility and ensure that appropriate remediation takes place.

Lighthouse Senior Living is an assisted living community with two Maryland locations – Ellicott City in Howard County and Middle River in Baltimore County.

For more information about Legionnaires’ Disease visit the Centers for Disease Control & Prevention (CDC) at www.cdc.gov

Original article on Fox Baltimore

 

Legionnaire’s Disease Kills 1, 2 More Sickened

posted 10.27.2011 by Steven Heisler

PLANT CITY, Fla. (AP) – The health department says one person has died and two others were sickened by Legionnaire’s disease at a mobile home park near Tampa.

The Hillsborough County Health Department says the death occurred Saturday. All three people were residents of a 55-and-older mobile home park in Plant City, a rural town east of Tampa. The health department didn’t release any more information about them except to say they were not relatives and did not live together.

The respiratory disease is spread through water and a water vapor. As a precaution, two swimming pools and two hot tubs at the mobile home complex were closed.

People most at risk for getting the disease are 65 and older, as well as smokers and those who have chronic lung disease.

Original article at WikiNews

 

Redstone Arsenal officials hold town hall on Legionnaires’ disease

posted 8.18.2011 by Steven Heisler

Huntsville, AL (WAFF) – Redstone Arsenal officials are conducting testing in one building for Legionnaires’ disease after a man who worked on base died.

They held a town hall meeting Tuesday for workers who want answers to any questions about Legionnaires’ disease.

A Huntsville man who worked on Redstone Arsenal in the PEO Aviation building died of the disease on August 4th. Several viewers contacted WAFF 48 News after learning the cause of the man’s death.

Legionnaires’ disease can have symptoms like many other forms of pneumonia, so it can be difficult to diagnose.

[Find out more about Legionnaires' disease from CDC]

Because Legionnaires’ is an airborne illness, Redstone officials are testing at the PEO Aviation building. They have not found any traces of the disease in the building so far. They are still waiting on results from a lab.

At a news conference Monday afternoon, officials said that civilian employees can take off work if they don’t feel it’s safe to be in the building.

Officials are also testing several people who are exhibiting upper respiratory problems. So far, there are no positive results for Legionnaires’ among these people.

A Redstone Arsenal spokesman said they are doing everything possible to get the word out to employees about the possible health risk.

WAFF 48 News will continue to track new developments in this story.

Original article at: WAFF.com

 

Richmond Health Center Employee Dies of Legionnaires’ Disease

posted 5.19.2011 by Steven Heisler

Experts are testing the water system at the Richmond Health Center after an employee there died of Legionnaires’ disease.

The center remains open and no other cases of the disease have been identified, said William Walker, director of Contra Costa Health Services.

Test results are expected this week.

Legionnaires’ disease is a pneumonia-like infection that is spread when people breathe in water mist contaminated with Legionella bacteria.

The bacteria, which occur naturally in the environment, live in water and can sometimes be found in hot tubs, air conditioning units in large buildings, decorative fountains, and water systems in cruise ships, hotels and hospitals.

Some people get it from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected.
The disease is not contagious.

Contra Costa County typically has three to 10 cases per year. Nationally, 8,000 to 18,000 people are hospitalized annually with the disease.

It may never be known where the medical records technician at the Richmond Health Center came in contact with the bacteria, Walker said.

But in 2008, after another Richmond Health Center employee became ill with Legionnaires’ disease, tests indicated that water in the health center’s cooling tower may have contained the bacteria.

Since then, the county has disinfected the heating and cooling system in the building regularly, Walker said.

The employee who fell ill in 2008 recovered, as do most people who contract the disease, which can be treated with antibiotics. Some people never have symptoms.

But Legionnaires’ can be fatal in 5 to 30 percent of cases, according to the national Centers for Disease Control and Prevention.

Those who are at greatest risk include smokers, people who have a weakened immune system, those with chronic lung disease, and the elderly.

Legionnaires’ disease can be difficult to diagnose initially because symptoms can be similar to the flu. About two to 10 days after becoming infected, people may develop a fever, chills, cough, muscle aches and headache.

Walker advises anyone with such symptoms to see a doctor.

In the latest round of testing at the Richmond Health Center, Walker said it is likely that some of the water samples will contain the Legionella bacteria because it is commonly found wherever tests occur.

But he stressed that county leaders will take steps to eliminate it and he noted that there have been no other cases of Legionnaires’ disease in the county this year.

“We consider the health center to be safe for both staff and patients,” Walker said.

The health center, which has served West Contra Costa residents since 1967 and sees about 7,000 patients monthly, will soon be replaced by a new, state-of-the-art facility.

On Friday, Rep. George Miller will join county leaders in a groundbreaking ceremony for a $45 million center in San Pablo. The 53,000-square-foot building is expected to be completed by July 2012.

County leaders say the current building, the only one of eight county health centers that has never been replaced, has outlived its usefulness.

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