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Another person whihc now totals 13 has come down with the deadly Legionnaires’ disease and health officials say the bacteria that causes the deadly respiratory ailment has been found at a second location, a Syracuse nursing home in NY.

So far investigators searching for the potential source of the outbreak have discovered that the Legionella bacteria that causes the illness in the water system of the 526-bed Van Duyn Home and Hospital, said Gary Sauda, the Onondaga County director of environmental health.

Legionnaires’ is a severe form of pneumonia. People become infected by inhaling airborne water droplets that contain the bacteria. It can be fatal if left untreated.

So far one person has died since the outbreak began June 30, although health officials said they have not yet confirmed Legionnaires’ was the cause of the person’s death.

Investigators suspect the outbreak was caused by Legionella bacteria discovered in one of the air conditioning cooling towers at Community General Hospital, but they have not yet proven it. Six of 13 people infected were Community General patients.

In Legionnaires’ outbreaks, people up to two miles away from the source can be infected. The nursing home and hospital are located less than a half mile apart.

The staff at Van Duyn is working with state health department officials to minimize risks to the nursing home’s residents, Sauda said.

On Wednesday, officials at Community General reported that their first effort to kill the Legionella bacteria in its cooling towers two weeks ago did not work. The hospital performed a 24-hour disinfection process July 4. The hospital received test results Tuesday showing the bacteria was still present.

At that point, the hospital had already carried out a second 48-hour disinfection process over the weekend, following federal Centers for Disease Control and Prevention guidelines, said Tom Quinn, the hospital’s president and chief executive officer.

Test results from the second cleaning may not be available for two weeks, he said.

Source

Legionella bacteria was discovered during routine testing in part of the water sytem within the prison in Kent. As a response, the area has been evacuated.

Inmates in one wing of Maidstone Prison were moved to other jails, while blood tests on a prison officers proved negative, the Ministry of Justice said.

Dr Mathi Chandrakumar, from Kent Health Protection Unit, said none of the prisoners had been affected, however further checks are still on-going.

The Prison Officers Association (POA) said over 80 inmates were moved to other jails, some as far as Durham.

A POA spokesman said the bacteria was found in the shower system in one wing.

A spokeswoman for the Ministry of Justice said it was a mild strain of the bug and the evacuation was a precaution for the safety of prisoners and staff.

“The prison is working closely with public heath officials, to ensure the full process is carried out appropriately,” she added.

And she said the wing would be cleaned, sanitised and then mothballed for pre-planned refurbishment in January 2008.

Hospital tests were carried out on a prison officer on Saturday, she added.

“The officer was discharged and returned to work the following day. The tests did not indicate that the officer has Legionella disease,” she said.

Victorian wings

Maidstone MP Ann Widdecombe praised prison officers for acting quickly.

She said the problem stemmed from overcrowded jails.

Speaking to BBC Radio Kent, she said: “I’m not terribly surprised by it.

“I think the prison service acted quickly. They warned me when they thought they had a problem.

“It seemed almost to be five minutes later that they said ‘Right, we’re going to take action’, so I think they’ve handled it properly.”

She added: “The problem is, when you’ve got prisons badly overcrowded as they are at the moment, and you are using what are described as Victorian wings, it isn’t always possible to be using simply appropriate accommodation.”

The prison currently holds nearly 600 inmates in four residential wings and one segregation unit.

Source

A new rapid test that will allow Legionella pneumophila serogroup 1 to be detected within 25 minutes is set to revolutionze the industry. The test developed by 4 Lothian scientists are set to make them a huge fortune after the groundbreaking breakthrough.

Unlike normal routine analysis which takes up to 14 days for a confirmation within a laboratory, this new test only takes 25 minutes. It is similar to the pregnancy style test in application and has a sensitivity level of 100 cfu/mL.

At a cost of £45, the device has the potential to rapidly diagnose the cause and allow specific antibiotics to be administered immediately for treatment.

The test kits were invented by the former research scientist Dr Neil Polwart from the Ministry of Defense who worked on chemical and biological weapon detection.

Dr Polwart, from Polmont, near Falkirk, came up with the idea after his wife, who was employed in the water industry, complained that it could take up two weeks to get legionella confirmed to specie levels by the testing laboratory. The revolutionary test is now set to make millions of pounds for the firm he set up with three colleagues in 2003 called Hydrosense.

The firm is now on course to make more than £500,000 in the US alone in its first year, and has just been launched in the UK. The tests can be used in any sources such as swimming pools and spas, as well as in water cooling towers.

According to the business development manager of Hydrosense, Brendan Cairns, he says “There are around two million tests for legionella carried out every year, so that gives an indication of how useful it could be.”

“It could save lives, because it cuts the waiting time to identify and confirm Legionella pneumophila serogroup 1 which causes the majority of the infections.”

The advantage of the new test is that it is rapid and provides a clear indirect visual indication of the presence of the bacterium which causes over 90% of Legionnaires’ disease deaths. It is the only kit in the world market designed to be used at the sample point.

Dr Giles Edwards, director of the Scottish Legionella Reference Laboratory, said the new product was a step forward.

“If you are investigating an outbreak, or responsible for maintaining a cooling tower, quicker response times will make the job much easier,” he said.

However, Dr Edwards said the test would still require confirmation.

For more information, you can visit Hydrosense or download the pdf file.

Following an inquest into the deaths of 3 people from the Legionella bacteria, it may now become compulsory for results of cooling towers to be made available to health officials.

According to Canterbury’s medical officer of health, Alistair Humphrey who told an inquest looking into three deaths from legionella in winter 2005 says that New Zealand should adopt a compulsory regime on testing and reporting of legionnaire’s disease.

All 3 deaths were part of an outbreak of 19 cases clustered in the southwest of Christchurch, Dr Humphrey told Southland-Central Otago coroner Trevor Savage at the inquest, which is likely to last two days.

“It is appropriate that New Zealand moves to adopt a compulsory regime,” Dr Humphrey said. “It will in my view minimise the risk of another outbreak and will be likely to save lives.”

Attention has centred on the cooling tower at the Ravensdown plant in the suburb of Hornby as a possible source, and the company had lawyer Robert Osborne at today’s hearing.

He asked about gaps in the testing of cooling towers, and reporting of results under the present voluntary regime, and Dr Humphrey agreed it was possible that none of the cases came from the Ravensdown cooling tower.

But Dr Humphrey also said: “Our view is that there is no way you can say none of them came from that point source. Everything pointed to a cluster in the southwest of Christchurch around the plant we are talking about, with what we found to be genetically identical species of legionella.”

He agreed with Mr Osborne that the strain was the ubiquitous Christchurch type of the disease.

Inquiries by health officials during the outbreak turned up 141 cooling towers. Some of the owners or those leasing the buildings had not co-operated by testing and providing results and had to be visited by officials.

It meant there were gaps in the knowledge of what was happening during the April to August outbreak. When tests were done it was not known how many had already used biocide to kill organisms in the cooling systems — a call made by health officials to contain the outbreak.

The inquest is hearing evidence on the deaths of Ross Hern 56, Peter Jones, 48, and Valmai Finlayson, 87, who died of legionnaire’s disease at Christchurch Hospital.

Legionella species are widely found in lakes, rivers, groundwater and soil. The hearing was told it was “generally benign” until it was turned into a mist and spread. This could be through hot water systems, air cooling systems, cooling towers, water spraying devices, water sprinklers, demisters, and spa pools. An Auckland outbreak had been traced to a high pressure hose used in a boat washing operation.

When Ravensdown tested its tower in April, it was found to have a high level of 2400 colony-forming units of legionella. Biocide was used and a later test showed the level was down to 260 units.

Ravensdown provided its results to the health authorities.

Dr Humphrey suggested four changes were needed to tighten testing and reporting procedures for legionella, consistent with requirements in New South Wales, Victoria, and now being considered by South Australia.

He wants local bodies to maintain a register of cooling towers, evaporation condensers, and scrubbing towers. In the 2005 outbreak it took health officials about two weeks to gather information on all these installations from Christchurch City Council records.

He also wants compulsory testing by owners and operators, and compulsory disclosure of the results to local authorities and medical authorities.

He also wants a consistent testing regime between commercial and industrial properties.

Giving evidence this afternoon, a senior technical adviser to the Department of Building and Housing, Bruce Trevor Klein, told the coroner that since 2004 all new buildings with water cooling towers required a building compliance certificate.

Owners were required to test their systems regularly for bacterial organisms.

Cooling towers under the 2004 Act had to be sited away from building air conditioning intake systems.

Building owners must furnish annual documents showing the cooling towers had been tested monthly for legionella bacteria.

Legislation required owners or operators of cooling towers showing a level of legionella bacteria exceeding 1000 colony-forming units (cfus) should notify a medical officer of health within 48 hours.

Test results had to be retained for two years.

Questioned by Mr Savage, Mr Klein said his department would need to investigate whether it would support the mandatory reporting of all water cooler test results to health authorities.

He cautioned against Canterbury Medical Officer of Health Alister Humphrey’s earlier assertion that New Zealand should adopt Australia’s reporting system.

Mr Klein said he understood the Ministry of Health was investigating adopting a system that would require the mandatory reporting of high legionella bacterial counts.

As the law stood now, building owners, cooling tower operators and laboratories had no onus to make such reports available despite having to test regularly and retain results.

Questioned by Donna Blandford, niece of the late Mr Hern, Mr Klein said under the Building Act, cooling tower owners or operators faced fines of up to $200,000 for non-compliance.

He was unaware of any prosecutions.

Source

According to the Leader, Health Authorities were quite about the number of buildings in St George being tested for Legionnaire’s disease.

Air-conditioning cooling towers were being examined in the Kogarah and Rockdale municipalities after two residents contracted the infection.

A man in his early 40s and a woman in her 70s are being treated for the illness in St George Hospital.

The woman was in a serious but stable condition on Monday. The man was listed as being stable.

Legionnaire’s is an infection of the lungs (pneumonia) caused by Legionella bacteria.

It can live in water sources including some air-conditioning systems. The disease can occur when people have breathed in mist from a contaminated cooling tower. The South Eastern Sydney and Illawarra Area Health Service expect to have results of the tests today.

Its public health unit has also been piecing together where the patients had been during the incubation period.

The pair was believed to have contracted the disease between the last week of March and the first week of April.

They were admitted to hospital last week.

Director of Public Health Mark Ferson said local emergency departments, GPs, pathology laboratories and chest and infectious diseases physicians had been warned to be on the lookout for any patients with pneumonia-like symptoms and to test for legionella.

”There have been two cases confirmed and, while this is not an unusually high number, both cases had onset dates around the same time and the patients all live in and frequent the same geographical area,” Professor Ferson said.

”As part of the investigation and response we are working with local council officers.”

Majority of people recover from the illness, however some can become very ill with pneumonia and may die.

A medical epidemiologist from the Public Health Unit, Philippa Binns, would not confirm which buildings had been tested, or how many.
She would also not be drawn on information received by the Leader that the male patient is an employee of a licensed premise in Kogarah which the female patient was believed to have visited.

”The point we do want to make is that people need to be aware of the symptoms and, if concerned, should go to a doctor to get assessed,” Dr Binns said.

Dr Binns said there tended to be more cases at this time of year when the temperature varied and cooling systems were turned off and on.

Councils are required to carry out regular maintenance and testing of cooling towers.

A spokesman for Rockdale Council said the outbreak was not in its area.

A spokesman for Kogarah Council said that there were 12 cooling towers in building towers in its municipality.

Source

The Queensland Health Authority has sent out a notification that two visitors to a Gold Coast resort had been diagnosed with legionnaire’s disease which they had contracted after using the resort’s spa bath.

Michael Whitby from the Australian Medical Association Queensland said the legionella bug was readily found throughout the world in the environment, from Antarctica to jet engine oil, but it was most commonly found in water.

Major outbreaks had occurred in Australia such as the Melbourne Aquarium and majority of cases it has been associated with the cooling towers of large buildings that had not been properly maintained.

“They have a lot of metal fragments which provide iron as a substrate for legionella to grow. For legionella to get into your lungs it has to be in very small particle size so you have to actually spray them out of the air-conditioning system forming aerosols that ends up being inhaled,” Dr Whitby said.

The same applies in a spa where the spray created when water is expelled at high pressure forming aerosols which can make them a potential risk.

According to Linda Selvey, Queensland Health Senior Director of Population Health, “the mist provided a perfect avenue for bugs to make their way into lungs.”

“The big issue with spas is that the water is warmer so it provides a nice environment for bugs to live in,” Dr Selvey said. “Secondly, because you’re forcing air through the pipes at reasonably high pressures to get bubbles, you get a mist of water above the spa pool and you actually acquire legionella infection by breathing in the bugs.”

The ideal way to reduce bacterial growth and prevent infection was to empty spa pools once a month and physically cleans the filters and pipes with sanitizer. This physical scrubbing is critical to removing biofilms which can protect the organism during harsh environmental conditions.

There are several types of legionella, but the two that occur most commonly here are Legionella pneumophilia type 1 and legionella longbeachae. To find out if your spa is contaminated with legionella it is best to have the water them tested by Independant Microbiology Consultants which are NATA accredited and are experts in the field.

The cooling towers of an Uluru hotel have tested positive for legionella and may be the source of infection for a European tourist who has legionnaires’ disease.

A spokesman for Voyages Hotels and Resorts, which owns the Desert Gardens Hotel near Uluru, said routine testing of the cooling towers carried out last week returned a positive legionella reading.

The towers were in an area adjacent to the hotel.

“We were advised on Friday that a European male tourist has contracted legionnaires’ disease on a recent visit to Australia,” the spokesman said.

“He stayed in a number of different locations but one was the Desert Gardens Hotel.”

He said that at this stage there was no evidence the two events were linked, but further testing would be done to establish whether the strain found in the cooling towers was the same as that contracted by the tourist.

“We are working with the Department of Health to establish whether we can match the two,” he said.

“We have identified the person’s doctor and are trying to get in contact with that person … to do the matching.”

All staff and visitors to the hotel between February 20 and March 14 this year were being contacted to advise them of the test findings.

The spokesman said staff were more likely to have been exposed to any danger, as the cooling towers were in an area not regularly frequented by guests.

The cooling tower system in question had been closed off and decontaminated, and the hotel was awaiting the results of new tests to give the all clear.

“In the meantime, it’s off limits to all people,” the spokesman said.

He defended the hotel’s maintenance routine, saying testing of cooling towers was not mandatory in the Northern Territory.

“We test ours every month, without fail,” he said.

Source: The Age

Legionella was detected in a New Zealand Hospital in Christchurch. Health officials say the office-type water cooler filter may be the first case of its type in the world.

They are warning businesses to test office water cooler filters after the find.

Microbiological testing was done at the hospital last October after a patient showed symptoms of legionnaire’s disease and one of 14 office-style water coolers was found to have a “significant level” of legionella bacteria in a filter.

Canterbury District Health Board spokeswoman Michele Hider said the bacteria found in the water filter was different to the type that had affected the female patient and the testing had been done as a precaution. There was no evidence to suggest the water cooler was linked to any hospital patients or visitors becoming unwell.

The hospital acted as soon as the results were confirmed by removing the filter. The filter still had some months to go before its expiry date.

Canterbury medical officer of health Mel Brieseman said office water coolers and drinking water filters were not usually checked for legionella because the disease was generally contracted through aerosol spray.

“We believe this is the first case of significant levels of legionella being detected in a drinking water cooler anywhere in the world, so we will be publishing the findings as a scientific curiosity,” he said.

Dr Briesman warned that water filters needed to be changed regularly to prevent a build-up of a variety of bacteria, including legionella.

It was “standard advice” for people to use masks and gloves when handling potting mix to prevent legionellosis.

Small amounts of legionella occurred naturally in all untreated water supplies but could multiply to potentially harmful levels in the right conditions.

However, Dr Brieseman said the risk of ill health from drinking water containing significant amounts of legionella was considered low, compared with inhaling the bacteria as mist or steam.

Source

According to the Sydney Morning Herald, the source of the Legionella outbreak has been linked to the Royal Automobile Club (RAC) building in Macquarie Street. The link is still to be confirmed.

It is interesting what they said a few days ago when the possible source could have been eliminated as the infection occurred around the New Year period. Since then the regular cleaning would have eliminated the source. It looks like there going to be a surge of Legionlla testing this year.

Anyhow here’s what they write:

“Seven cases of the potentially fatal disease have been reported in NSW this month, including six patients who were in the Circular Quay area on New Year’s Eve.

Outbreaks are usually associated with readings above 1,000.”

One of the 25 cooling towers near Sydney’s Circular Quay has been disinfected and will be sterilised after low risk traces of the bacteria causing legionnaires’ disease were discovered.

Seven cases of the potentially fatal legionnaires’ disease have been reported in NSW this month, including six patients who were in the Circular Quay area on New Year’s Eve.

The results from tests on another 21 towers in the area will be known in the next two days, while the remaining three cooling units will be tested early this week.

Professor Mark Ferson from NSW Health said the overall results would provide authorities with a much clearer indication of the role played by the Circular Quay towers in the outbreak, but he doubted there was a link.

“That may help us but it’s actually quite uncommon to find a proven link between a cooling tower and an outbreak of legionnaires’ disease,” Prof Ferson said.

“I don’t think we know yet whether the two events are related.”

The towers were tested by an independent laboratory last week, with the unit at Customs House registering a reading of 200 colony-forming units per millilitre, a category considered by the Department of Health to be of low risk to public health.

Outbreaks are usually associated with readings above 1,000.

Three new cases were reported this weekend, with one man in his 50s in intensive care at a Sydney hospital, although his case is not believed to be linked with Circular Quay.

The two other patients, a woman in her 40s and a man in his 50s, have both told authorities they were in Circular Quay on December 31.

Four other men who were in the same area on New Year’s Eve were diagnosed with the disease earlier last week.

Source: SMH