Two Legionella cases at a Brisbane hospital prompts investigation
With reports of two recent Legionella infections, with one patient dying and the other in ICU, at a Brisbane hospital, Queensland Health have opened a formal investigation to determine whether changes need to be made to existing regulations, according to a media statement Friday.
A 60-year-old man, reportedly with underlying medical conditions (cancer), died at the hospital on Sunday and a second patient, a woman, has also contracted the disease. She is currently in intensive care.
Image/CIA
This has prompted Wesley Hospital in Brisbane to contact some 1400 past patients who were at the hospital from May 25, according to a TV NZ.com report.
“We are trying to get into contact with 1400 former patients who have been in the hospital during the incubation period,” Richard Royce, executive director of UnitingCare Health, operators of the Wesley Hospital said.
Queensland’s Chief Health Officer Dr Jeannette Young said the investigation has begun gathering information and will result in advice to the Minister that may alter health and water treatment legislation in Queensland.
“All aspects of the handling of these two cases at the Wesley will be subject to a detailed and exhaustive investigation and the findings will be tabled in Parliament. “I’m unable to speculate when that might happen until the full scope of this investigation is finalized next week.”
The investigation will include among other things, whether initial pathology results from the first Legionella case at the Wesley Hospital were communicated to Queensland Health in a timely manner and whether scheduled testing and treatment of hot water systems in public and private hospitals should be enforced through legislation.
What is Legionnaires’ disease?
Legionnaires’ disease gained national notoriety in 1976 when the Centers for Disease Control and Prevention (CDC) discovered it during an epidemic of pneumonia among American legion members at a convention in Philadelphia.
Legionella Image/CDC
The causative organism is the bacteria, Legionella pneumophila. Other species have also been implicated in Legionnaires’ disease. The legionella bacteria are found throughout nature, because of this most people become exposed to it but few develop symptoms.
The primary place in nature it’s found is water sources particularly at warmer temperatures; lakes, rivers and moist soil.
It is also found in man-made facilities (frequently the source of outbreaks) such as air-conditioning ducts and cooling towers, humidifiers,whirlpools and hospital equipment.
People get exposed through inhaling infectious aerosols from these water sources. There is no transmission from person to person.
The infection can appear in two clinical forms: Legionnaires’ disease and Pontiac fever.
Both conditions are typified by headache, fever, body aches and occasionally abdominal pain and diarrhea.
Legionnaires’ disease is the cause of pneumonia where a non productive cough is typical. Fatality rates of this form of the infection are around 15 % even with improvements in treatment.
Pontiac fever is a self limiting flu-like illness that does not progress to pneumonia or death. Diagnosis is usually made by typical symptoms in a outbreak setting.
Diagnosis of Legionnaires’ disease depends on identifying the bacteria in microbiological culture, detecting the antigen in urine samples or a fourfold increase in antibody titer.
Certain health conditions make you more susceptible to infection to include increasing age, smoking, chronic lung disease, malignancy and diabetes mellitus.
Legionnaires’ disease is treatable with antibiotics.
To following things can be done as preventive measures: cooling towers should be drained when not in use and cleaned to remove scale and sediment and biocides can be used to limit bacterial growth. Tap water should not be used in respiratory therapy devices.
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