Hastings hospital Legionella-free after 2 illnesses, 1 death

Officials for Spectrum Health Pennock Hospital and the Barry-Eaton District Health Department (BEDHD) said they successfully removed Legionella bacteria from the Hastings hospital’s water system in Hastings, Michigan.

The water system tested positive for Legionella – the bacteria that causes Legionnaires’ disease – in late December after a Legionnaires’ disease outbreak in which two patients were sickened in three months, and one of them died.

Legionnaires’ disease – also known as legionellosis and Legionella pneumonia – is a severe type of pneumonia (or lung infection) caused by Legionella. The bacteria are contracted by inhaling microscopic water droplets (vapor or mist).

Officials for Spectrum Health Pennock Hospital in Hastings, Michigan, said the hospital’s water system is free from Legionella bacteria. Two cases of Legionnaires’ disease were reported at the hospital, and one victim died.

Hastings hospital:
92-year-old man dies

The Hastings hospital’s water system was tested twice a month in January and February, and all results were clear of Legionella (there is one more test in March). Monthly tests will be performed in April, May, and June, and the BEDHD will continue to monitor results.

The patient who passed away was a 92-year-old man who was diagnosed with Legionnaires’ disease in November. He was treated for the disease, then discharged to a rehab center, where he died from “chronic aspiration pneumonia.”

Dr. J. Daniel Woodall, medical director of BEDHD, said at the time that it’s “not possible to determine if (the patient’s death) was linked to Legionnaires’ disease.”

The other patient was treated for Legionnaires in September and recovered. It’s unknown whether their illness was hospital-acquired.

Hastings hospital:
Remediation underway

After the discovery of Legionella in the water system, bottled water was supplied to patients, staff members, and visitors, and hospital officials installed filters on faucets and showers. In addition, a monochloramine water treatment unit – a disinfecting system combining chlorine and ammonia (known as “chloramine”) – was installed as a long-term solution.

Spectrum Health Pennock officials said they are working with the Michigan Department of Environmental Quality (MDEQ) to obtain the required permits and approvals to operate the secondary treatment system.

“The health and safety of our patients, community, and employees is of utmost importance to us,” Angie Ditmar, Spectrum Health Pennock president, told MLive.com. “We acted quickly when we learned of the problem, and we are committed to making sure the water remains safe and clean.”

A 2015 study by the Centers for Disease Control and Prevention (CDC) stated that “75 percent of (Legionnaires’ disease) acquired in health-care settings could be prevented with better water management.”

Hastings hospital:
High-risk demographics

Most people exposed to Legionella do not get sick, but people 50 and older – especially those who smoke or have chronic lung conditions, such as COPD (most commonly, emphysema or bronchitis) – are at a higher risk of an infection.

Other people more susceptible include:

• organ-transplant recipients
• people on specific drug protocols (for instance, corticosteroids)
• alcoholics.

This list also includes people with an immune system weakened by:

• frequent and recurrent pneumonia, sinus infections, ear infections, meningitis, or skin infections
• organ inflammation and infection
• blood disorders, such as anemia or low platelet counts
• digestive problems, such as cramping, appetite loss, diarrhea, and nausea
• delayed growth and development.

Hastings hospital:
Warm water problematic

According to the CDC, an estimated 25,000 cases of pneumonia due to Legionella bacteria (scientific name: Legionella pneumophila) happen yearly in the U.S. Only 5,000 cases are reported, however, because of the disease’s nonspecific symptoms.

Legionella thrive in warm water, and they are found primarily in human-made environments, such as:

• water systems of large buildings (hospitals, nursing homes, hotels, etc.)
• air-conditioning system cooling towers
• large plumbing systems
• hot-water heaters and tanks
• bathroom showers and faucets
• swimming pools, whirlpools, hot tubs
• physical therapy equipment
• mist machines, like those in the produce sections of grocery stores
• hand-held sprayers
• decorative fountains.

Hastings hospital:
Legionnaires complications

If Legionnaires’ disease is not diagnosed early enough, it can lead to severe complications. After the disease has been diagnosed, hospitalization is often required.

In the most severe cases, complications can occur. Those include:

• endocarditis, which is an infection of the heart’s inner lining that can affect its ability to maintain adequate blood flow through the body.
• kidney failure, which occurs when Legionella toxins damage the kidneys’ ability to eliminate waste from the blood.
• pericarditis, which is a swelling of the pericardium, the primary membrane around the heart. This also can affect the ability of the heart to circulate blood throughout the body.
• respiratory failure, which is caused by changes to the lung tissue, or oxygen loss in arteries supplying the lungs.
• septic shock, which can occur when Legionella toxins enter the bloodstream and cause a drop in blood pressure, leading to a loss of adequate blood supply to the organs.

Although Legionnaires’ disease primarily affects the lungs, it occasionally can cause infections in wounds and elsewhere in the body, including the heart.