Ochsner Medical Center Legionnaires outbreak: two ill in New Orleans

Two patients at Ochsner Medical Center in New Orleans were diagnosed with Legionnaires’ disease, Ochsner Health System (OHS) officials announced. No other information was released on the patients.

“Preliminary environmental test results detected Legionella bacteria at OMC–Jefferson Highway,” according to a statement released by the OHS on its website. “The cultures obtained lead us to believe the bacteria were from isolated fixtures and not in our water system.”

The statement also emphasized: “These cases have not been confirmed to have been acquired at OMC–Jefferson Highway.”

Officials said precautions have been put in place at the hospital (1514 Jefferson Highway), including:

• Extensive water testing is in progress and will be ongoing for at least one year. Hospital officials said tests are performed routinely as part of the water-management plan.
• OMC-Jefferson Highway is implementing a response plan to remove all bacteria from the water system.
• The rooms in which the patients received care have been removed from service.
• The hospital is augmenting its mechanical water delivery systems.
• The Infection Prevention department will assess all high-risk patients for Legionella and recommend additional testing when appropriate.
• The Office of Public Health has been brought in to provide both resources and expertise.

Ochsner Medical Center Legionnaires outbreak:
Is stagnant water to blame?

Legionella bacteria is contracted by inhaling microscopic water droplets in the form of mist or vapor. The bacteria thrive in warm water, and they are found primarily in human-made environments, such as:

• water systems of large buildings, such as hospitals, nursing homes, and hotels, to name just a few
• large plumbing systems
• hot-water heaters and tanks
• bathroom showers and faucets
• physical-therapy equipment
• whirlpools, hot tubs, and swimming pools
• air-conditioning system cooling towers
• mist machines and hand-held sprayers
• decorative fountains.

The Occupational Safety and Health Administration (OSHA) says that warm, stagnant water provides the right conditions for growth of Legionella. The bacteria can multiply between 68 degrees and 122 degrees Fahrenheit, and temperatures of 90 degrees to 105 degrees are optimal for that to occur.

Meanwhile, 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.”

Two patients have been sickened in an Ochsner Medical Center Legionnaires outbreak in New Orleans. Officials said Legionella was detected in the hospital’s water system.

Ochsner Medical Center Legionnaires outbreak:
Feeling ill? See a doctor

Legionnaires’ disease often is overlooked or undiagnosed, leading to it being underreported, according to the CDC. For that reason, current and recent patients, visitors, and employees of OMC–Jefferson Highway are being advised to see their health-care provider if they are feeling flu- or pneumonia-like symptoms.

For Legionnaires’ disease to be classified correctly, specific testing and diagnosis must be done, and those tests often are not ordered. It is not required for physicians to order Legionella-specific testing when a patient presents with pneumonia.

Ochsner Medical Center Legionnaires outbreak:
Symptoms are numerous

Legionnaires’ disease usually begins with the following symptoms:

• severe headaches
• muscle aches
• fever, which can be 104 degrees Fahrenheit or higher, and chills.

By Day 2 or 3, symptoms can worsen to include:

• coughing, which can produce mucus or blood
• shortness of breath (dyspnea)
• chest pains (pleurisy, pleuritis, pleuritic chest pains)
• gastrointestinal symptoms, such as nausea, diarrhea, and vomiting
• mental changes, most prominently confusion.

Legionellosis is the collective term for the two diseases caused by Legionella bacteria: Legionnaires’ disease, which is also called Legionella pneumonia, and Pontiac fever, which does not affect the lungs and is much less severe. Although Legionnaires’ disease primarily affects the lungs, it can cause infections elsewhere in the body, including the heart.

Ochsner Medical Center Legionnaires outbreak:
Legionella and Louisiana

• About 31 legionellosis cases have been reported in the state since 2008, according to the 2018 Louisiana Health Report Card produced by the state health department.
• In 1989, there was a Legionnaires’ disease outbreak in Bogalusa that resulted in 33 illnesses, including eight deaths. The source was a grocery store’s misting device, which created a fine mist that was more easily inhaled than the larger droplets put out by standard mist machines. State health officials said it was the first known outbreak linked to a misting device.