UW Health not only hospital system battling Legionella

The University Hospital Legionnaires’ disease outbreak in Madison, Wisconsin, has been making headlines for a month, but the UW Health hospital is not the only one in the news.

Legionella bacteria, which causes Legionnaires’ disease, was found during a New York State Department of Health inspection of the water system at New York-Presbyterian Brooklyn Methodist Hospital in the Park Slope neighborhood.

“The water supply of many large buildings and hospitals often contains small amounts of Legionella bacteria, and most people who are exposed to Legionella will not become ill,” a hospital spokesperson said. “If Legionella does cause an infection, it is treatable with antibiotics and does not generally pose a threat to the public.”

To be safe, hospital officials said they put in water restrictions and took steps to disinfect the water sources. In addition, the Department of Health is working with hospital officials to investigate.

Legionella was found during a New York State Department of Health inspection of the water system at New York-Presbyterian Brooklyn Methodist Hospital. In Madison, Wisconsin, UW Health has been battling a Legionnaires’ disease outbreak for the past two months.

UW Health: three dead in outbreak

As of Dec. 21, 14 cases of Legionnaires’ disease had been identified at University Hospital, and three patients have passed away. A UW Health statement said that all three patients who died had “serious, life-limiting health conditions.”

Additionally, test results confirmed that the Legionella strain in three patients was identical to the Legionella strain found in University Hospital’s water system. The other 11 patients did not provide samples for testing.

UW Health: chlorine working

The Wisconsin Department of Health Services (DHS) website states that the investigation of University Hospital is ongoing. Meanwhile, hospital officials said they have flushed the water system with high levels of chlorine to eliminate Legionella.

“Testing completed so far continues to show the expected reduction in the bacteria,” a statement read. “UW Health will continue intensive monitoring of its water system to ensure patient safety.”

UW Health: outbreak timeline

The DHS was notified Nov. 28 by UW Health of confirmed cases of Legionnaires’ disease among patients admitted to University Hospital since Oct. 31. At that time, UW Health officials attributed the outbreak to a change in the hospital’s hot-water system.

“The flow was altered in the system,” Nasia Safdar, medical director of infection control for UW Health, said. “So, instead of being at a consistent high flow, it was altered to be more flexible to be on demand.”

On Nov. 29, UW Health officials announced a fifth case as well as the first fatality. The case count was subsequently increased to 11 in early December, and on Dec. 18, it rose to 14 with two more deaths being reported.

UW Health: difficult diagnosis

The Centers for Disease Control and Prevention (CDC) estimates about 25,000 annual cases of pneumonia due to Legionella bacteria (Legionella pneumophila). Only 5,000 cases are reported, however, because of the disease’s nonspecific signs and symptoms.

Legionnaires’ disease – which is also known as legionellosis and Legionella pneumonia – is treatable with antibiotics if diagnosed early. If that does not occur, however, severe complications can develop, and the disease can become deadly, as evidenced by the UW Health outbreak.

UW Health: symptoms

Legionella can produce Legionnaires’ disease from two to 10 days after exposure, and symptoms generally begin with:

• headaches
• muscle aches
• fever, which can be 104 degrees Fahrenheit or greater
• chills.

By day 2 or 3, symptoms can worsen and include:

• coughing, which can bring up mucus or blood
• dyspnea (shortness of breath)
• pleuritic chest pain, or pleurisy, which results when the lungs’ lining is inflamed
• gastrointestinal symptoms such as diarrhea, nausea, and vomiting
• mental confusion.