Suspected Legionnaires’ disease case in ECMC patient leads to water restrictions

Suspected Legionnaires’ disease in a patient at Erie County Medical Center prompted testing that found slightly elevated levels of Legionella bacteria in the hospital’s water system.

The Grider Street hospital late last week began imposing temporary water-use restrictions as a result.

It’s not clear how the patient, diagnosed about one week ago, developed the disease — whether the patient came into the hospital already sick with it or whether there is a link to the water system, said Peter Cutler, the hospital’s vice president for communications and external affairs.

“So far, it’s a case of unknown origin,” he said.

The hospital tested for the bacterium in 12 locations at the medical center and found slightly elevated levels in three of them, he said, leading officials to impose the restrictions on the use of tap water.

“We put the water restrictions in place out of an abundance of caution,” he said.

The medical center also has been installing filters on faucets, shower heads and ice machines, as well as distributing bottled water throughout the facility. It’s skilled nursing facility, Terrace View, relies on a different water system and was unaffected.

Hospital workers received notices to avoid using tap water starting on Sept. 29, Cutler said.

Legionnaires’ disease is caused by a type of bacterium called Legionella that is named after a 1976 outbreak at a Philadelphia convention of the American Legion at which 29 attendees died from the illness.

Legionellosis is a bacterial disease associated with two distinct illnesses: Pontiac fever, an influenza-like illness, and Legionnaires’ disease, a severe type of pneumonia. People can get Legionnaires’ disease when they breathe in small droplets of water in the air that contain the bacteria, which can thrive in warm water.

Most healthy people exposed to Legionella don’t get sick, according to the federal Centers for Disease Control and Prevention, which received about 6,000 reports of the disease nationwide in 2015. But the disease, which is treatable, can pose serious risks to those with increased risks, such as the elderly, those with lung disease, and patients with weak immune systems.

There were 63 reported cases in Erie County in 2015.

The ECMC patient is in stable condition, Cutler said. He said hospital operations have not been affected.

The medical center, in a project unrelated to the situation, is in the process of replacing its water tank system.

CDC Report Looks At Legionnaires’ Disease In Healthcare

About 3% of Legionnaires’ disease cases were determined to be “definitely associated with a healthcare facility,” with 17% of cases listed as “possibly associated.”

More than 76% of Legionnaires’ disease cases acquired from Legionella exposure in healthcare facilities can be particularly harsh, including possible fatal risks to patients, according to a report released today from the Centers for Disease Control and Prevention (CDC). Legionnaires’ disease is a serious type of pneumonia caused by bacteria, called Legionella, that lives in water. Legionella can make people sick when they inhale contaminated water from building water systems that are not adequately maintained.

Image: CDC

The report’s findings, which were a part of the CDC’s monthly Vitalsigns publication, are based upon exposure data from 20 states and New York City. According to the CDC, the analysis was limited to these 21 jurisdictions because they reported exposure details for most of their cases, which allowed the CDC to determine how Legionnaires’ disease was associated with healthcare facilities.

About 3% of Legionnaires’ disease cases were determined to be “definitely associated with a healthcare facility,” with 17% of cases listed as “possibly associated with a healthcare facility.”

“Determining Legionnaire’s disease causation is not simple since the mere presence of Legionella in a water system or device is not sufficient to cause disease. The bacteria must ultimately be inhaled or aspirated into the lungs of a susceptible person to cause disease,” says Michael Patton, member of ASHRAE Committee SSPC 188. “Since people with conditions that have reduced their ability to fight off infections are especially susceptible, it is not a surprise the report found patients in healthcare facilities to be at risk. It’s vitally important all buildings incorporate good design, operations, and maintenance procedures that prevent growth and spread of Legionella as these are regarded as the best methods of preventing disease.”

The incorporation of a Water Management Plan will reduce the chance of heavy colonization, amplification, and dissemination to people. With this in mind, ASHRAE developed ASHRAE Standard 188: Legionellosis: Risk Management for Building Water Systems to assist designers and building operators in developing a Water Management Plan that includes practices specific to the systems that exist in a particular building, campus, or healthcare facility. (ASHRAE Standard 188 can be previewed at no cost on the ASHRAE website.

Based upon this ASHRAE standard, the CDC developed a toolkit entitled “Developing a Water Management Program to Reduce Legionella Growth and Spread in Buildings: A Practical Guide to Implementing Industry Standards.” The document (initially released in 2016 and updated on June 5, 2017) provides a checklist for facility owners and managers to help identify if a water management program is needed, examples to help identify where Legionella could grow and spread in a building and ways to reduce risk the of contamination

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Legionella found in Harrison Medical Center after patient contracts Legionnaires’ disease

Employees at Harrison Medical Center in Bremerton, Wash., are working to eliminate Legionella bacteria from the hospital’s water supply after a patient contracted Legionnaires’ disease — a virulent type of pneumonia — in December, according to a report from the Kitsap Sun.

After confirming the Legionnaires’ case, the Washington State Department of Health, Kitsap Public Health District and workers at the hospital conducted an investigation to determine the source of infection. Samples extracted from the hospital’s water system in January tested positive for Legionella. On Feb. 3, Kitsap health officials issued an order to the hospital to address the health risk. The order contained recommendations, which the hospital is following.

The hospital’s parent company, Tacoma, Wash.-based CHI Franciscan Health, issued a statement saying hospital staff, patients and visitors are being provided bottled water until the issue is resolved.

“CHI Franciscan Health and Harrison Medial Center implement rigorous safety protocols above and beyond government and industry standards to keep our patients and staff safe,” said David Schultz, market president of the Peninsula Region at CHI Franciscan Health, in a statement provided to Becker’s. “When we detected Legionella pneumophila, we immediately contacted county and state health authorities and began an investigation to find the source with an intention to eradicate it. There is no indication of any threat to the public or patients at Harrison.”

No additional cases of Legionnaires’ disease have been reported at the hospital.

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Mold Growth: Keeping your home safe

best mold testing companiesMold, The Hidden Danger

We all love our comfortable safe homes. That place we gather with our families and loved ones after long hectic days. The place that keeps us sheltered from the elements. In the hustle and bustle of our daily lives sometimes we are so busy we can overlook little hidden dangers. Small spots of water, little leaks and even our sponges and countertops. These are the obvious places where mold can grow, however there are other more hidden places where mold growth cannot as easily be seen and most homeowners won’t notice until there is an odor or moldy patches start to appear.
Molds can spread fast and usually grow in the span of 24-72 hours. They feed on dry wall, wood and any other organic material inside the house. For this reason it can be a huge threat to us and our families if we do not take it seriously. No one wants to live in a house full of molds and the hazards they can create.
Mold can put our health at risk. After lots of researches, it has been found that too much exposure to molds can create health problems, especially in the upper respiratory system. Infants, children and the elderly are at a greater risk due to their immune systems and can be easily infected when exposed to molds. Those people currently suffering from a respiratory ailment can suffer even more severe health problems. The results from mold exposure vary widely but can include:
• Asthma
• Flu like symptoms
• Itching
• Hypersensitivity
• Depression
• Pulmonary injury
• Neurotoxicity
• Hematologic and immunologic disorders
• Hepatic, endocrine and/or renal toxicities
• Pregnancy, gastrointestinal and/or cardiac conditions
• Cancer
There is also a certain type of mold namely, “Stachybotrys” which can start with the simple itchiness of your eyes, sneezing, cough which if not checked and diagnosed, could possibly damage your lungs permanently, which could eventually end in death. This is only likely to occur in the most extreme cases but why would you want to put your family at any unnecessary risk.

It can destroy everything inside the house. Little by little, if not dealt with mold can destroy every part of the home. It does not discriminate between your important documents, frames, ceilings, wood beams, floors or furniture. These microscopic organisms will destroy it all. We may not be able to notice it at first glance, but later on when the mold patches are visible, the harm it has caused to your home is already evident. Mold generally starts from a small spore that then grows into clusters. These clusters can spread easily if not discovered early.
We cannot say whether our home is mold-free or not if our home does not undergo a home inspection. Home maintenance is an essential procedure in making sure that there is no mold growth in our home. There are professional mold inspectors available who will gladly come out and test your home. Having this done can help guarantee your home is safe, and that your family is living in a heathy environment. It is always better to let the professionals handle our concerns before it becomes a serious problem putting ourselves at risk.
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Mold Growth: Keeping your home safe

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PCBs in our Malibu Schools

MALIBU, Calif. | PCBs The high school here is ranked among the best in the country, with students each year moving on to Ivy League colleges. The location, on a hill down the block from the beach where “Baywatch” was filmed, offers a multimillion-dollar view of the Pacific Ocean.

Yet parents here have been yanking their children out of Malibu High School, concerned about PCBs, the highly toxic chemical compounds, that have been found in caulking of the school’s windows.

A battle over how to handle the PCBs, which were first discovered three years ago, is now convulsing this famously wealthy beach community, with parents, television stars and a supermodel pitted against one of the most elite public school districts in the country.

The Santa Monica-Malibu Unified School District insists that its classrooms are safe; the Environmental Protection Agency agrees.PCBs in Malibu School Buildings

But not all parents and teachers are convinced: They blame PCBs for an array of maladies, including migraines, thyroid cancer and common colds, and they have sued to compel the district to remove all contaminated caulking. A judge ruled last week that the lawsuit could move forward.

In the meantime, school board meetings have turned chaotic, with parents shouting down district officials and calling them liars.

“The school district is telling us our kids are safe, but that’s what they were telling parents in Flint, Mich.,” said Jennifer deNicola, a mother of an eighth grader and a 10th grader who has spearheaded the push to remove PCBs. “We know there’s a problem, and they refuse to acknowledge it.”

But school and health officials insist that simply because PCBs are in the building materials does not mean the students are at risk of exposure. The school district tests the air in classrooms — the primary medium through which children could be exposed — and cleans regularly to reduce dust from the caulking, school officials said.

“Just because something is present doesn’t mean it can cause harm,” said Doug Daugherty, a managing principal at Ramboll Environ, the environmental consulting firm the district has hired.

The district has already spent millions of dollars on lawyers, environmental consultants and a public-relations campaign.

But, this being Malibu, parents have waged their own media campaign, complete with environmental experts and celebrity advocates. Cindy Crawford, the supermodel, has gone on national television to explain why she pulled her two children from Malibu High, and offered to pay to test caulking for PCBs throughout the campus, which also includes an elementary school and a middle school. (Her offer was declined.)

PCBs, or polychlorinated biphenyls, were widely used in building materials and electronics until they were banned in the late 1970s, and they remain in many older buildings. Research from the Harvard School of Public Health estimated that the substances could be present in upward of 20,000 schools nationwide. The compounds have been linked to cancer, immune problems and lower I.Q.s among children.

Federal law requires that any building materials found to contain PCBs be removed. But to the chagrin of parents here, there was no requirement to test the caulking in the first place.
Jennifer deNicola, a mother of two who has spearheaded the push to have PCBs removed, with her daughter Sami, 13, whom she is now home-schooling. Credit Monica Almeida/The New York Times

The E.P.A. has endorsed the district’s approach to handling the PCBs in its buildings. And scientists who studied PCBs in New York City schools said this method — of testing air quality and cleaning assiduously — was very effective.

Laurie Lieberman, the president of the Santa Monica-Malibu Unified school board, said the administration had confidence in the safety of its facilities and has been doing its best to reassure parents.

“We have tremendous empathy for people who are fearful and scared,” Ms. Lieberman said. “We’ve really tried to explain why the schools are safe now.”

Malibu parents have a history of skepticism about official health advice, including routine childhood vaccinations: At some local elementary schools in 2014, fewer than 60 percent of kindergarten students had received the full lineup of recommended vaccines, far below the state average.

In this case, the distrust on both sides became plain last fall, when supporters of caulking removal secretly took their own samples from classrooms and had them independently tested. Ms. deNicola announced that the results showed extraordinarily high levels of PCBs. The school district asked the sheriff’s office to investigate her for trespassing and vandalism.

The battle now threatens to tear apart the school district: Concern over PCBs has fueled an existing effort here to break away from Santa Monica so that Malibu can be in control of its own schools.

Beth Lucas, a parent, pulled her son, Christian, out of Malibu High after their endocrinologist said it was especially dangerous for him to remain there. Christian, now 17, had a malignant brain tumor at age 6, and the radiation used to treat it left him with a diminished immune system and thus more vulnerable to the effects of PCBs, the doctor told the family.

“We moved to Malibu for the schools, so it has been a big slap in the face to have the school district treat the parents and teachers and children so poorly,” Ms. Lucas said. She is also considering removing her daughter, who is in middle school, at the end of the year, but worried about the cost of private school.

“Yes, we live in this nice house,” she said, sitting on a hilltop porch that overlooked a wide expanse of ocean. “I don’t want to have to sell my house and leave Malibu. The district has put us in a horrible position.”

Currently, only one of the seven school board members represents Malibu. He supports replacing the caulking, but has been voted down by board members who live in Santa Monica.

“I think the board members have convinced themselves that the science is right and the parents are overreacting,” said Craig Foster, Malibu’s representative on the school board, and the father of a seventh grader at the middle school here. “But what if in five years it turns out testing the air and dust wasn’t enough? How do you sleep?”

Some other school districts across the country have acted more aggressively, often at the E.P.A.’s behest, to remove the source of PCBs. Parents here point to Clark Elementary School in Hartford as an example of a school district that handled matters responsibly: In that case, an entire school building was closed — and may be abandoned — because of PCB contamination.

But testing at Clark Elementary indicated elevated levels of PCBs in the air, whereas testing at Malibu High has not, E.P.A. officials said.

Jim Jones, an assistant administrator at the E.P.A., said the agency worked with schools to “get below the risk threshold using the best management practices.”

“We’re always trying to find what’s a cheaper way,” Mr. Jones said, adding that the caulking at Malibu High would all be replaced within several years as part of planned renovations. For now, he said, cleaning and ventilation are “far less costly than removal.”

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Santa Monica – Malibu Union School District

CDC – Puerto Rico Zika Virus Outbreak


Puerto Rico may be on the brink of a massive outbreak of Zika, a mosquito-borne virus which has been linked to birth defects, and cash is urgently needed, warned US health authorities on Thursday.

Tom Frieden, the chief of the US Centers for Disease Control, told reporters on a conference call that he had just returned from a visit to the US island territory, and was worried by what he had seen.

“Puerto Rico is on the front lines of the battle against Zika and it is an uphill battle,” said Frieden.

“I am very concerned that before the year is out there could be hundreds of thousands of Zika infections in Puerto Rico and thousands of infected pregnant women,” he added.

“The rainy season is around the corner and funding from Congress is urgently needed,” said Frieden.

The virus has already swept through Brazil, where thousands of babies have been born with microcephaly, a defect in which the head is unusually small.

Some microcephaly cases have been directly linked to infection with Zika virus while the mother was pregnant.

While researchers caution that Zika has not yet been proven to cause birth defects, evidence so far strongly suggests the possibility.

Frieden also said a link between Zika and Guillan Barre syndrome — in which the immune system attacks the nervous system — “is likely to be proven in the near future.”

Efforts to control mosquitoes have been further complicated by the discovery that some common repellants are not working.

“We are finding widespread resistance to some insecticides,” said Frieden.

– ‘Unmet’ needs –

Other top concerns listed by Frieden include the lack of access to contraception in Puerto Rico, a Caribbean island with some 3.5 million inhabitants.

Last month, the island territory declared a health emergency due to the Zika virus, which can be transmitted by sexual contact as well as by mosquitoes.

Health experts have urged women who want to become pregnant or who are pregnant to avoid travel to the more than 30 areas of the world where Zika is present — or if they live there, to postpone plans to get pregnant if possible.

Men are urged to use condoms, or refrain from sex with pregnant partners.

“Never before have we had a mosquito-borne infection that could cause birth defects on a large scale,” said Frieden.

“Most of the pregnancies in Puerto Rico are unplanned, unintended and there is an unmet need for contraception.”

The latest figures, released in February, showed that Puerto Rico has documented 22 cases of Zika. Updated figures are expected on Friday, Frieden said.

Health authorities anticipate “the number of cases in Puerto Rico at some point beginning to increase not steadily but dramatically,” he said.

– Rainy season –

There is no vaccine to prevent Zika, and in four out of five cases, the infection shows no symptoms. Otherwise, it may cause fever, rash and red eyes.

Speaking to reporters on the same call, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, said early vaccine trials may get under way by late summer or early fall, but reiterated that it will likely be years before an effective vaccine is widely available.

Some 100 CDC staff are working in Puerto Rico, as part of 750 CDC workers assigned to work on the Zika virus, Frieden said.

“There is nothing about Zika control that is quick or easy,” he added.

“The only thing quick is the mosquito bite that can give it to you. And the only thing easy are wrong answers.”