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VA Pittsburgh testing sickened workers for Legionnaires connection

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By Adam Smeltz
Monday, Dec. 3, 2012, 6:00 p.m.
 

Three workers at the VA Pittsburgh Healthcare System hospital in Oakland contracted pneumonia within the past several weeks, though it's not clear whether their illnesses resulted from the fatal Legionnaires' outbreak there, a union leader said on Monday.

A fourth worker at the VA's University Drive Campus reported respiratory problems, according to AFGE Local 2028 President Kathi Dahl.

She referred the employees for testing in the VA employee-health unit, which could determine whether they contracted pneumonia within the hospital, she said. All four recovered and returned to work.

VA spokesman David Cowgill would not comment on the employees' illnesses. Dahl said one worker missed six weeks of work and another missed four weeks.

“It's not real clear to the union when knowledge of this” outbreak first reached VA leaders, said Dahl, whose union represents several hundred workers in the Oakland hospital. She said she learned of the problem in late November.

Five hospital patients became ill — and one died — from Legionnaires' disease, a form of pneumonia. Four recovered, Cowgill has said.

The VA made the outbreak public on Nov. 16, suggesting a water-treatment system may not have been as effective as once thought.

Cowgill would not say when the hospital reported the initial Legionnaires' cases. A state health official said he could not specify those dates, citing an open investigation that includes the Centers for Disease Control and Prevention in Atlanta and the Allegheny County Health Department.

The CDC referred questions to the VA, pending the completion of an investigative report.

CDC officials shared recommendations with the VA, spokesman Thomas Skinner said. Cowgill would not discuss them.

About two months ago, the VA alerted county health officials to two Legionnaires' cases at the University Drive Campus, according to Dr. Ron Voorhees, the acting county health director.

At the time, VA staff thought the cases were unlikely to have originated inside the facility, he said. Tests proved otherwise, illustrating the cases were part of the outbreak.

“It should have never happened in the first place. If we're serving our veterans, we need to make sure that all our loose ends are tied up,” said Matt Mahoney, development manager at the nonprofit Veterans Leadership Program of Western Pennsylvania.

He called the outbreak “a prime example of the VA not meeting the individual needs of each veteran.”

“I'm hopeful this will be a wake-up call for the VA to understand it's not the amount of money placed in the infrastructure. It's the investment made in the people who care for our veterans,” Mahoney said.

Even one case of Legionnaires' disease in a hospital should “trigger a questioning period” to determine whether “something could be handled better or differently,” said Dr. Bruce W. Dixon, the former county health director.

The cases reported two months ago should have prompted the VA to scour the Oakland facility immediately for potential sources, Dixon said. He said identifying Legionella in a water system typically takes 10 days to two weeks.

Cowgill would not discuss the VA's response.

“I think everybody could have been a bit swifter at the beginning. But having known about it, they've done all the appropriate things, I think,” Dixon said.

U.S. Sen. Bob Casey Jr., D-Scranton, has urged the VA to explain the outbreak. He said on Monday that the department needs “an action plan to prevent this from happening again.

“When you have a death, that makes it especially urgent,” Casey said. He was waiting to hear from the VA and hoped to speak directly with Secretary Eric K. Shinseki, Casey spokesman John Rizzo said.

Health officials have not released the name of the patient whose death they confirmed on Friday. A VA spokesman in Washington said the Pittsburgh system has reduced Legionella counts in its water system since the outbreak and would respond to Casey's concerns.

The Oakland hospital lifted water restrictions last week. It announced a switch from copper-silver ionization to chlorination as a primary method of water treatment and Legionella prevention.

The CDC has not released its findings.

“I can say we've had very good cooperation from the VA,” said Dr. Stephen Ostroff, the state acting physician general. State investigators are not worried about the quality or speed of the VA response to the Legionnaires' cases, he said.

Ostroff is monitoring the investigation but declined to release details of that effort before a final report.

“What you think is correct today may not turn out to be that way tomorrow,” Ostroff said.

Staff writer Luis Fábregas contributed to this report. Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or asmeltz@tribweb.com.

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