Legionella widespread at Oakland VA
Not even the landscaping was safe.
Legionella bacteria became so pervasive in the Pittsburgh VA's Oakland hospital that it contaminated an outdoor decorative fountain, making the water feature one possible source in the fatal outbreak of Legionnaires' disease revealed during the fall, the Centers for Disease Control and Prevention found.
A 56-page CDC report obtained by the Tribune-Review outlines stark details in the case, including that workers super-heated and flushed pipes at the hospital a half-dozen times from January 2011 to October 2012.
VA officials first told the public of hospital-linked Legionnaires' cases in mid-November, about two weeks after the CDC first told the VA that in-house bacteria were causing pneumonia.
The repeated super-heating makes it “pretty clear they recognized there was a problem,” said Janet Stout, a former VA official, Legionnaires' researcher and co-founder of the Special Pathogens Laboratory, Uptown. “The fact that they had to do it repeatedly suggests that it was not done hot enough and long enough.”
A Pittsburgh VA spokesman could not be reached for comment Monday.
Sen. Bob Casey Jr., D-Scranton, who sparked an internal investigation at the VA, said the CDC report “still leaves many unanswered questions.”
“It is imperative that these events are reported appropriately to both the CDC and the public in order to keep people both safe and informed,” he said.
VA leaders say they sought CDC help late last year in evaluating the outbreak of Legionnaires', a waterborne and sometimes-fatal form of pneumonia. They had acknowledged only five cases linked to hospital tap water contaminated with Legionella, the bacteria that causes the disease.
A bombshell summary of CDC findings released last week at a congressional hearing showed 21 cases since January 2011 probably originated at the Oakland hospital or the VA's H.J. Heinz Campus in O'Hara. Five of those patients died.
The Pittsburgh VA said Friday another Legionella-infected patient died in late January, though it remains unclear whether that veteran came in contact with the bacteria in the Oakland hospital or elsewhere.
The complete CDC report dated Jan. 25 illustrates more detail found by the federal reviewers, who are tracing the outbreak's genesis before 2011, the document shows. Among highlights in the report sent to the VA and state Health Department by Dr. Alicia Demirjian in the CDC Division of Bacterial Diseases:
• Legionella was “widespread throughout the hospital” in Oakland by fall 2012. Sixty-six percent of environmental samples collected by the CDC in November showed Legionella growth at the Oakland hospital. One round of tests found “every water sample we took was positive for Legionella except for hot water collected from two stand-alone hot-water heaters,” the report reads.
• In some instances, reviewers discovered a delay of more than two days in relaying patients' Legionella-positive test results from the hospital laboratory to an internal infection-prevention team. The prevention team “does not typically contact (the doctors) with results,” though it did meet with an administrator for infectious diseases to classify Legionnaires' cases.
• Systems that use copper and silver ions were supposed to prevent Legionella in the tap water. Only seven of 11 samples found copper and silver levels were within a manufacturer's guidelines for Legionella control.
• Extensive construction at the hospital probably contributed to the Legionella outbreak.
“When we're called, we're happy to assist,” CDC spokesman Tom Skinner said Monday night. “We try to be as thorough as possible and leave no stone unturned.”
Rep. Tim Murphy, R-Upper St. Clair, voiced concern about the delay between the discovery of Legionella in the hospital lab and when the lab got word out. Former VA official Dr. Victor Yu, a University of Pittsburgh professor whom the VA fired, called it “incomprehensible that they didn't tell physicians that Legionella had re-entered the drinking water.”
“If there was a fire in the building, would you pull the fire alarm and call 911, or would you send the fire department a letter?” Murphy said.
Dr. Ronald Voorhees, the acting health director for Allegheny County, said he felt the VA's actions “have been on target.”
“I think there have been hiccups along the way,” Voorhees said. “But once they recognized they had a problem, they took action to treat all their water.”
He said he was still reviewing the CDC report and would be “looking into appropriate responses.”
“I think the bigger issue is that we know water systems — not just at the VA — have Legionella,” Voorhees said. “We are in desperate need of having a certified method for how to deal with it.”
A congressional subcommittee under the House Committee on Veterans' Affairs is weighing federal standards for Legionella prevention. County and VA standards have long held that hospitals should be concerned when testing finds Legionella in more than 30 percent of samples.
Federal epidemiologist Lauri Hicks told the congressional subcommittee Feb. 5 that the CDC knows of no safe level for Legionella.
Staff writer Mike Wereschagin contributed to this report. Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or firstname.lastname@example.org.
Show commenting policy
TribLive commenting policy
You are solely responsible for your comments and by using TribLive.com you agree to our Terms of Service.
We moderate comments. Our goal is to provide substantive commentary for a general readership. By screening submissions, we provide a space where readers can share intelligent and informed commentary that enhances the quality of our news and information.
While most comments will be posted if they are on-topic and not abusive, moderating decisions are subjective. We will make them as carefully and consistently as we can. Because of the volume of reader comments, we cannot review individual moderation decisions with readers.
We value thoughtful comments representing a range of views that make their point quickly and politely. We make an effort to protect discussions from repeated comments either by the same reader or different readers.
We follow the same standards for taste as the daily newspaper. A few things we won't tolerate: personal attacks, obscenity, vulgarity, profanity (including expletives and letters followed by dashes), commercial promotion, impersonations, incoherence, proselytizing and SHOUTING. Don't include URLs to Web sites.
We do not edit comments. They are either approved or deleted. We reserve the right to edit a comment that is quoted or excerpted in an article. In this case, we may fix spelling and punctuation.
We welcome strong opinions and criticism of our work, but we don't want comments to become bogged down with discussions of our policies and we will moderate accordingly.
We appreciate it when readers and people quoted in articles or blog posts point out errors of fact or emphasis and will investigate all assertions. But these suggestions should be sent via e-mail. To avoid distracting other readers, we won't publish comments that suggest a correction. Instead, corrections will be made in a blog post or in an article.
- Duquesne University to raise minimum wage floor
- Pittsburgh Mayor Peduto in Cuba on manufacturing trade mission
- Plum schools, dealing with sex scandal, to form panel in June
- Land eyed for trail connectors to expand Harrison Hills Park
- Penn Hills votes to sell, lease vacant school space
- Air rifle incidents on the rise, experts say
- Lawsuit filed against PWSA for inaccurate billing from radio-controlled meter readers
- Mt. Lebanon police chief to retire, replacement selected
- Former executive says Pittsburgh Urban Redevelopment Authority fired her for reporting overbilling
- CMU, Pittsburgh’s Surtrac program aims to ease traffic congestion
- Allegheny County Council begins process to replace Barbara Daly Danko