Sixth veteran with Legionella likely didn't get it at a VA Pittsburgh hospital
By Adam Smeltz and Luis Fábregas
Published: Thursday, March 7, 2013, 4:24 p.m.
A veteran who died in January after contracting Legionella does not appear to have acquired the bacteria while a patient in the VA Pittsburgh Heathcare System, the Department of Veterans Affairs announced on Thursday.
An outbreak of Legionnaires' disease at the VA's Oakland and O'Hara campuses sickened as many as 21 veterans between January 2011 and November 2012. Legionella bacteria spread from contaminated tap water at the facilities, the Centers for Disease Control and Prevention found.
Five of those patients died. Legionnaires' disease, caused by the waterborne Legionella bacteria, is a form of pneumonia.
But the bacterial strain found in a sixth VA patient who died after contracting Legionella does not match the atypical strain found in the 2011-12 outbreak inside Pittsburgh VA facilities, according to a statement from Veterans Affairs spokesman David Cowgill. That determination was based on a lung-tissue biopsy of the sixth veteran provided by the CDC in Atlanta.
“The CDC noted this is a virulent strain of Legionella that is associated with frequent outbreaks in both the U.S. and Canada,” the VA statement said of the strain found in the sixth veteran.
VA officials reported the veteran died in late January in the VA's Oakland hospital on University Drive, though they did not disclose the veteran's name or exact cause of death, citing federal privacy laws. Cowgill said the patient had pneumonia when admitted that month.
The CDC recommended remediation of the sixth veteran's residence, according to the VA — a sign the veteran might have contracted the common Legionella at home. People with weakened immune systems tend to be more susceptible to the bacteria, which they can inhale in contaminated droplets from shower heads or other fixtures.
CDC representatives were not available on Thursday for comment. The federal agency found at least 11 Pittsburgh VA patients with Legionella between January 2011 and December 2012 had contracted the bacteria outside the hospital system. The Legionella strain found in the VA Pittsburgh system appeared to be a descendant of the strain involved in a deadly 1982 outbreak.
VA officials first announced the recent outbreak to the public in mid-November 2012. The scope of the outbreak linked to the Oakland and O'Hara hospitals remains a question. CDC workers are looking as far back as 2007 for Legionnaires' cases that probably originated in the VA health care system.
The VA Office of Inspector General and an investigative subcommittee under the House Committee on Veterans' Affairs are running their own inquiries into the outbreak, which fell under congressional scrutiny in a Feb. 5 hearing.
Michael Moreland, director of Pittsburgh-based Veterans Integrated Service Network 4, a region that includes most of Pennsylvania, northern West Virginia, southern New Jersey and Delaware, testified that he first knew of concerns about Legionnaires' cases in the fall of 2011. While cases at that point were not tied to VA Pittsburgh facilities, he said, the VA stepped up flushing of its plumbing systems to try to eliminate any Legionella.
VA Pittsburgh shut off the water systems at Oakland and O'Hara in November 2012 and flushed them with superheated and chlorinated water. Signs were placed on public fountains and faucets. Bottled water was brought in for patients.
Environmental sampling of the water in the VA Pittsburgh system is done every two weeks, and remediation efforts “have been successful,” Cowgill's statement said.
VA Pittsburgh “continues to consult with the CDC and the Allegheny County Health Department and has taken appropriate steps to control Legionella.”
The American Federation of Government Employees on March 1 called for Moreland's temporary suspension and a separate investigation into his handling of the outbreak.
David J. Hickton, the U.S. Attorney for Western Pennsylvania, has pledged his office will conduct an independent review once the Inspector General's report is completed, likely this month.
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