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Regional task force to shape Legionella policies

| Wednesday, March 27, 2013, 11:37 p.m.

Allegheny County and Pittsburgh Veterans Affairs health officials plan a regional task force to help prevent Legionnaires' disease in medical facilities within the county because of an outbreak in two VA hospitals.

“We don't even know how many facilities in the county are currently treating water or doing monitoring” for Legionella bacteria that cause the disease, said Dr. Ronald Voorhees, the acting county health director. “We'd like to make the risk as low as possible.”

Legionella in water supplies at the Oakland VA hospital on University Drive and the VA Heinz campus in O'Hara sickened up to 21 patients between February 2011 and November 2012, according to the Centers for Disease Control and Prevention in Atlanta. Five died, the agency said.

A CDC investigation found that VA officials failed to recognize “for an extended period” that hospital water had sickened patients.

Voorhees said the outbreak shows a need to develop national standards to monitor and prevent Legionella in hospitals.

“In the absence of them, we need to do the best we can locally,” he said.

Workers at the Allegheny County Health Department and VA Pittsburgh Healthcare System independently suggested a task force to update county recommendations for watching and controlling Legionella at health care facilities, Voorhees said.

The agencies met on March 14 and plan to form a list of desired task force members, specify goals and set a tentative schedule for moving forward.

They hope to involve the state Department of Health and other area hospital systems, Voorhees said.

State Health Department officials “look forward to partnering” in the effort, spokeswoman Kait Gillis told the Tribune-Review.

“We think that involving stakeholders in building consensus around monitoring for and remediating Legionella bacteria is a good idea,” said CDC spokeswoman Alison Patti. “As long as regional guidelines are based upon good scientific evidence, we can't foresee any drawbacks at this stage.”

Pittsburgh VA CEO Terry Gerigk Wolf cited the task force as one of several steps the VA is taking to avoid Legionnaires' outbreaks, calling the disease “not merely a VA issue.”

“This is a prevalent and pressing public health issue,” Wolf said.

By working with health departments and others, she said, “we are committed to advancing this conversation and helping to usher in a new era of Legionella control.”

UPMC and West Penn Allegheny Health System spokeswomen said they were not familiar with the proposed task force and declined to comment.

“I definitely think it's a positive move,” said Dr. Victor Yu, a University of Pittsburgh faculty member and ousted VA lab director who helped write the Allegheny County recommendations for controlling Legionella, last revised in 1997. “A lot of things have happened in the last (16) years,” he said.

The 15-page county recommendations became a basis for Legionella standards in Maryland, New York and Texas, as well as parts of Europe and Taiwan, Yu said. The Department of Veterans Affairs in Washington used the county document to help steer Legionella control strategies at VA hospitals nationwide, he said.

The VA and the CDC are rethinking those strategies after the Pittsburgh outbreak of Legionnaires' disease, a form of bacterial pneumonia. Though VA and Allegheny County standards suggest hospitals should go on high alert if more than 30 percent of water samples test positive for Legionella, the CDC has said it knows of no safe level for the bacteria.

The county standards focus on how health officials should watch for Legionnaires' disease and eradicate Legionella from plumbing by using measures such as super-heated flushing of pipes and copper-silver ionization systems that add charged particles to water.

Adam Smeltz is a staff writerfor Trib Total Media. He canbe reached at 412-380-5676or asmeltz@tribweb.com.

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