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Sen. Casey wants to add illnesses beyond Legionnaires' to VA reporting requirements

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By Adam Smeltz
Thursday, April 18, 2013, 11:59 p.m.

Sen. Bob Casey Jr. is toughening his proposal for new disclosure standards for Department of Veterans Affairs hospitals, pushing to require they report to outside health agencies each case of several serious illnesses.

The Scranton Democrat's plan in March would have applied only to Legionnaires' disease, a sometimes-fatal form of pneumonia that sickened as many as 21 veterans from February 2011 to November 2012 in the Pittsburgh VA hospital system.

“The goal is basically to hold the VA accountable in ways it hasn't been held accountable to date,” Casey, D-Scranton, told the Tribune-Review on Thursday. “It's unfortunate that we have to specify in a prescriptive way those entities that the VA should report to, but that's what we have to do.”

As federal facilities, VA hospitals fall outside conventional standards for reporting infectious diseases to state and county health departments, though many VA facilities do so voluntarily. The Tribune-Review discovered the loopholes in a March investigation into the Legionnaires' outbreak in the VA Pittsburgh Healthcare System in Oakland and O'Hara. Five of the sickened veterans died.

The Pittsburgh VA “could have and probably should have” shared information more readily with health officials as the outbreak developed, acting state Secretary of Health Michael Wolf told the Trib last week.

VA Pittsburgh spokesman David Cowgill declined to comment on Thursday on Casey's expanded reporting proposal but has said the Pittsburgh system consistently shares “all information” with state and county officials. A national VA spokesman said he is looking into Casey's proposal.

Under Casey's plan, 152 VA medical centers and 1,400 outpatient clinics nationwide would be required to alert immediately the federal Centers for Disease Control and Prevention and state and county health departments every time they find Legionnaires' disease, rabies, measles or yellow fever. Casey said he is still weighing whether to add more bacteria-related ailments to the list.

He said he reworked the plan after his staff consulted with the CDC.

Better disease surveillance “is clearly a key” to stopping future outbreaks, CDC spokesman Tom Skinner said.

“CDC shares the goal of having the best possible surveillance systems to track disease in order to protect the nation's health,” he said.

Health officials including Dr. Ronald Voorhees, the Allegheny County acting health director, have said prompt, complete reporting is critical in helping public officials find links among individual cases of disease.

Voorhees applauded Casey's approach, saying open collaboration with health agencies “adds more of a seamlessness that, hopefully, will increase the effectiveness and timeliness of the response we can assist with.”

“If what the VA is seeing is a reflection of what's happening in the community, there's a direct tie there,” said Dr. Paul Etkind, senior director for infectious diseases at the National Association of County and City Health Officials in Washington. “The sooner that everybody is informed, the swifter control measures can be put into place.”

The Pittsburgh VA outbreak prompted several federal reviews, including one by the VA Office of Inspector General in Washington. Casey said he will introduce his bill after the OIG releases its report, which he expects this month.

Adam Smeltz is a staff writer for Trib Total Media. He can be reached at 412-380-5676 or

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