No known illnesses from Legionella bacteria found in Washington County VA clinic, official says
By Adam Smeltz and Luis Fábregas
Published: Thursday, May 16, 2013, 5:30 p.m.
The bacteria that cause Legionnaires' disease have been found at the Pittsburgh VA's outpatient clinic in the Washington Crown Center mall in North Franklin.
Clinic officials are not aware of any illnesses from the contamination, so there were no cases to report to state health officials, said Brandon Blatt, a vice president of Sterling Medical Corp., the Cincinnati-based firm that leases and runs the clinic for the Department of Veterans Affairs.
Company and VA officials canceled Friday appointments there so workers can install a system to superheat the tap water and purge the Legionella. The facility is expected to reopen on Monday. Sterling knows of no Legionella threat elsewhere in the mall, Blatt said.
Legionnaires' symptoms often start with headaches, muscle pains, chills and fevers that run 104 degrees or warmer. Symptoms typically appear within two to 14 days of exposure to the bacteria.
The Veterans Affairs Pittsburgh Healthcare System announced in a news release that “low levels” of waterborne Legionella bacteria were reported Thursday in test results from routine water testing. The naturally occurring bacteria cause Legionnaires' disease, a sometimes-fatal form of pneumonia that sickened as many as 21 patients in an outbreak from February 2011 to November 2012 at the Pittsburgh VA campuses in Oakland and O'Hara. Five patients died.
“We are getting ahead of this situation (and notifying the public) as soon as the results come in,” Blatt said.
The bacteria discovered at the clinic were in “an extremely low-risk environment” at “a very low level” of one to 20 colonies per liter, he said.
Pittsburgh VA spokesman David Cowgill, who issued the press statement announcing the discovery, referred questions to Sterling, contending that “this is not our property.”
Workers at Garfield's Restaurant, a Subway and several other mall businesses contacted by the Tribune-Review said they were not notified of the Legionella findings from the VA testing. It was unclear if any water testing was conducted at other locations within the mall.
The general operations manager at the mall could not be reached. A spokeswoman at the Pennsylvania Department of Health did not know if state officials had been notified of the discovery.
Pennsylvania American Water, the Hershey-based water company whose system supplies the mall, had not heard of the clinic's bacteria issue until the Trib called on Thursday evening, spokeswoman Josephine Posti said.
Outpatients at the VA clinic would generally face a “very, very low” risk of Legionella exposure, said microbiology expert Janet Stout, who formerly worked at the Pittsburgh VA system. The elderly and others with compromised immune systems are most susceptible to the bacteria, which cause Legionnaires' when inhaled as mist from showers or spas.
“A certain percentage of us live with Legionella in our home,” said Stout, who now runs the Special Pathogens Laboratory, Uptown. “Most of us are exposed to Legionella without harm.”
She said patients in hospitals or other inpatient facilities can face a higher exposure risk because they stay for prolonged periods of time.
The federal Centers for Disease Control and Prevention found contaminated water caused the outbreak at the VA's facilities at University Drive in Oakland and the H.J. Heinz campus on Delafield Road in O'Hara. The CDC and a review report by the VA's Office of Inspector General cited problems with water system maintenance, medical monitoring and the response by VA Pittsburgh officials to the outbreak.
A criminal investigation by the VA Inspector General and a review by a congressional subcommittee are ongoing. Notices of intention to file civil suits have been filed by some victims' families, and veterans' groups and lawmakers have sharply criticized the VA Pittsburgh management.
The U.S. Attorney for Western Pennsylvania, David J. Hickton, has pledged a separate legal review of the deadly outbreak.
Pennsylvania American Water does not routinely monitor water for Legionella but treats water sources to prevent bacteria. Problems with Legionella are usually limited to one building and linked to the water customer's plumbing, water quality manager Ron Bargiel said.
“Where you want to look first is in the internal plumbing and air conditioning,” which also can spread Legionella, Bargiel said.
He added that the company increases bacteria monitoring in neighborhoods where customers find Legionella levels have increased.
“Customers are the best defense,” Bargiel said.
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