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Allegheny County health officials call on retirement homes to stay vigilant on Legionella prevention

| Thursday, Oct. 23, 2014, 6:36 p.m.

The Allegheny County Health Department is urging retirement complexes and other group homes for the elderly to monitor often for waterborne Legionella, the common bacteria that causes the potentially deadly Legionnaires' form of pneumonia.

County health officials released Thursday about 70 pages of expanded guidelines to help personal care homes and hospitals prevent and diagnose the disease, which federal officials blamed for sickening at least 22 patients in 2011 and 2012 in the Veterans Affairs Pittsburgh Healthcare System. Six of them died.

The outbreak patients were among several dozen cases recorded each year in Allegheny County, where reported rates of Legionnaires' disease are more than double state averages. Doctors reported 91 cases last year in the county and 52 since January.

“I think the word is out that this is something to be proactive about,” said Sharon Silvestri, the infectious diseases program chief at the Health Department.

While hospitals are “very, very proactive at this point in being aware of Legionella,” she said nursing homes and similar facilities might overlook the threat.

Silvestri didn't know how many local Legionnaires' cases originate in long-term-care homes, but the elderly, diabetics and people with weakened immune systems tend to be most vulnerable to Legionella. The bacteria can cause Legionnaires' when inhaled in contaminated droplets from a shower, fountains or other sprays.

Doctors suspect that's how patients contracted the disease in the VA Pittsburgh system, where the outbreak caught the attention of the Downtown-based Jewish Healthcare Foundation.

The foundation collaborated with the Health Department and contracted with the RAND Corp. to update the county Legionella control guidelines, which the county had last refreshed in a 15-page document in January 1997. The foundation paid RAND $60,000, spokeswoman Laurie Gottlieb said.

County officials have said the voluntary standards should help fill a critical void since national and state rules do not mandate how all health care facilities should test for Legionella.

“Clearly, something more pro-active, more action-oriented is necessary to impact prevention,” said Janet Stout, director at the Special Pathogens Laboratory, Uptown, and a former microbiologist at the now-shuttered VA Pittsburgh's Oakland laboratory. She is among more than two dozen experts a task force consulted to develop the guidelines.

The guidelines illustrate how facilities with at-risk patients or residents can check for Legionella, outlining regular testing protocols, systems and methods that reduce the bacteria and practices for disease testing.

Stout said the proportion of hospital-acquired Legionnaires' cases in the county fell from 33 percent to 9 percent after the 1997 guidelines appeared.

The Environmental Protection Agency, the Occupational Safety and Health Administration and the Centers for Disease Control and Prevention are working on their own Legionella guidelines and related reference materials for national use.

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

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