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Legionnaires' kills patient at VA hospital in Pittsburgh

| Thursday, April 23, 2015

The Veterans Affairs Pittsburgh Healthcare System is investigating how a patient contracted a fatal case of Legionnaires' disease, the hospital system reported Wednesday.

The unidentified male patient died early Wednesday in the VA hospital in Oakland after arriving Monday with pneumonia, said Dr. Brooke Decker, the infection prevention director for the VA Pittsburgh system.

She said doctors diagnosed him late Tuesday with Legionnaires', a severe form of pneumonia caused by waterborne Legionella bacteria. The VA did not release his name or age.

“It seems most likely that this is a community-acquired case,” not one tied to the VA, Decker said. She cited the patient's limited exposure to the medical center and near-spotless Legionella testing results there in recent months, among other factors.

At least 22 veterans fell ill and six died in a Legionnaires' outbreak from February 2011 to November 2012 at VA campuses in Oakland and O'Hara. The regional system has revamped Legionella prevention practices, strengthened monitoring to spot water contamination and toughened standards to check for Legionnaires' infections.

While state health records show up to 118 Legionnaires' cases a year in Allegheny County, Decker said the case this week is the only one in 2015 at the Oakland VA hospital, located on University Drive.

“It is likely a community-acquired case because the deceased had very little contact with the hospital during the time when he may have contracted the illness,” said Melissa Wade, a spokeswoman for the Allegheny County Health Department.

She said the department followed up with the hospital and believes “the VA is handling the situation appropriately.”

The patient visited the Oakland hospital for a few hours about six days before his first potential symptoms emerged April 15, according to the VA. Legionnaires' can appear two to 10 days after a person aspirates the bacteria, which typically hobble people with weakened immune systems.

Decker said VA workers have no evidence that the patient had any exposure to water during the prior visit, in a care area where more than 100 water samples turned up no signs of Legionella in the past two years.

Hundreds of other water tests this year at the Oakland hospital produced one Legionella-positive result, in an administrative area in February, Decker said. She said workers have since removed the sink where the bacteria were found.

To identify the Legionella source in the April case, Decker said the VA is looking into water tests at the patient's home and workplace. It is testing again for Legionella in parts of the VA where the man received care.

Additionally, workers are using a lung culture to see whether they can match his Legionella type with available water samples, including those at the Oakland hospital.

That process could take at least two weeks to begin showing results, although VA investigators might never know where the bacteria originated, Decker said. The Centers for Disease Control and Prevention in Atlanta is expected to help.

Doctors at the Oakland hospital last saw a Legionnaires' patient in September, another case thought to be community-acquired, according to the VA. The last definite hospital-acquired case there was in 2012, a spokesman said.

Adam Smeltz is a staff writer for Trib Total Media.

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