• Testing Change Possible After Flint-Area Legionella Outbreak

    February 17, 2016

    By COREY WILLIAMS, ASSOCIATED PRESS DETROIT — Feb 16, 2016, 4:55 PM ET

    Another part of the problem, according to Stout, is the CDC does not tell hospitals to test for legionella as a preventative measure.

    "Our group ... has been saying that's backward and they should be making sure health care facilities should be testing," she said.

    Michigan, seeking to prevent another oversight fiasco after lead poisoning in Flint and a deadly Legionnaires' disease outbreak in the area, is considering new water testing rules for hospitals and possible changes to how large facilities manage their water systems that could include new monitoring requirements.

    State officials are analyzing Michigan's public health code in terms of "the requirement and enforcement of water testing in hospitals and other facilities," Jason Moon, a spokesman for the Department of Licensing and Regulatory Affairs, told The Associated Press.

    The Legionnaires' outbreak killed 9 people and sickened at least 78. Water testing found Legionella bacteria in at least one Flint hospital.

    In addition, officials are looking at updated guidelines for building operators to mirror the standards developed by a national industry group that require building owners and managers to conduct annual surveys to look out for Legionella bacteria risks and develop plans to control it.

    Both are part of the response by Gov. Rick Snyder's administration to the surge in Legionnaires' cases after Flint switched its water source in 2014 from the Detroit water system to the Flint River water that wasn't properly treated. The move, while the city was under emergency state financial management, allowed lead to leach from old pipes into Flint homes and businesses. Tests later showed high lead levels in some Flint children.

    Moon did not give details of the testing requirements, so it's difficult to say whether any changes would put Michigan at the forefront of building water systems safety. One expert tells The AP that no state requires any advance or preventative testing for Legionella in building water systems, and another notes that the drawback to the standards developed by the American Society of Heating, Refrigerating and Air Conditioning Engineers is that they are voluntary.

    "To get teeth, it needs to be adopted into plumbing, regulatory codes," said Janet Stout, president of Pittsburgh-based Special Pathogens Laboratory, who has researched links between Legionella bacteria and public water supplies. "The only way" to prevent it "is to test before somebody gets sick." 

  • WKAR's Current State Interviews Dr. Janet Stout on Michigan State Health Department Response to Legionnaires' in Flint

    February 15, 2016

    Detroit News investigation reveals state’s laissez-faire response to Flint Legionnaires’ outbreak

    The state of Michigan is under fire over information contained in newly released emails that show a less than urgent response to an outbreak of Legionnaires’ Disease in Flint. We talk about it with Chad Livengood of the Detroit News and Dr. Janet Stout, a researcher from the University of Pittsburgh.

    The Flint Water Crisis has mushroomed beyond a dire public health crisis to a political lightning rod rife with missteps, accusations and hints of cover-up.

    Last Friday, The Detroit News reported on the state’s delayed response to  cases of Legionnaires’ Disease that surfaced in Flint in early 2014. Reporters combed through some 24,000 emails voluntarily released by the Snyder administration. Some of those notes indicate the governor himself did not learn of the outbreak until months later.

    Current State talks with Chad Livengood, the capitol reporter for The Detroit News, and an expert on Legionnaires’ Disease, Dr. Janet Stout, a research associate professor and president of the Special Pathogens Laboratory at the University of Pittsburgh.

     

  • Expert: Quick state action might have saved Flint lives

    February 15, 2016

    Quick state action to involve federal agencies and inform the public might have shortened an outbreak of Legionnaires’ disease in the Flint area and saved lives, a national expert on the respiratory disease told The Detroit News.

    Michigan turned down help from the U.S. Environmental Protection Agency and the Centers for Disease Control and Prevention, according to a Detroit News analysis of more than 24,000 pages of emails released by the Snyder administration and Genesee County.

    State agency officials also tried to steer Genesee County health officials away from examining the municipal water system as a potential source of the Legionella bacteria that sickened 87 people between May 2014 and November 2015, killing nine.

    Legionnaires’ disease is caused in warmer months by a bacteria in warm, fresh water that leads to a severe form of pneumonia and can be found in large plumbing systems, hot tubs and air-conditioning units.

    The state’s handling of the crisis contrasts markedly with how New York state officials dealt with a Legionnaires’ outbreak last summer in the Bronx, said Dr. Janet Stout, a research associate professor with the University of Pittsburgh who assisted with both outbreaks. The Bronx spate included 133 cases, resulting in six deaths.

    “New York City and New York state were very, very aggressive in terms of doing the testing and informing the public, and as a result they were able to contain the outbreak very quickly,” said Stout, president of Special Pathogens Laboratory, which conducted water testing in the Bronx.

    The outbreak lasted about a month — from July 8 to Aug. 3 — and was traced to a cooling tower on top of a hotel, according to New York City.

    “As a result, they were able to contain the outbreak very quickly,” Stout added. “If you don’t make that progression of doing the testing of the environment, the cases continue — which is what we saw in Flint.”

    A study by state of Michigan epidemiologists of 45 Flint area cases that occurred from June 2014 through March 2015, resulting in five deaths, found that 16 cases were associated with McLaren Regional Medical Center in Flint.

    Stout, who was hired by McLaren as a consultant, concluded Legionella bacteria likely entered the hospital through brown water from the municipal water system. But the cache of emails between state, county and federal health agencies documents the state’s reluctance to search the water system for clues or relinquish control of the scientific investigation.

    by Karen Bouffard, The Detroit News, February 15, 2016

  • Legionella bacteria found in Flint hospital’s water

    January 22, 2016

    Water testing during an outbreak of Legionnaires’ disease in Genesee County found Legionella bacteria was present in water at McLaren Regional Medical Center — and an expert hired by the hospital said this week the organism likely came from Flint River water delivered by the city water system.

    In an email to The Detroit News, McLaren spokeswoman Laurie Prochazka confirmed the facility undertook “aggressive testing” of it’s water after noting an increase in Legionnaires’ there and at other hospitals in the spring of 2014. “Early test results indicated the presence of a low level of Legionella,” she said.

    The medical center took action, and “All Legionella testing continues to show the McLaren Flint water supply is well within safety and quality standards,” Prochazka added.

    Janet Stout, a research associate professor at University of Pittsburgh’s Swanson School of Engineering and an expert on Legionnaires’ disease, said this week the germ likely entered the hospital via brown water, which was delivered by the Flint water system, laden with organic matter on which Legionella and other bacteria feast. McLaren hired Stout early on in the outbreak to assess the possible presence of the bacteria and recommend remediation, if necessary.

    State epidemiological reports found more cases “associated” with McLaren than with any other source of exposure, but have not made a connection with Flint River water. The clash highlights the controversy over the state’s insistence the city’s contaminated water isn’t the definitive source of the outbreak.

    Asked Thursday if Flint River water caused the outbreak, Michigan Department of Health and Human Services spokeswoman Jennifer Smith said a “strain match” is needed “to make a definitive statement on environmental causation.” Officials have said it’s impossible to identify the strain because Legionella samples were never kept from the patients who had Legionnaires’.

    According to Stout, studies have estimated Legionella would be found in about 50 percent of hospitals if water testing were required by the federal Centers for Disease Control and Prevention.

    According to Stout, studies have estimated Legionella would be found in about 50 percent of hospitals if water testing were required by the federal Centers for Disease Control and Prevention.

    Legionnaires’ disease is caused in warmer months by a certain bacteria in warm fresh water that leads to pneumonia and sometimes death. The bacteria can be found in large plumbing systems, hot tubs, air-conditioning units and fountains.

    Read entire article on Detroit News web site.

    - Karen Bouffard, The Detroit News

  • Baby's Death Puts Focus on Risks of Legionnaires'

    December 21, 2015

  • Baby's Death After Contracting Legionnaires' Disease in Hospital Highlights Risks

    December 19, 2015

    by Micheal Kosnar, NBC News

    From birth, Northern California newborn Ryland Joseph always seemed happy with a constant smile and twinkle in his brown eyes. But just four months after he was born, the child was diagnosed with Wiskott-Aldrich Syndrome, a rare genetic disorder. 

    His parents, Rodd and Kellie Joseph, knew their son's only chance for survival was a bone marrow transplant. They chose the highly regarded Benioff Children's Hospital at the University of California San Francisco Medical Center for the procedure. 
    But after a successful operation, the boy's health took a serious turn just days later. He died on May 16, 2013. The Josephs said they were shocked to learn Ryland didn't die as a result of the transplant or even his genetic disorder — he died from the Legionnaires' disease that he contracted in his own hospital room. 

    "I was angry like I've never been angry in my life. This was my only son," Rodd Joseph told NBC News. "I mean, had they tested for it, my son might still be here."

    Since the Legionnaires bacteria was first identified after scores of men fell ill at Philadelphia's American Legion Convention in 1976, thousands are still sickened every year in the U.S., even though some experts say it's almost entirely preventable. 

    At risk in particular are hospitals, with unsuspecting patients — even babies — vulnerable to a killer in the water. 

    Most people get Legionnaires by breathing in mist from water that contains the bacteria. It can cause severe pneumonia.

    At Benioff Children's Hospital, Ryland, who had a weakened immune system, was in a special unit away from other people and sources of infection.

    The hospital had a policy in place prohibiting "tub baths or showers" in the rooms which would have prevented the spread of Legionnaires through the inhalation of microscopic water droplets.

    But hospital cleaning personnel violated that policy by turning on the shower.

    The Legionella bacteria thrives in warm water environments like cooling towers and large plumbing systems, but the hospital hadn't tested for it since 2006.

    "It was a shock to me," Kellie Joseph said. "And I think that people need to be aware of what it is, and that it's lurking, and it's in the hospitals."

    The Josephs sued the UCSF Medical Center for the wrongful death of their son. The case was later settled out of court.

    In court documents, the hospital admits that Ryland contracted Legionnaires' Disease in their facility.

    The hospital states it had been using Legionella mitigation practices consistent with industry standards, such as heating water to a certain temperature as it comes into the building from the city, and that it implemented new policies after Ryland's death.

    "There are people in public health that are afraid to tell people that this bacteria survives water treatments in our water systems," [Dr Janet] Stout said. "The thing we hear about is we don't want to start panic. We don't want to alarm people unnecessarily. So what happens is inaction. The hospitals don't test their water because the Center for Disease Control and Prevention says wait until there are cases before you go looking for the source. And we think that's backwards."

  • Legionnaires' Disease: The Illness That Just Won't Go Away

    December 19, 2015

  • Take Care's Interview with Dr. Janet Stout on WRVO

    December 07, 2015


    Legionnaires' disease: cause, diagnosis and treatment

    Listen to the interview with Dr. Janet Stout, who was a guest WRVO's health and wellness program, Take Care, hosted by Lorraine Rapp and Linda Lowen. The interview aired December 6. Following is an excerpt about the interview:

    Legionnaires’ disease is a kind of pneumonia spread through the legionella bacteria. Unlike other some other kinds of bacteria that sickens humans, this one is spread through water, not by person-to-person contact. The bacteria usually live in manmade water systems, like in buildings.

    People contract the disease by breathing in mist with the bacteria or they drink the water, but it has to get into the lungs, says Stout.

    But it can be difficult to figure out where Legionnaires’ is coming from, says Stout. For one reason, the time of exposure to legionella bacteria to a patient showing signs of Legionnaires’, like fever and cough, can be anywhere from two to 10 days.  

    Click here to listen to interview with Dr. Janet Stout on WRVO's website.

  • Why It’s Actually a Good Thing More Legionnaires’ Has Been Found in the Bronx

    September 30, 2015

    NEW YORK— Thirteen more people were diagnosed with Legionnaires’ disease in the Morris Park section of the Bronx. Although one patient has died, medical specialists are saying that the diagnoses itself should be seen as a good thing.

    “It’s not an outbreak. It’s an outbreak of diagnosis,” said Janet Stout, a microbiologist who has researched Legionella, the bacteria that causes Legionnaires’ disease, for more than 30 years.
    Legionnaires’ disease, a rare but severe form of pneumonia, had taken 12 lives and sickened more than 120 people in July and August during an unrelated outbreak in South Bronx.

    But the increase of Legionnaires’ infections doesn’t necessarily indicate that more people are getting sick. It means more doctor are testing for it, showing a critical shift in the New York medical establishment’s attitude toward the disease that can potentially save many lives.

    Legionella is a bacteria that is commonly found in the water supplies of large buildings. It doesn’t pose any danger to most healthy people. But it can be life-threatening for the elderly and people with weak immune systems. Since it is an uncommon illness, Legionnaires’ disease has historically been misdiagnosed as some other form of pneumonia.

    The number of deaths caused by the Legionella bacteria is still unknown.  The Centers for Disease Control and Prevention (CDC) estimates somewhere between 8,000 to 18,000 people are hospitalized with Legionnaires’ disease each year in the United States, yet only about 3,000 cases are reported to CDC each year. The rest are misdiagnosed.

    This is worrisome because according to the World Health Organization, Legionnaires’ patients who are diagnosed and treated early can fully recover with few side effects while those who go untreated after a week can face cognitive damage, organ failures, or death.

    Sadly, outbreaks and deaths are what it takes to get people’s attention.
    Legionella.org, an advocacy organization run by Victor L. Yu, M.D., and Stout, Ph.D, believe that because of the severity of the malady, Legionnaires’ disease should be tested significantly more often than it is.

    “Sadly, outbreaks and deaths are what it takes to get people’s attention,” Stout said.

    {EXCERPT}

    - Amelia Pang, Epoch Times | September 30, 2015

     

  • Pharmaceutical Giant Detects Legionella Bacteria In Cooling Towers

    August 12, 2015

    Tess Owen | VICE News | August 12, 2015

    The massive pharmaceutical company GlaxoSmithKline (GSK) had to temporarily shutter its North Carolina factory -— which produces medications for respiratory conditions —after Legionella bacteria was detected in one of the plant's cooling towers this week.

    The factory, which is located in Zebulon, North Carolina, reportedly handles more than 30 brands, including Combivir, which treats HIV, the antidepressant Wellbutrin, and Zofran, which is used to prevent chemotherapy induced nausea. Respiratory drugs that the plant produces are Advair, Breo, and Ellipta, all of which come in the form of an inhaler and are prescribed to people with asthma and chronic lung diseases. Advair is the largest product line at the Zebulon plant.

    Legionella bacteria tends to thrive in warm water — and is often found in hot tubs, extensive plumbing systems, decorative fountains, or cooling towers. To become infected, a person has to be exposed to the mist or vapor containing the bacteria — it can't spread from one person to another.

    GSK representative Marti Skold Jordan told VICE News on Wednesday that "the cooling tower is a standalone structure which does not come into contact with product manufactured at the facility."

    Jordan also said that all employees working at the facility had been sent home and the cooling towers will be fully cleaned and retested before the factory reopened.

    GSK's detection of the bacteria coincides with a recent outbreak of Legionnaire's disease in the South Bronx, which has so far killed 12 and infected over 100.

    The incubation period for the Legionella bacteria usually lasts between two and 10 days, but people can still begin exhibiting symptoms around two weeks after exposure. A report from the New York City's Department of Health and Hygiene says that all 12 people who died had existing medical problems, which Legionnaire's complicated.

    Janet Stout, director of the Special Pathogens Lab in Pittsburgh, told VICE News that she thought GSK's decision to close the factory was overly cautious. Many cooling towers will test positive for traces of Legionella bacteria, Stout says, but those traces won't necessarily lead to an outbreak of Legionnaire's disease.

    "You just need to adjust your water treatment program to get those numbers [Legionella bacteria] down," she said.

    "People get very anxious when an outbreak occurs," she added while commenting on the Bronx outbreak. "But when you look at all the people who are exposed to the bacteria, only 2-5 percent become infected."