VA hospital says patient had Legionella exposure

A patient of the Fayetteville Veterans Affairs hospital was exposed to Legionella bacteria sometime within the past year, the hospital reported Friday.

The patient was transferred from a community hospital to the veterans hospital Dec. 8 with pneumonia and remains hospitalized, spokesman Wanda Shull said. Hospital staff members have given the patient a presumptive diagnosis of Legionella pneumonia based on a positive Legionella antigen test.

The positive test was reported to hospital leadership at 8 a.m. Friday, Shull said. A positive antigen test does not confirm the presence of the disease but does indicate the patient's exposure, she said.

"Veterans Health Care System of the Ozarks would like to stress that our operations are ongoing, and we continue to see patients in our inpatient and outpatient clinics without any disruption," Shull said. "We are taking all steps as precautionary measures."

The hospital also moved some patients and closed some patient rooms after low levels of the bacteria were found in three sites, Shull said. Patients with respiratory symptoms common to legionellosis will be tested for the antigen, she said.

The hospital notified the Arkansas Department of Health as required Friday, spokesman Kerry Krell said. The department has received reports of 35 cases of diseases caused by Legionella bacteria this year, including four during the month of December.

The hospital notified the family of the patient who tested positive but did not notify other patients because the bacteria is not transmitted from person to person, Shull said. Hospital leadership did notify staff and the media, she said.

Legionella bacteria can cause a mild infection known as Pontiac fever and a more serious infection known as Legionnaires' disease, according to the Centers for Disease Control and Prevention.

Patients with Legionnaires' disease will have pneumonia, cough and fever, and hospitalization is common. The disease has an incubation period of two to 14 days.

Pontiac fever does not result in pneumonia, and hospitalization is uncommon, according to the CDC. The illness typically lasts two to five days.

The elderly and people with chronic lung disease or weakened immune systems are more vulnerable to an infection, Shull said.

Legionella bacteria are transmitted in water droplets, such as mist or vapor, according to the CDC.

Legionella bacteria are found naturally and widely in the environment, usually in water, Shull said. The chance of getting Legionella bacteria from a water source is low, but problems can arise when high concentrations of the organism grow in water systems.

The key to preventing legionellosis is maintenance of the water systems in which Legionella grow, according to the CDC.

Hospital staff members do not know how or when the Veterans Affairs patient came into contact with the bacteria, but the positive test prompted the hospital to take precautions, Shull said. The hospital is in contact with the national Office of Infectious Diseases.

Routine water samples at the hospital detected low levels of Legionella bacteria in three places, and "rooms in question" were taken out of service until follow-up testing confirms the absence of the bacteria, Shull said.

Twenty patients were moved to different rooms, she said. On Friday morning, the hospital had 43 patients, though several were scheduled to be discharged by the end of the day, she said.

The hospital is following federal regulations from the Veterans Affairs Department and the CDC, Shull said. The hospital's engineering department is preparing to "hyper-chlorinate" the water system as a remediation strategy and will continue to monitor water systems.

Metro on 12/20/2014

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