Allegheny County Sets New Guidelines to Fight Legionella Bacteria

Oct 24, 2014

When six people died from Legionella bacteria in Pittsburgh’s Veterans Affairs hospitals in 2011-12, the Pittsburgh Regional Health Initiative (PRHI) and Allegheny County Health Department (ACHD) set out to find a better way to combat future outbreaks.

The organizations have now released updated guidelines to control Legionella bacteria in western Pennsylvania.

Karen Wolk Feinstein, PRHI president and CEO, said they convened all the key players – hospitals, nursing homes, even engineering sanitation departments – to talk about what could be done as a region to prevent a widespread outbreak.

“I think there’s going to be a heightened alertness, there’s going to be a lot of sharing,” Feinstein said. “These meetings were very collegial; people came together across any kind of competitive boundaries to work together on identifying what to do when there’s an outbreak.”

Keith Kanel, PRHI Chief Medical Officer, said the focus of the guidelines is to familiarize the general public about how to approach the bacteria, not to define standards of care.

“The guidelines are mainly aimed at people that house at-risk individuals,” Kanel said. “So we’re talking about community hospitals, skilled nursing facilities, adult residences, etc., the type of people that are most vulnerable to Legionella.”

The last update was in 1997.

“The science for how to manage Legionella has advanced quite a bit,” Kanel said. “We now know a lot more about sterilization procedures about how one should maintain the water supply, and I think we can share that information now with a much wider audience.”

Feinstein said the updated guidelines stemmed from the 2011-12 Legionella bacteria outbreak at the Pittsburgh’s Veterans Affairs hospitals that killed six patients and sickened 21 others. 

“The sad deaths at the VA hospital I think have put everyone on alert that Legionella does pose a real and present danger when it’s present in the water supply in certain quantities and particularly when that water affects people who are fragile,” Feinstein said.

The bacteria can be found in water systems such as faucets and showers, pools and hot tubs and even in air conditioning systems.  The bacteria can cause Legionnaires’ Disease, with symptoms similar to pneumonia, and can result in lung failure or death.

While the updated guidelines provide new information about the disease, Feinstein said they need to know more about the bacteria to properly combat it.

“We definitely need more research on Legionella,” Feinstein said. “I don’t think we’ve yet come to what will ultimately turn out to be the best solutions, because the current solutions are very costly and some of them pose dangers.”

She called current guidelines to control Legionella “imperfect” and costly.