A new report by federal health regulators suggests that cases of Legionnaire’s disease are being spread through health care facilities far more often than expected.
The U.S. Centers for Disease Control and Prevention (CDC) indicates that health care facilities are linked to one-third of all outbreaks of Legionnaire’s disease in a Vital Signs report released this month.
“The size and complexity of health care facility water systems and the vulnerability of the patient populations served by these facilities increase the risk for Legionella transmission and severe outcomes,” the CDC report states. “A review of 27 Legionnaires’ disease outbreaks investigated by CDC during 2000–2014 indicated that health care–associated Legionnaires’ disease accounted for 33% of the outbreaks, 57% of outbreak-associated cases, and 85% of outbreak-associated deaths.”
The report warns that the size and complexity of health care facility water systems may be increasing the risk of the growth of Legionella. These systems then expose patients who might be more susceptible to Legionnaire’s disease to these infections, according to the CDC.
Legionnaire’s disease is transmitted by the inhalation of small droplets of water containing Legionella. It causes severe lung infections which have a 25% fatality rate.
“Exposure to Legionella from health care facility water systems can result in Legionnaires’ disease,” the CDC reports. “The high case fatality rate of health care–associated Legionnaires’ disease highlights the importance of case prevention and response activities, including implementation of effective water management programs and timely case identification.”
According to the findings, 80% of the outbreaks linked to health care facilities were associated with long-term care facilities, such as nursing homes. The CDC found that 18% of those outbreaks were linked to hospitals and two outbreaks were linked to both. Most of the cases occurred in patients 60 years or older.
The CDC report indicates that effective water management of health care facility systems should include maintaining water temperatures that are “outside the ideal range” of Legionella and should prevent water stagnation. Those systems require regular monitoring, and proper maintenance of those systems should prevent the growth of Legionella as well as other bacterial contamination problems, according to the report.
“This report demonstrates that Legionnaires’ disease continues to result from exposures to health care facility water systems,” the CDC researchers concluded. “The high case fatality rate of health care–associated Legionnaires’ disease underscores the need for effective prevention and response programs. Implementation and maintenance of water management programs, combined with rapid case identification and investigation, could reduce the number of health care–associated Legionnaires’ disease cases.”