UW Medicine reports 2nd death from Legionnaires disease

By JoNel Aleccia

The Seattle Times

SEATTLE — The bacteria that cause Legionnaires’ disease have been detected in part of the water supply at the University of Washington Medical Center, where officials said a second person linked to an outbreak has died.

An ice machine and two sinks in the cardiac units of the hospital’s Cascade Tower were found to be contaminated with the germs that can cause the potentially deadly form of pneumonia, officials said Wednesday.

Signs warning patients, family and staff not to use the drinking fountains and sinks were posted throughout the tower on Wednesday. The Cascade Tower is supplied with city of Seattle drinking water, but there’s likely little risk to surrounding areas, said Dr. Tom Staiger, UWMC medical director.

“We don’t have any indication that people in the general public should be worried about this,” he told reporters.

Hospital officials have trucked in “a lot” of bottled water for an outage that could last at least two weeks, Staiger said.

The announcement follows reports of two previous cases of Legionnaires’ disease in patients treated in the UWMC cardiac-care units: a 30-year-old woman reported on Aug. 26, and a 50-year-old man reported Sept. 6, health officials have said. The man died Sept. 8, King County health officials said.

The most recently announced case occurred in a woman in her 50s, who died Aug. 27. An infection with the Legionella bacteria was detected during an autopsy. Health officials said it may have contributed to her death.

The patients were infected with Legionella pnemophila, one of about 60 different types of the bacteria. Tests of 15 other patients in the UWMC units have shown no evidence of infection, Staiger said.

With assistance from Larry Lee, an industrial-hygiene consultant, they have intensified testing of water systems throughout the hospital, with focus on the areas where the bacteria were detected. Officials are also installing new filters on sinks, fountains and showers. They’re testing patients with symptoms of respiratory problems and culturing samples to check for Legionella bacteria.

“We are doing everything that we can identify that is reasonably possible to put in place to reduce the risks to patients, family and staff,” Staiger said.

But patients and their families were alarmed by news of the potential risk. Lisa Baker, 46, of Snohomish has been in the Cascade Tower since before Aug. 25, when she underwent a stem-cell transplant to treat myelodysplatic syndrome, a bone marrow disorder, diagnosed last spring.

On Tuesday, her husband, Bob Baker, 46, got a text from his wife saying a nurse had just taken away a container of ice chips and warned her not to use the sink or shower.

“The nurse seemed upset. She said she hadn’t seen anything like this in 34 years,” Baker said. “That got us both nervous.”

Baker said he is waiting for doctors to test his wife for Legionella infection — or explain why they won’t.

Public Health — Seattle & King County is assisting with the investigation. The water restrictions were put in place Tuesday evening, as soon as Legionella was confirmed; other patients could still test positive for infection, said Dr. Meagan Kay, a county medical epidemiologist.

In addition, the federal Centers for Disease Control and Prevention has been notified of the findings.

Further test results that could specify what kind and how much of the Legionella bacteria were found could take two weeks to come back, Lee said.

Ice machines have been linked to past episodes of Legionella infections — and deaths — in hospitals. The machines often contain water reservoirs located next to compressors, which can warm the water enough to allow any bacteria present to grow, investigations have found.

Legionnaires’ disease is reported in about 5,000 people a year in the U.S., according to the Centers for Disease Control and Prevention. In Washington state, the number of cases varies each year from fewer than 10 to more than 50. In 2014, 63 cases of Legionnaires’ disease were reported, including eight deaths, according to the state health department.

It’s a relatively rare disease. Most people don’t get sick if they’re exposed to the bacteria, but some might, particularly if they’re older than 50, current or former smokers, have a chronic lung disease or have immune systems weakened by disease or medications.

The disease was identified after an outbreak in 1976 sickened many attendees at an American Legion meeting in Philadelphia.

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