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LiquiTech endorses CDC town hall on Legionnaires’ disease

With Legionnaire’s disease on the rise in hospitals and healthcare facilities, the need for routine testing and preventive treatment has become clear, CDC event shows
The federal Centers for Disease Control and Prevention (CDC) held its first-ever Vital Signs Town Hall webinar on Legionnaires’ disease on June 13, 2017, calling attention to its recent one-year study of 20 states detailing a rise in Legionnaires’ cases across the U.S. People contracted the disease from a healthcare facility in 76% of locations reporting exposures, the study found. The CDC also noted that Legionnaires’ kills one in four people who contract it while in a healthcare facility.

The virtual town hall, “Health Care-Associated Legionnaires’ Disease: Protect Patients with Prevention and Early Recognition,” brought together public health officials and hospital infection control and facilities managers. Among the presenters was John T. Letson, MBA, Vice President of Plant Operations at the Memorial Sloan-Kettering Cancer Center in New York City.

With 50 buildings in New York comprising 6 million square feet of space and serving mostly immunocompromised cancer patients, Legionnaires’ poses a particular threat to Sloan-Kettering. The risk of getting the disease is higher for people who are older and have compromised immune systems, which is why healthcare facilities are so often the source of outbreaks.

A possible hospital-acquired case of Legionnaires’ in 1999 spurred the renowned cancer center to action. The incident involved a bone marrow transplant patient; a culture from the patient matched one taken from a shower head in the patient’s room. “This case led us to immediately adopt a zero-tolerance policy for Legionella,” Letson said. (Legionella is the bacteria that causes Legionnaires’ disease. People can become ill with a virulent form of pneumonia after aspirating water vapor from showerheads, cooling towers, hot tubs and decorative fountains.)

Letson and his team put together a comprehensive plan to eliminate the threat posed by the Legionella. “This long-term strategy involves proactive monitoring of all water systems, remediation when needed and continual improvements over time,” he said.

“The biggest risk, he said, is in hot water systems, because patients who take showers are exposed to the most water vapor. In 2000 Sloane-Kettering installed a copper silver ionization system for long-term protection. This system introduces positively charged copper and silver ions into the water supply as current is applied across copper and silver electrodes. The positive ions bind to the negative cell walls of bacteria, which causes the proteins in the cell wall to break down, effectively killing the cell.

“In developing our long-term strategy in the fall of 1999, I concluded that ‘heat and flush’ or any form of chlorine-based mitigation would not work at (Memorial Sloan-Kettering). So, we reviewed the suppliers, and we selected what I thought to be the best copper silver system.”

Two weeks after installation, the hospital’s infection control team did its monthly testing and found that there were zero positive test results, down from 27% prior to the copper silver ionization. “The system has maintained this level ever since,” Letson said.

Key to success of any water management plan is independent testing, Letson said, a view validated by recent policies from the CDC and the Centers for Medicare and Medicaid Services. “It is the only way to measure and qualify that anything you put in place is effective. Testing of water supply and distribution systems and domestic water storage tanks and our cooling towers done by a third party ensures nobody is manipulating test results.”

Testing can reveal issues at the micro level, such as when juice machines at Sloan-Kettering were found to have a form of Legionella. The machines used the same cold water line as ice machines and water fountains, so the hospital re-piped the lines and installed silver-lined antimicrobial filters.

Water management is dynamic, Letson said, so every healthcare facility needs to watch for patterns and make improvements as needed. That watchfulness, he added, is only possible through a disciplined regimen of testing.

For more information on the CDC Town Hall the recording.