Most outbreaks preventable with properly designed and maintained water systems.
Most of the country has seen cases of Legionnaires’ disease associated with healthcare facilities, CDC officials said Tuesday.
This is “a concerning finding,” a CDC statement said, because of the illness’s increased severity when contracted in hospitals and long-term care facilities. The fatality rate for definite healthcare-associated Legionnaires’ disease was 25% in a new CDC analysis.
Surveillance data from 20 states and one large city identified 2,809 Legionella infections.
Although the analysis found that only 3% of confirmed cases were definitely acquired in healthcare institutions, officials said they believe that a much larger fraction were contracted in such facilities but were diagnosed only after discharge. The CDC’s Vital Signs report indicated that another 17% of infections were suspected to have originated in healthcare facilities, in that the patients had been in such a facility within 10 days of symptom onset.
During a press call with reporters, CDC Acting Director Anne Schuchat, MD, said the study highlights the important work that hospitals and long-term care facilities must do with regard to their water systems. Legionella organisms live in water and outdated systems allow them to spread.
Proper water management “could have prevented four out of five Legionnaires’ disease outbreaks,” Schuchat said. “This means tending to the buildings’ water infrastructure,” she added, particularly in older facilities.
The chief of CDC’s respiratory diseases branch, Cynthia Whitney, MD, MPH, noted on the press call that the agency has developed a water-management toolkit for hospitals and other facilities to minimize Legionnaires’ disease. As important as having a program, she emphasized, is assigning “a dedicated team to execute the program.”
Whitney and Schuchat also said they believe many, perhaps most, Legionnaires’ cases go undiagnosed. Whitney said it’s vital that patients with symptoms consistent with the condition undergo specific testing for Legionnaires’ disease, so that outbreaks can be curtailed at their outset.