Guernsey Hospital System Failure of Legionella

The BBC reported an article on the high levels of bacteria and legionella found at Guernsey's Princess Elizabeth Hospital.


... "Legionella bacteria have been eradicated from the water system at Guernsey's Princess Elizabeth Hospital, according to the health department.


Ed Freestone, from the department, said: "We have basically cleared it out of the system and that is a really good result. We have cracked the problem."


Heat treatment was used after chemicals failed to solve the problem.
Unacceptably high levels of bacteria were found in January following the implementation of new, routine checks
"We've found taps we never knew we had," he said.
The source of the bacteria has not been identified.


However, Mr Freestone pointed to the number of phases of development at the hospital over 80 years, leading to water lying stagnant in some lengths of redundant pipe-work.


Mr Freestone said all the plumbing in the hospital would now be "flushed at regular intervals"."

Need a legionella risk assessment? visit www.spectrum-env.co.uk  

News Update: Infection Control: Legionnaires' disease and dental unit water

We came across this brilliant article on : Infection Control: Legionnaires' disease and dental unit water - If you're a dentist, and worried about legionella, we don't blame you...

"On a certain Monday morning in February, some of us were getting the same question from our patients. The question was similar to the questions that dental offices received in 1987 regarding transmission of HIV in the dental setting, as well as questions in 2001 regarding the transmission of HBV in the dental setting. My hope was that you answered these questions without hesitation.
Your current answers should be that your office is doing everything they can to comply with the guidelines, regulations, and laws governing infection control in the dental setting, including infection control procedures that treat the water lines.
In Rome, Italy, it was confirmed that an 83-year-old Italian woman who died from Legionnaire’s disease contracted the infection from the water lines in a dental practice.
The case was quickly diagnosed, and the source of the disease is unquestioned. The woman was admitted into the hospital with breathing problems and a very high temperature. She was admitted to the intensive care unit with continued fever and respiratory distress.
Chest radiography showed several areas of lung consolidation. She had no underlying diseases or conditions. Legionnaires’ disease was promptly diagnosed by a Legionella pneumophila urinary antigen test; a bronchial aspirate was taken for microbiological examination. Oral ciprofloxacin (750 mg every 12 hours) was started immediately. Nevertheless, the patient developed fulminant and irreversible septic shock and died two days later. An investigation to find the source of L pneumophila infection was initiated. After testing, she was diagnosed with legionnare’s disease.(1,2)
The part of this story that makes it clear that the disease was a direct result of dental treatment is what led up to this. The patient left her house only two times within the incubation period of two to 12 days. Both of those trips were direct trips to the dentist and back.
The evaluation of the dental setting included an evaluation of the water in the dental lines. Samples of water were taken from the dentist’s tap, from the dental unit water line, and from the high-pressure pump supplying the waterline. The testing that was done revealed that all three samples of water tested positive for Legionella pneumophila bacteria and the sample from the water pump was particularly convincing. Aerosolised water from high-speed turbine instruments was most likely the source of the infection. Warm temperatures and periods of water immobility provide a breeding ground for the bacteria. Distributed in fine droplets by a spray, the bacteria are then breathed in. Elderly people or individuals with poor immune systems are most at risk.
Genetic sequencing confirmed that the bacteria found in the dental water line directly matched the bacteria that killed the patient. The bacteria is a particularly virulent substrain called Benidorm.
Legionnaire’s disease, as we all know, is unusual. Most cases have involved air conditioning units, spas, and water fountains that are not properly cleaned or looked after. No one previously has identified the dental setting as a possible source of this disease, but we all know it could happen. That is why we are all so diligent in applying infection control guidelines, regulations, and laws into our daily practice of dentistry.
The case report has suggested a number of recommendations, including the use of filters and sterile water and adding a continuous loop of disinfected water. 

What is Legionnaires’ disease? 

The Centers for Disease Control and Prevention (CDC) defines Legionnaires’ disease as a disease that is caused by a type of bacteria called Legionella. The bacteria got its name in 1976, when many people who went to a Philadelphia convention of the American Legion suffered from an outbreak of this disease, which is a type of pneumonia (lung infection). Although this type of bacteria was around before 1976, more illnesses from Legionnaires’ disease are being detected now. This is because we are now looking for this disease whenever a patient has pneumonia.
Legionella bacteria are found naturally in the environment, usually in water. The bacteria grow best in warm water. This is why you will find it in places such as hot tubs, air conditioning units, and water tanks. People acquire Legionnaires’ disease when they breathe in a mist or vapour (small droplets of water in the air) that has been contaminated with the bacteria. One example might be from breathing in the steam from a whirlpool spa that has not been properly cleaned and disinfected, or a dental hand-piece that has water flowing through to cool it down that is aerosolized. This disease is not spread from one person to another, but rather from the environment to the person.
The populations at the greatest risk for developing this disease are older people (usually 50 years of age or older), people who are current, former smokers, those who have a chronic lung disease (such emphysema), people who have weak immune systems from diseases, or those who take drugs to suppress (weaken) the immune system.
The problem with diagnosis of this disease is that symptoms are similar to other forms of pneumonia. It may be hard to diagnose at first. Symptoms of the disease can include a high fever, chills, and a cough. Some people may also suffer from muscle aches and headaches. Chest X-rays are needed to find the pneumonia caused by the bacteria, and other tests can be done on sputum (phlegm), as well as blood or urine to find evidence of the bacteria in the body. Symptoms usually begin two to 14 days after being exposed to the bacteria.
Legionnaires’ disease can be very serious and can cause death in 5% to 30% of cases. Most cases can be treated successfully with antibiotics, and healthy people usually recover from infection. "

Read more at DentistryIQ...

For more information on Legionella Bacteria and control measures call Spectrum Environmental Solutions on 0870 729 0199

The Next 'Combating Legionella Conference'

H&V News has announced the dates for the second annual Combating Legionella Manchester conference.

In a statement it said: “Building on the success of last year’s event, H&V News is delighted to announce the dates for the second annual Combating Legionella Manchester conference, taking place on the 28-29th March 2012.”
"This event will bring together facilities managers, designers and engineers from across the industry to hear essential updates on guidance and legislation, and share best practise in preventing and dealing with a legionella outbreak.”

Looks like we all need to keep our eyes open for even more changes after March 2012!

The Changes to ACOP (L8) BS 8580:2010

Okay; There have been some changes to the way things work around here, and it seems no ones really noticed...

What We All Know about the ACoP (L8) and the Control of Legionella Bacteria...

Most of us are aware, in layman's terms, that bacteria beasties can accumulate in water that isn't 'looked-after'. We also know, as duty holders, we have to abide by some rules, namely the ACoP (L8). We know we need an annual monitoring plan, and a legionella risk assessment, at least once every 2 years as a matter of routine to keep these beasties at bay.

This is No Longer the Case!
Not many people realise, some changes were made to the overall approved code of practice, late in 2010. Some added literature, which is available at a rather large sum of money, can tell you the nitty-gritty. All I know is, there's one thing that my customers really need to know, and I'll tell you for free.

Legionella Risk Assessments are now considered 'live' documentation. These changes also specify that the document must be updated in anticipation of changes to the system, and then reviewed after too.
I think it's safe to say, not coordinating the risk factor with your system designer (if indeed, they are separate), is a huge mistake, since modifications to pipework systems is a main contributor in creating 'deadlegs' (a piece of unused or capped pipework, where the legionella can grow quickly in stagnant water).

Luckily, this new course of practice makes way for a lower and more controlled risk. This also means that your supplier of water treatment services could be updating your building's risk assessment as frequently as monthly if needed!

This doesn't mean that you'll never need a full risk assessment again, since the amount of added documentation could crowd and confuse the risk assessment document itself.
It does mean, that any authority or duty holder looking for a water treatment contractor, or has a current contractor working for them, should make sure these new features of the ACoP(L8) are followed.

For a water treatment contractor that does, visit www.spectrum-env.co.uk - stay tuned, more updates of the ACoP (L8) coming soon ...

(For more info see our blog post: How often do I need an ACoP (L8) Risk Assessment?)

Legionaires Outbreaks Spain and Hong Kong

There have been, reported today, two legionella outbreaks resulting in illness and, sadly, death.

The BBC News published an article this morning, reporting the bacteria has been found in a Government Complex in Hong Kong; The threat was found only when a minister was taken ill last month, and hospitalised with the potentially fatal disease.

"Hong Kong's Centre for Health Protection has been collecting water samples from various sites in the new Central Government Offices after Education Secretary Michael Suen was diagnosed with Legionnaires' disease last month.

Samples collected from various toilets - including those at the office of Chief Executive Donald Tsang - tested positive for Legionella pneumophila, said a government statement.

Other troublespots include water taps inside the kitchens of a canteen and the Dining Hall in the Legislative Council Complex."

 Hopefully, the minister will recover, but no further report on his condition has been made. Unforgettably, the same cannot be said for British tourists aged 73, 76 and 78 died after contracting disease in Spain. a further 11 people were taken ill in Spain, who were also saying at the resort promoted by Saga Holidays. This was reported with the mailonline:

"The AR Diamante Beach Hotel in Calpe which is at the centre of the outbreak has been temporarily closed.

A regional health authority spokesman said: 'The results of our investigation into the cases of Legionnaires' Disease in Calpe show it's an outbreak which has so far affected 14 people, ten British tourists and four Spaniards.

'Recently we've learned tests on three British people aged between 73 and 78 suffering pneumonia who died in hospital showed they had contracted Legionnaires' Disease. 

'The deaths occurred on January 26 and 31 and February 2.'

The pensioners aged 73 and 78 who passed away after getting Legionnaires' died from unrelated conditions. Only the death of the 76-year-old has been attributed to the disease. 

Relatives of the three victims are thought to have flown to Spain to be by their bedsides before they died."

Read more: http://www.dailymail.co.uk/news/article-2095709/Three-British-pensioners-die-Legionnaires-Disease-outbreak-Spanish-beach-hotel.html#ixzz1lJ9voKhv"

These reports should serve as a reminder to all, especially in hotel establishments, that assessing buildings for legionella is an important step in health and safety.  

NHS Lanarkshire fined £24,000 After Patient Contracted the Potentially Lethal Legionnaires’ Disease

A 64 year old woman was taken 'gravely' ill in the formerly known Hartwoodhill Hospital - this following statement was reported:

"An investigation by the Health and Safety Executive (HSE) identified Legionella bacteria in three sources in the water system at the hospital. Two of these sources, including the shower used by the patient daily, matched the strain that caused her illness."

Usually we would assume that there was no scheme in place to protect the patients from the bacteria, commonly know to proliferate in stagnant water, or built up scaly pipework - the way the disease is contracted, is through inhaling air particles carrying a spray or mildly evaporated form of the contaminated water... unfortunately, this is exactly how this woman fell ill.


The statement went on to say:

"The HSE investigation established that assessment of the risks from the potential presence of Legionella bacteria to those using the facilities had not been carried out. Neither was there a safe scheme to manage and control the risks of exposure to that form of bacteria in the water system at Hartwoodhill Hospital. The hospital officially closed last year."

These are the types of instances that can be easily avoided by implementing a good team of experts to help monitor the risks associated with legionella. 


Procurement managers - Listen up! Contact a great supplier with brilliant rates - especially if your building(s) have older patients or people, that are more at risk of contracting the disease! These things could be avoided quite easily, there is certainly no reason for anyone's life to come under threat. There is a ton of information available on the web, and good suppliers out there waiting for your call!


Let's get on top of your Health and Safety eh?


For more quick information on how you can obtain a risk assessment at a price that wipes the floor with most of their competitors, contact Spectrum, a leading supplier in the water treatment industry, on 0870 729 0199


Read more of the story quoted, published by Wishaw Press here

Our Hearts Go Out - Baby's Death caused by Pseudomonas in Belfast Hospital

This is why we deem our work of the utmost importance. Water treatment, and monitoring, is one of the least talked about legislation's on the map, but is, for all to see, so very important to keep on top of.


These poor children, unfortunately, have to pay devastating consequences of a poor monitoring system, obviously being performed by a completely incompetent company, who should take their work much more seriously. Either that, or the authority just couldn't be bothered to sign off a few purchase orders to keep on top of their water hygiene. 
Either way, This is an incident that should never have happened; we would like to send our deepest condolences to the families of these young children - our hearts go out to you completely, and honestly.


The  Belfast telegraph reported this:

"The latest results show that none of the 24 babies who were patients at the Belfast’s Royal Jubilee Maternity’s neo-natal unit at the time news of the outbreak broke last week have shown signs of an active infection of Pseudomonas. However five babies are being closely monitored because tests showed they have the bacteria on their skin"

Read more: http://www.belfasttelegraph.co.uk/news/local-national/northern-ireland/baby-deaths-regulator-has-never-inspected-neonatal-unit-at-belfast-hospital-16107523.html#ixzz1kIVHPj1k

We sincerely hope that these children get the best care and treatment and we wish them a swift recovery.


Article written on behalf of the staff at Spectrum Environmental Solutions Limited - Please contact us for a monitoring regime that wont fail - UK - 0870 729 0199.