Water-associated infectious disease outbreaks are more likely to occur in areas where a region's population density is growing, according to a new global analysis of economic and environmental conditions that influence the risk for these outbreaks. Ohio State University scientists constructed a massive database containing information about 1,428 water-associated disease outbreaks that were reported between 1991 and 2008 around the world. By combining outbreak records with data on a variety of socio-environmental factors known about the affected regions, the researchers developed a model that can be used to predict risks for water-associated disease outbreaks anywhere in the world.

The study shows that clusters of reported outbreaks tended to occur in Western Europe, Central Africa, Northern India and Southeast Asia. These regions, as well as Latin America and eastern Brazil, were targeted as potential "hot spots" at highest risk for future water-associated disease outbreaks ranging from E. coli-related diarrhea to dengue fever.

World health experts conservatively estimate that 4 percent of deaths -- almost 2 million annually -- and 5.7 percent of illnesses around the world are caused by infectious diseases related to unsafe water and sanitation and hygiene problems. Getting a better handle on the socio-environmental factors that affect the risks for water-associated disease outbreaks is a first step toward guiding policymakers as they prioritize the distribution of health resources around the world, the researchers say.

"We know water is essential to life, but we also know that water is a vehicle that can carry hazards. If we understand the risk factors of disease better, we can inform policy decisions because resources are limited. Second, we can provide an early warning to certain places that are undergoing global environmental change because our model shows how those changes affect outbreak risks," said Song Liang, senior author of the study and an assistant professor of environmental health sciences at Ohio State.

Each disease tracked in the database was classified into one of five categories:

• water-borne (such as typhoid and cholera), caused by microorganisms that enter water through fecal contamination and cause infection when humans consume contaminated water. A subset of these, called "water-carried" diseases, result from accidental ingestion of contaminated water in a recreational setting;

• water-based (such as schistosomiasis), caused by parasites that spend part of their life in water;

• water-related (such as malaria and trypanosomiasis), which need water for breeding of insects that act as vectors in transmitting disease to humans;

• water-washed, caused by poor personal or domestic hygiene because no clean water is available; and

• water-dispersed (such as Legionella), caused by infectious agents that thrive in water and enter the body through the respiratory tract.

Even with all of the data available, the researchers suggest that their database and map represent just a fraction of the actual outbreaks that have occurred because the under-reporting of these diseases is a common problem, especially in the developing world.

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.

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 aquire Legionnaires’ disease when they breathe in a mist or vapor (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) Source: Dentistry IQ (via twitter)

The proper control of the fatal strand of the above legionella bacteria mentioned in the article is required under Government legislation, for more information please call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

When he finally walked out of hospital they called him, endearingly, “Dead Guy from 35”, a man so close to death he became the daily rallying point for staff patrolling the ward around room 35 at Juravinski Hospital.

Popular Hamilton chef Mark Farrugia, 38, dipped perilously near the end during a near month-long battle to bring him back from the precipice. It was this bad: Grief counsellors were put on notice three times their services might be needed.

“There was a point where if he’d got sicker there was nothing we could have done,” said Dr. Graham Jones, who supervised Farrugia’s treatment and care for two weeks. Farrugia, who runs La Piazza Allegra on James Street South, had contracted Legionnaires’ disease in an isolated case health officials can’t explain. The potentially lethal water-bred and airborne legionella bacteria hit massively, damaging his lungs and requiring an induced coma for 16 days as medical staff pumped antibiotics and painkillers into him. When he fully pulled out of his death spiral, doctors told him he survived thanks to his dedication in the gym and high fitness level.

“I have always been active and was a regular at the Rymal Road Y. I worked out three or four times a week, both weights and cardio and was careful with my diet. The doctors said that saved me.” Dr. Jones, an associate professor at McMaster University and respiratory specialist, said Farrugia’s rebound from near death is one more good reason for high levels of physical fitness.

“What Mark went through was the ultimate physical stress test. The stronger you are, the more able you are to withstand what’s happening to your body.” But the patient himself says a strong team of devoted medical staff — more than 10 including various specialists who were called in — gets the bulk of the credit. “I have a new appreciation of how spectacular doctors can be, how great the nurses were. They went above and beyond what you’d expect.”

Now he’s back in special training to restore strength to his damaged lungs and muscles that withered by 40 per cent while he lay motionless.
“I plan to be back playing soccer this summer in the Burlington men’s league,” he vows.

Farrugia’s ordeal began just after Halloween when he began to feel tightness in his chest that progressed to laboured breathing. A mere cold, he thought at first. He had it checked out at a walk-in clinic and was prescribed a puffer for bronchitis. But he felt worse. A visit to hospital produced the advice he give the puffer more time to work. But the effect of the bacterial infection became crushing. When he decided he must go to hospital, he collapsed in his home.

(Read More) Source: TheSpec.com (via twitter)

It is important to note that most fatal cases of Legionnaires' Disease occur in the elderly and those that are immunocompromised but the proper control of the bacteria is required under Government legislation, for more information please call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

Meridian Bioscience, Inc. (NASDAQ: VIVO) today announced that it has received FDA clearance from the U.S. Food and Drug Administration (FDA) for TRU Legionella™, a new rapid assay for detection of legionellosis.

TRU Legionella is a rapid lateral flow device that provides optimized detection of Legionella pneumophila serogroup 1 that is most commonly associated with Legionnaire's disease. Suspected infection is characterized by non-specific upper respiratory symptoms. The disease accounts for almost 100,000 cases per year in the U.S., and it is estimated that 10,000 to 20,000 people are hospitalized with Legionnaire's disease. However, many infections are not diagnosed due to poor diagnostic options and these numbers may be higher.

The TRU Legionella test provides a much needed solution for an often under-diagnosed disease. Approximately 4 million to 5 million cases of community acquired pneumonia occur each year in the U.S. and Legionella is implicated in 5-8% of the cases. According to published statistics, incidence of Legionella cases has nearly tripled in the past decade and could be attributed to increase testing for disease. TRU Legionella empowers laboratories with an accurate, cost effective, and rapid result for Legionelladetection.

John A. Kraeutler, Chief Executive Officer, stated, "TRU Legionella is an important addition to our respiratory product portfolio given the prevalence of the disease. This new assay solidifies our position as a leader in rapid, accurate testing methods for infectious disease testing. TRU Legionella provides labs with a highly accurate tool that can speed the detection of an under-diagnosed pathogen enabling rapid treatment for the patient. TRU Legionella is in distribution, via Meridian Bioscience Europe, for our European customers."

(Read More) Source: News Medical (US)

We are committed as a company to researching and getting behind anything that legitimately prevents and detects causes of Legionnaires' Disease, for more information on those products call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

Twenty-six people died from Pseudomonas in Northern Ireland between 2008 and 2011, the assembly has been told.

A further two people have died after contracting the infection this year although those figures are provisional. The figures do not include the recent deaths of four babies at neo-natal units.

The Health Minister, Edwin Poots, revealed the figure on Wednesday as he briefed the assembly's health committee on the investigation. Mr Poots said it should be considered within the context of the number of confirmed cases each year, approximately 85.

In December, a baby died from a Pseudomonas infection at Altnagelvin Hospital in Londonderry. In January, three more died from a different strain of the infection at the Royal Jubilee Maternity in Belfast.

Mr Poots told the committee there had been no new cases of Pseudomonas in neo-natal units since 24 January. He added that the independent investigation into the outbreak was under way and an interim report was expected by 1 March.

(Read More) Source: BBC News

For further information on services that we provide to help control waterbourne bacteria like Pseudomonas call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

A Wiltshire tourist attraction, reliant on weekly deliveries of fresh water after its supply failed, has spent £20,000 on a new water source.

For seven months Crofton Pumping station, near Marlborough, has had to buy in water after tests revealed its water source was "heavily polluted".

The source, a deep level borehole, had provided water to a cafe, toilets and cottages at the historic attraction.The Kennet and Avon Canal Trust said a new borehole had now been drilled.

The pumping station, built in the 1800s, is run by Canal Trust volunteers as a museum exhibit. Mike Rodd, from the trust, said: "The existing borehole was possibly too shallow and, with underground water levels low, the theory is that there wasn't enough fresh water in the aquifer to prevent canal water seeping into the borehole.

"The new bore hole is deeper and further up the hill, well away from the canal."

(Read More) Source: BBC News

Please click on the link below to read the official Case Report about the sad death of an elderly lady in Italy reported on February 17th 2012.

http://press.thelancet.com/crdental.pdf

The Department of Health report that this is the "first case case of Legionnaires' disease stemming from a dental waterline" even though it is has been widely regarded as a problem area which has led to government legislation document:

Health Technical Memorandum 01-05: Decontamination in primary care dental practices which can be found by clicking the link.

The proper control of the legionella bacteria is vitally important and required under government legislation, for more information call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

The prevention and control of legionella at an Essex hospital remains a "significant concern", according to a health care watchdog.

The Care Quality Commission (CQC) said Basildon University Hospital had taken several measures to combat the disease, but further improvements were needed.

It said three people had acquired the disease while at the hospital in 2011. The hospital's trust said it was already taking further steps to address the issue and other areas of concern. The report followed a recent inspection on 9 February. It said there had been a history of people catching legionella at the hospital, citing 13 cases since 2002.

"More attention needed"

The most recent cases were in August, September and November 2011. The report said the hospital had made an "investment in measures to control legionella" including the introduction of a silver and copper ionisation disinfection system, to replace its chlorine dioxide one. It added a legionella management group met once a month and the hospital worked with several other agencies regarding the outbreaks.

Despite this, the CQC said it was disappointed there were still cases arising and the trust needed to do more to reduce the risk of re-occurrence.

(Read More) Source: BBC News

The proper control of legionella bacteria is vitally important and required under government legislation, for more information call:

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.

Thorough guidance on decontamination in primary dental care should control any risks from legionella.

That's according to the Department of Health today in light of a case of an elderly woman who died from Legionnaire's disease after she contracted the infection from a dental practice in Italy.

The DH issued a statement, after the case was reported in The Lancet. A government spokesperson said that it 'required practices in England to comply with best practice guidance on controlling the risks from legionella and to carry out a risk assessment'.

Doctors in Italy confirmed that the 83-year-old woman who died from Legionnaire’s disease contracted the infection from a dental practice.The patient had only left home twice within the incubation period of between 2 and 10 days and both trips were to the dentist.

Samples of water were taken from the waterline, the tube that supplies water to dental instruments and analysed. All three samples of the water tested positive for the Legionella pneumophila bacteria and the sample from the water pump was particularly convincing.

This is the first case of diease stemming from a dental waterline, depsite the fact that it is kown that the germ can effect waterlines.

The Department of Health spokesperson said: 'There have never been any cases of Legionnaire’s disease traced to contaminated dental surgery equipment in the UK, but we will continue to keep all evidence under review.

'The Department of Health has thorough guidance on decontamination in primary dental care, requiring practices in England to comply with best practice guidance on controlling the risks from legionella and to carry out a risk assessment.

Further treatment has started at a Guernsey hospital after tests showed a higher level of Legionella than authorities were "prepared to accept".

Following work in January the majority of the hospital's water supply has tested within acceptable levels. But Richard Evans, director of corporate services, said higher bacteria levels in water at the new clinical block meant further treatment. It will involve the water being heated and chemically treated.

Mr Evans said: "This is the only area of the hospital that remains a concern and it is the hot water supply in this area that needs further treatment.

"As before, this work will be done in a way that will minimize the inconvenience to patients and staff and ensure that normal operation of the clinical block continues while the treatment is taking place."

In a statement the Health and Social Services Department said it would be conducting further testing next week to check the levels of bacteria following this latest treatment.

It said no cases of related illness had been identified in patients, visitors or staff, but that staff remained vigilant for signs of infection. The department said the treatment process was a precautionary measure and until it was carried out water in the new clinical block of the PEH remained safe for routine use.

(Read More) Source: BBC News

If you need your water checked/treated it is vitally important that all measures are taken in controlling the risk of Legionella, for more information please call

Vectair Environmental Ltd on 0118 981 7437 or get in touch via our contact page.