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Winnipeg Free Press - PRINT EDITION

Hospital water fountain infects 8 with disease

Sources of calm can pass on ills

By: Helen Branswell

Posted: 01/11/2012 1:00 AM | Comments: 0 (including replies)

Janice Haney Carr / The Canadian Press A colourized micrograph image shows Legionella bacteria. Fountains and hospitals don�t mix, a new study says.

Fountains and water walls can be sources of calm, of negative ions that improve the moods of those around them.

But they can also be fonts of a dangerous bacterial disease, especially in hospitals, public health disease investigators in Wisconsin are reporting.

In a new study, staff of the Wisconsin Division of Public Health detail how eight people contracted legionnaires' disease from tiny bacteria-laced water droplets sprayed from a water feature in the lobby of a hospital.

None of the people were in-patients; three were there for medical appointments, three were picking up prescriptions at the pharmacy, one was a delivery person and one was waiting for a relative who had an appointment.

Yet in as little time as those activities took, the eight were infected with Legionella bacteria, the bug that causes legionnaires.

All needed to be hospitalized, though all eight recovered.

The outbreak happened in March 2010 at Aurora Hospital in Cudahy, Wis., which is just south of Milwaukee. The incident is described in a study that will be published in the February issue of the journal Infection Control and Hospital Epidemiology.

"Fountains and health-care facilities don't mix," lead author Thomas Haupt, a respiratory diseases epidemiologist, said in an interview from Madison, the state capital.

Haupt said there was a previous report of a hospital patient being infected with legionnaires after repeatedly passing in front of a water wall at a National Institutes of Health hospital in the Washington, D.C. region. But this may be the first where the people infected were not even patients of the hospital.

After they became ill, half of the people turned to Aurora Hospital for care while the other four sought care in another facility.

Outbreaks of legionnaires aren't uncommon in hospitals and long-term care facilities, but having the patients come in with the disease and having them admitted to two different hospitals was initially perplexing. Once investigators realized six of the patients remembered spending time in the lobby of Aurora Hospital, however, things started falling into place fast. (Pharmacy records placed the other two there as well.)

Legionella bacteria are ubiquitous, at low levels, in water. Under the right conditions colonies of the bugs can multiply to dangerous levels. Previous outbreaks have been linked to air conditioning units, shower heads and other settings where water is aerosolized.

A fountain in which water gets recycled through a closed system and water temperatures rise to Legionella-friendly levels -- 25 to 42 Celsius -- provides just such a setting.

Water samples taken from various locations in the hospital and from the water wall pinpointed the latter as the source of infection, the study says.

In this case, pieces of foam were the problem. The water feature had a tiled wall down which water flowed; the water collected in a trough filled with decorative rocks at the base of the wall. The rocks rested on a bed of foam-like material. Flood lights located over the feature and in the trough had the effect of heating the water, as did a fireplace that was located on the reverse side of the water wall.

Testing showed the foam was heavily contaminated with Legionella bacteria.

-- The Canadian Press

Republished from the Winnipeg Free Press print edition January 11, 2012 A8

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