Legionella E-news -- 16 August 2000

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Legionella E-news, 16 August 2000
HC Information Resources Inc.
Matthew R. Freije, Editor

**IN THIS ISSUE**
1. State of Maryland issues Legionella recommendations
2. New JCAHO standard indicates Legionella prevention
3. Recently released publications

1. STATE OF MARYLAND ISSUES LEGIONELLA RECOMMENDATIONS return to contents list
The new Maryland Department of Health and Mental Hygiene (DHMH) recommendations (posted at http://www.dhmh.state.md.us/html/legionella.htm ) emphasize "individualized risk management" rather than "imposition of blanket guidelines." Here are highlights:

- All Maryland acute-care hospitals should provide legionella urinary antigen testing and Legionella culture. Hospitals that routinely perform and care for patients with solid organ and/or bone marrow transplants should have the ability to perform legionella culture on site.

- Clinicians should always consider legionella in diagnosis for nosocomial (and community-acquired) pneumonia.

- Cooling towers should be designed and constructed so that tower drift is directed away from the hospital's air intake system and the volume or aerosol drift is minimized. For all operational cooling towers, hospitals should install drift eliminators, use a biocide regularly, maintain towers according to manufacturers recommendations, and keep adequate maintenance records

- Hospitals should assure reporting of cases of Legionnaires' disease to their local health departments, and complete the CDC "Supplemental Case Report" form for legionella cases.

- Plumbing systems within acute care hospitals should be routinely cultured. The periodicity and interpretation of environmental testing should be determined as part of an overall risk assessment process.

- Each hospital should formulate a group of representatives (a "Legionella Team"). The team should develop a written legionellosis control plan encompassing surveillance, environmental culturing, remediation, and reporting.

2. NEW JCAHO STANDARD INDICATES LEGIONELLA PREVENTION return to contents list
The Joint Commission on Accreditation of Healthcare Organizations (Oakbrook Terrace, IL, USA) has updated its standard EC 1.9. The new standard, which goes into effect January 2001, indicates proactive efforts to minimize the risk of Legionella and other bacteria in plumbing systems and cooling towers. EC 1.9 will require a utility systems management program to "reduce the potential for organizational-acquired illness." More specifically, health facilities will be responsible for "managing pathogenic biological agents in cooling towers, domestic hot water, and other aerosolizing water systems." The new standard is posted at http://www.jcaho.org/standard/stds2001_mpfrm.html.

3. RECENTLY RELEASED PUBLICATIONS return to contents list
Below are publications released by HC Information Resources Inc. within the last three months, along with a URL for more information:

Item 310e - How to Reduce Your Risk of Legionnaires' Disease in Public Places - http://hcinfo.com/310info.htm

Item 311e - Spas, Hot Tubs, and Whirlpool Bathtubs: A Guide for Disease Prevention - http://hcinfo.com/311info.htm

Item 312e - Home Plumbing Systems: How to Reduce Your Risk of Legionnaires' Disease and Other Bacterial Infections - http://hcinfo.com/312info.htm

Item 313e - Dental Water Line Contamination - http://hcinfo.com/313info.htm

Item 314e - Home Humidifiers: Reducing Your Exposure to Harmful Bacteria - http://hcinfo.com/314info.htm

Item 315e - Cryptosporidium and Water: A Public Health Handbook - http://hcinfo.com/315info.htm

Item 316e - Cryptosporidium: What You Need to Know to Protect Yourself - http://hcinfo.com/316info.htm

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THANK YOU!

Matt Freije
HC Information Resources Inc.
http://hcinfo.com

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