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Source of illness unclear after hospital patient with Legionnaire's Disease dies

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By Thomas J. Morgan

PROVIDENCE, R.I. -- Four of 24 ice machines at Kent Hospital in Warwick were found to be contaminated with the bacteria that cause Legionnaire's Disease in a search prompted in May by the death of a patient who also was "very ill" with other health problems, hospital spokesman James Beardsworth said Wednesday.

Although the unidentified patient's diagnosis was considered to be "hospital-acquired" legionnella, as the disease also is known, the hospital's investigation did not positively link the patent's illness to the ice machines or any other source at Kent Hospital, Beardsworth said.

"We had a patient who was very ill with several health issues and also legionnella," he said. "That person met the definition of hospital-acquired because there is a ten-day incubation period. If a patient stays ten days in the hospital it is considered hospital-acquired. "We try to tell people that legionnella occurs naturally. It's in our homes, our water systems, businesses."

He said statistics from the state Department of Health suggest that 20 to 40 cases are identified each year in Rhode Island. So far this year, he said, the Department of Health has reported 32 cases. "We are still around the mid-level mark," he said.

He said the disease raises alarms when it occurs in patients who have compromised health issues, such as the patient who died.

"We had a few cases that came through our emergency department in late spring that were community-acquired cases," Beardsworth said. "Upon examination and testing they were positive for legionnella." He said the hospital notified the Department of Health promptly when the diagnoses were made.

He said Kent Hospital took measures that went beyond what is required.

"We are considered to be the gold standard in the way we test and monitor for this," Beardsworth said. "When we found out that we had this patient that was labeled as hospital-acquired we went even further. We ruled out the ventilation system -- the most
common source. We know the drinking water supply was negative. One way legionnella can be spread is through water vapor and mist. We flushed all water systems and shower heads. We took steps most hospitals will take only with immuno-supressed patients. We went to the ice machines."

Testing disclosed the presence of the bacteria in tubing within the machines.

"There was some pooling water, and positive cultures were found," he said. "They were cleaned, retrofitted and brought back on line."

But, he added, "We cannot make any definitive link between those ice machines and that patient. We simply know what we know, and sadly we had a patient with hospital-acquired legionnella, but we cannot positively link the two."

He said there have been no other cases at Kent Hospital since the patient's death.


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