Several patients have tested positive for the bacteria that causes Legionnaires’ disease, Berkshire Health Systems says | Breaking

PITTSFIELD — Seven patients have tested positive for the bacteria that causes Legionnaires’ disease, Berkshire Health Systems reported on Thursday.

One of the patients later died, although because of their existing comorbidities, it’s not possible to know whether their death was the result of their infection, officials said. Not all seven patients with positive tests were admitted for treatment. 

That has led the hospital to a series of steps to assure the safety of its water supply, including increased chlorination and filtration and providing bottled water for drinking. 

“We don’t know where people got this from but it behooved us to do what we felt was in best interest of all patients, no matter what the number was,” said Dr. James Lederer, the chief medical officer and chief quality officer for Berkshire Health Systems, which operates Berkshire Medical Center. 

Legionella, a naturally occurring bacteria found in fresh water, can cause Legionnaires’ disease — a potentially fatal lung infection. Symptoms can include fever, cough, or shortness of breath. The disease can be treated with commonly available antibiotics.

“[It] hits fairly quickly, and it’s rapid onset and aggressive,” Lederer said. As is the case with COVID, patients with underlying conditions and weakened immune systems are most vulnerable,

In the past four months, the BMC laboratory has reported seven positive patient tests for the bacteria. The last known positive test result was recorded Aug. 22.

In a note being sent to patients and staff, Berkshire Health Systems on Thursday said the hospital has flushed its water system and is “currently deploying a heightened level of precautions.”

The hospital also detected slight increases in the levels of Legionella bacteria in its water, though those levels “remained within acceptable levels, according to our Water Management Plan,” the statement said. The hospital did not say what those levels are, though Lederer said DPH’s target is always zero.

Legionnaires’ disease does not typically spread from person to person. Legionella spreads through tiny droplets of water containing the bacteria that get into the air. The disease often is spread through large-scale, central air conditioning systems.

There is no way to determine for certain how the patients contracted Legionella, but because some patients interacted with Berkshire Medical Center during a 14-day window prior to the onset of symptoms, the CDC defines these cases as possible health care-associated Legionella, the statement said.

The hospital also has notified the Massachusetts Department of Public Health. 

A positive test for Legionella is not the same as a diagnosis of Legionnaires’ disease, Lederer said. “Not all of them are classic pneumonia — either it was very early onset or other reasons.”

However, a number of patients who tested positive were admitted as patients.

It’s impossible to know where the patients were exposed to Legionella, Lederer said. And some of the patients who were admitted had significant underlying medical conditions that weakened their immune systems.

According to Lederer, the hospital regularly provides water samples to a third-party testing vendor “so we can get an ongoing flow of information on those parts of systems we feel most at risk” due to their age or length. The longer a supply pipe runs, the greater the odds water within that pipe can become stagnant, he said.

If a testing center in Massachusetts detects Legionella in a hospital setting, it’s obliged to report that result to DPH, Lederer said. Those test results, along with the reports of patients testing positive, spurred the hospital to take action.

Lederer said BMC is taking its response to the “highest level of mitigation strategy so we can return to what seen before and hope to have — which is zero colony forming units in water samples.”

One of the reasons Legionnaires’ disease is often severe is “it tends affect those most significantly at risk,” Lederer said. Younger patients who don’t have underlying conditions or immunity deficiencies may still contract pneumonia from it, “but the likelihood of doing better is much higher … you’re not the optimal host.”

Among those steps taken by the hospital include: 

• Increasing chlorine levels in the hospital’s water supply to disinfect the system. 

• Increasing the sensitivity of the filters on all patient showers and ice machines to provide an even higher level of filtration for the water.

• Providing bottled water to all patients and staff.

As those tasks are implemented, the hospital will collect water samples and send them out for testing.

The timing for declaring the issue resolved is up to DPH, not the hospital, Lederer said. “They want to see a set of three negative cultures,” he said — meaning three rounds of tests showing no Legionella in the water. 

Pittsfield Mayor Peter Marchetti said he was updated Thursday by Berkshire Health Systems and Department of Public Health officials.

“At the moment [the culprit] does not appear to be the city water system,” Marchetti said. “We will be participating in any conversations with DPH and the hospital going forward.”

The city water department does not test for Legionella, Marchetti said, for one very good reason: The level of chlorine the city uses to treat its drinking water is enough to kill the bacteria.

A message left with DPH was not returned by press time Thursday. 

Legionnaires’ disease information

What is Legionnaires’ disease?

Legionnaires’ disease is a form of pneumonia caused by Legionella bacteria.

What’s Legionella? 

Legionella is a naturally occurring water-borne bacteria found in fresh water environments.  

Where else are Legionella bacteria found?

Many outbreaks of Legionnaires’ disease have been related to contaminated air conditioning cooling towers, but not window air conditioners. It also has been found in hot and cold water taps, showers, whirlpool baths and hot tubs, creeks, ponds and wet soil.

How does Legionnaires’ disease sicken people?

People get Legionnaires’ disease by breathing in the Legionella bacteria, usually carried by mist. Numerous outbreaks have been caused by central air conditioning equipment with stagnant or contaminated water, including the 1976 outbreak at an American Legion convention in Philadelphia that gave the disease its name. 

Can I catch Legionnaires’ disease from someone who has it?

No, it is not passed person to person like a cold or the flu. 

Can I catch Legionnaires’ disease from drinking water containing the bacteria?

No. Infection comes from breathing aerosolized water or mist containing the bacteria. 

What are the symptoms?

Symptoms usually begin two to 10 days after a person is infected with the bacteria. People with Legionnaires’ disease often have flu-like symptoms with muscle aches, headache, loss of appetite and dry cough. Fevers are often between 102 and 105 degrees Fahrenheit. Some patients experience stomach cramps and diarrhea. Chest X-rays usually show pneumonia. 

Is it serious?

Yes. Legionnaires’ is one of the most serious forms of pneumonia. It hits quickly and aggressively and can be fatal. People with compromised immune symptoms and lung diseases such as COPD are at greater risk. 

Can it be treated?  

Legionnaires’ disease can be effectively treated with antibiotics. Catching and treating it early produces the best results. 

Does Legionella cause any other illnesses?

Another illness caused by Legionella bacteria is called Pontiac fever. It consists of fever, headache, weakness and muscle ache, usually lasts for 2-5 days. It does not cause pneumonia.

Source: Massachusetts Department of Public Health